[POSTPRANDIAL ADAPTATION OF PANCREATIC SECRETION. On the 90th anniversary of the outstanding scientist and organizer of science, academician Aleksandr Mikhailovich Ugolev].

AIM OF REVIEW: Statement of modern traditional and original view on essence and mechanisms of postprandial adaptation of pancreatic enzymes secretion is presented. MAIN POINTS: The exosecretion of synthesized de novo and recreted pancreatic enzymes is adapted to nutrient content of the meal by means of duodenal-pancreatic stimulated and inhibition peptidergic mechanisms, generalized and selected-induced enzyme-substrate complexes of duodenal chyme. The managed module secreted-transported pancreatic system is important as a normal criterion in urgent adaptation.

[Types of digestion in breast feeding: returning to the problem].

During the breast feeding the hydrolysis of breast milk nutrients in natural conditions provides by milk enzymes, digestive gland secrets and intestinal epitheliocyte as autolytic induced digestion with following including and development of auto-digestion in hydrolysis of milk lipids and proteins. Milk lactose is hydrolyzed as a type of auto-intestinal digestion. Breast glands release enzymes according to a year lactation dynamics. The mechanism of hydrolase recreation from the mother's blood takes part in milk hudrolase origin.

[DIGESTION IN BREAST FEEDING AS NATURAL TECHNOLOGY].

During the breast feeding the hydrolysis of breast milk nutrients in natural conditions provides by milk enzymes, digestive gland secrets and intestinal epitheliocyte as autolytic induced digestion with following including and development of auto-digestion in hydrolysis of milk lipids and proteins. Milk lactose hydrolyses as a type of auto-intestinal digestion. Breast glands release enzymes according to a year lactation dynamics. The mechanism of hydrolase recreation from the mother's blood takes part in milk hydrolase origin.

[The problem of autolytic digestion at amniotropic and lactotropic feeding].

The review presented the results of the author, his co-workers and investigators of other laboratories about types of feeding (histotropic, hemotropic, amniotropic, lactotropic, definitive) and digestion (autolytic, native) of a fetus and an infant. The study was based on analysis of enzymes that provided hydrolysis of amniotic fluid and breast milk. The data about probable technology of abovementioned types of digestion in earlier stages of individual human advance and opportunity of hydrolase recretor origin in amniotic fluid and breast milk are shown.

[The transport component of the secretory activity of pancreas].

The transport processes take place on the all stages of pancreatic secretion. The article highlighted the multi-parametric regulated exosecret transport through the duct system of the pancreas. The system has valves and micro-reservoirs of secret. A disturbance of their motor coordination leads to the main cause of acute pancreatitis.

[Proteolysis in digestive system regulation].

Signal enzymes with direct and indirect hormone releasing action are formed by means of proteolysis from exogenic and endogenic proteins. The proteolysis is the basis of hormone processing. The limited proteolysis forms hormones from pro-hormones, ligand proteolysis excludes or reduces their stimulated or inhibited effects. The existence of polipotent proteinaso-activated receptors with regulative and modulated role in norm and pathology was proved.

[Formation of blood hydrolytic activity and exo-secrets of the digestive glands].

The results of own study and literature review about digestive glands enzymes transport into the bloodstream, simultaneous controlling exosecretion of two enzyme pools - poliglandular, recreting from blood, and new synthesized, gematoglandular recirculation of hydrolytic enzymes are presented.

[Evacuation activity of gastroduodenal complex as a digestive process].

Literature data and the results of own examinations of speed and differentiation of stomach evacuation of test breakfasts consisted of different nutrients were presented. The relation of evacuation speed, antegrade and retrograde gastro-duodenal passage to digestive fermentative potential of gastro-duodenal complex was shown. It was concluded about the possibility of it's system characterizing by the ultrasonographical examination of speed and character of test breakfast's evacuation from the stomach.

[Exo- and endosecretive digestive glands of enzymes as modulators of secretion].

Enzymes, exosecreted by the digestive glands plays not only a role of the hydrolases, but also an informational and modulating role in the urgent adaptation of the enzyme secretion to the structure and properties of the luminal content of the gastrointestinal tract. Endosecreted enzymes in the blood not only inform about enzymatic condition of the hydrolase-producing glands and duct system, but also plays an informational and modulating role by the inhibition of the secretion of the same enzymes, and by the stimulation of the secretion of the heteronymic enzyme, defines a parity of their secretion and recretion, integrates enzyme secretion of the pancreas and gastric glands.

[Using of adaptive biocontrolling feedbak in the treatment of irritable bowel syndrome].

In original research are compared results of treatment of irritable bowel syndrome (IBS) by standard technique and treatment with to additional application of the control of a biofeedback. The analysis was carried out on dynamics of clinical symptoms in 1 and 6 months after course of treatment. Research showed improvement of results of treatment IBS in the group with additional treatment of a biofeedback.

[Regulation of pancreatic exosecretion].

The review contains the materials on scientific literature, research results of the author and his colleagues about organization of pancreatic exosecretion activity. Peptidegric regulatory mechanisms and pancreatic exosecretion of the hydrolytic enzymes, their participation in adaptation of the pancreatic enzymatic discharge to the nutrient composition of duodenal chyme are underlined.

