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Hormonale und metabolische Funktionen des Dünndarms

Hormonal and metabolic functions of the small intestine

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Zusammenfassung

Der Dünndarm besitzt zahlreiche hormonale und metabolische Funktionen, für die neben den Enterozyten enteroendokrine Zellen in der Mukosa verantwortlich sind. So führt eine Freisetzung von Cholezystokinin zu einer Sekretion von Pankreasenzymen und einer Gallenblasenkontraktion. Kürzlich wurde eine hormonelle Regulierung der Gallenblasenfüllung durch das Hormon FGF-15/19 beschrieben, das vermittelt durch Gallensalze aus Enterozyten des terminalen Ileums sezerniert wird und daneben eine Verminderung der Gallensäure- und Fettsäuresynthese sowie eine Hemmung der Glukoneogenese bewirkt. Mit Ghrelin ist ein intestinales Hormon bekannt, das die Nahrungsaufnahme steigert. Dem stehen eine Reihe von Sättigungshormonen wie z.  B. Cholezystokinin und Glucagon-like Peptide gegenüber, durch deren Wirkung die Nahrungsaufnahme gehemmt wird. Die Kenntnis dieser Hormone und ihrer Funktionen ist für das Verständnis der Stoffwechselkontrolle und der Pathophysiologie zahlreicher Erkrankungen wesentlich. Hieraus ergeben sich pharmakologische Ansätze z. B. zur Behandlung von Motilitätsstörungen, des Diabetes mellitus Typ 2, der nicht-alkoholischen Fettlebererkrankung und der Adipositas.

Abstract

The small intestine exhibits numerous hormonal and metabolic functions. These are mediated by enteroendocrine cells that are expressed in addition to enterocytes in the mucosa of the small intestine. The release of cholecystokinin causes the secretion of pancreatic enzymes and a contraction of the gallbladder. Recently, a hormonal regulation of gallbladder filling was confirmed. This is mediated by the hormone FGF15/19 which is secreted by enterocytes of the terminal ileum following induction of its expression by bile acids. In addition, FGF15/19 reduces synthesis of bile acids and fatty acids and inhibits gluconeogenesis. Ghrelin is the only intestinal hormone that increases food intake. Contrary, a number of hormones such as cholecystokinin and glucagon-like peptide are expressed in the small intestine and mediate satiation. Knowledge of the intestinal hormones and their functions is important for the full understanding of metabolic control and provides targets for innovative therapy of several diseases such as diabetes type 2, non-alcoholic steatohepatitis and obesity.

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Abbreviations

cAMP:

Zyklisches Adenosinmonophosphat

CCK:

Cholezystokinin

CYP7A1:

Cholesterin-7α-Hydroxylase

DPP-IV:

Dipeptidylpeptidase IV

FXR:

Farnesol-X-Rezeptor

FGF:

Fibroblast Growth Factor

FGFR:

Fibroblast Growth Factor Receptor

FOXO-1:

Forkhead Transcription Factor 1

GLP:

Glucagon-like Peptide

IgA:

Immunglobulin A

mRNA:

Messenger-Ribonukleinsäure

NPY:

Neuropeptide Y

PYY:

Peptide Tyrosine Tyrosine

SHP-1:

Small Heterodimer Partner 1

VIP:

Vasoaktives intestinales Peptid

ZNS:

Zentrales Nervensystem

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  1. Department für Innere Medizin, Neurologie und Dermatologie, Klinik und Polklinik für Gastroenterologie und Rheumatologie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103, Leipzig, Deutschland

    H. Wittenburg, U. Tennert & J. Mössner

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  1. H. Wittenburg
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  2. U. Tennert
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  3. J. Mössner
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Correspondence to H. Wittenburg.

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Wittenburg, H., Tennert, U. & Mössner, J. Hormonale und metabolische Funktionen des Dünndarms. Internist 51, 695–701 (2010). https://doi.org/10.1007/s00108-009-2564-y

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