[The duodenal wall injury as a cause of acute pancreatitis].

Dynamics of cholecystokinin-like, secretin and somatostatin immunoreactivity of blood plasma and extracts of duodenal mucosa, frequency of acute pancreatitis (AP) after the resection of the duodenum was studied on not purebred dogs. Rising of a secretin concentration in blood plasma after the clinoid resection of the duodenum, accompanied by decreasing of its concentration in duodenal mucosa, was revealed. Decreasing of cholecystokinin concentration in a neutral extract was revealed. In 24 hours alter resection of the duodenum AP was observed in 38% of cases, infusion of the lorglumide was reduced the frequency of this complication up to 6.2% (p<0.05).

[Salivation in healthy volunteers and patients with complicated duodenal ulcer depending on Helicobacter pylori contamination of the stomach mucous coat].

Such salivation parameters as saliva volume, total protein saliva concentration and amylolytic enzyme activity as well as their discharge levels were compared to the level of H. pylori contamination of the stomach mucous coat in clinically healthy people (30 people) and patients with complicated duodenum ulcer (142 patients) within various terms after the duodenoplasty eradication and within long-term periods after the selective proximal vagotomy (50 patients). The amylolytic enzyme activity and ptyalin discharge was higher in clinically healthy but HP-contaminated subjects than HP-negative people. A direct relationship that was expressed by the salivation volume and ptyalin discharge best of all with the level of the stomach mucous coat contamination in healthy volunteers and patients with duodenal ulcer was established.

[The regulatory contours of correction of the pancreatic secretion].

It is offered to allocate three basic contours of regulation and self-regulation of pancreatic secretion: duodeno-pancreatoglandulary, hemato-pancreatoglandulary and ductulo-pancreatoglandulary, at which participation the correction of enzymatic structure of a secret of pancreas concerning permanent properties of duodenal chyme and variation of enzymatic spectrum of a secret in the postprandial period of secretion is carried out. In all three contours in quality of the regulatory factor acts actually a pancreatic secret and its components, and also condition of ductal hydrokinetics of a pancreatic secret. Is established, that the pancreatic secretion is provided with the large number of the functionally nonequipotential secretory-transport modules having certain determinants of their morpho-functional organization.

[Differential evacuation activity of the human gastroduodenal complex]. / Differentsirovannost' évakuatornoi deiatel'nosti gastroduodenal'nogo kompleksa cheloveka.

In clinical healthy volunteers (20) the rapid of gastric evacuation of three types of test meals: the gruel with egg protein or butter are investigated by sonography. There are investigated (117): the half-time of evacuation, the area of a diameter of the antrum in the systole and diastole, the amplitude of the contraction and the frequency of it. In healthy volunteers the differentiative evacuation of the three types of the test meals are established. The reception of pancreatin (KREON 10,000) with the test meals are increasing the speed of it evacuation, but without changing the differentiative of gastric evacuation.

[Morphofunctional organization of pancreatic secretory activity (a new paradigm)]. / Morfofunktsional'naia organizatsiia sekretornoi deiatel'nosti pozheludochnoi zhelezy (novaia paradigma).

This is a review of physiological, morphological and clinical studies of pancreas secretion with the emphasis placed on pancreatic enzymes. It was established that different parts of the duodenal mucous coat have different chemosensory thresholds to the stimulators and inhibitors of pancreatic secretion. Secretory regions of the pancreas having a modular organization are also functionally different. The module is a set of pancreatic acinar and ductal cells (a secretory component), a system of ducts with their valve structures and a microdepository of secretion (a transport component) with control mechanisms specific for the module. Pancreatic secretion is a result of stimulation and inhibition of specialized secretory and transport modules.

[Pancreatic exocrine secretion in experimental acute postoperative pancreatitis]. / Vneshniaia sekretsiia podzheludochnoi zhelezy pri éksperimental'nom ostrom posleoperatsionnom pankreatite.

Transformations of parameters of pancreatic exocrine secretion after the direct operations on the pancreas of a dog were studied during the experiment. It was determined that the early post-operative period proceeds in the conditions of the expressed pancreatic hypersecretion, hyperenzymemia and ductal hypertension. Their intensity reduces as the destructive process in pancreas develops. This results in changes of pancreatic exosecretion in two phases: the increasing and decreasing hypersecretion. The role of augmentation of the secretory activity of pancreas in pathogenesis of the acute postoperative pancreatitis is discussed. Its development was observed in all operated animals. This enabled us to resolve all contradictions and to prove the expediency of the application of pancreas secretion inhibitors at the prevention of acute post-operative pancreatitis.

[Recretion of enzymes and hormones by exocrine glands]. / Rekretsiia fermrntov i gormonov ékzokrinnymi zhelezami.

The article reviews a poorly explored issue of secretive physiology-recretion from blood by glandulocites of various endocrinal glands of hydrolytic ferments and hormones that have been synthesized by digestive and endocrinal glands. The article discusses potential physiological role of the recretion function and the diagnostic significance of information obtained from analysis of recreted ferments and hormones in exosecretions.