The Entero-Insular Axis

  • Susan M. Wood
Part of the NATO ASI Series book series (volume 80)


Although circulating glucose is the prime regulator of insulin secretion, it is unlikely that the insulin rise occurring in response to a meal is mediated solely by a change in the glucose concentration bathing the B cell. If this were the case one would expect to observe a large rise in plasma glucose followed by a rise in insulin, such a delay in the insulin response would be unlikely to maintain glucose homeostatis. In practice plasma glucose and insulin rise in parallel, suggesting a mechanism whereby insulin requirements are anticipated by the B cell, resulting in appropriate insulin secretion to hold the postprandial glucose rise within narrow limits. The most logical site for such a regulatory mechanism would seem to be the gut. The first appreciation of gut regulation of the pancreas began as early as 1902 when Bayliss and Starling introduced the concept of ‘chemical regulation’. At that time they showed that the intravenous injection of an extract of intestinal mucosa stimulated pancreatic exocrine secretion in the dog to the same extent as acid placed in the gut; and acid produced the same effect even when all neural connections between gut and pancreas were cut.1 The chemical messenger within these extracts was of course secretin, which was not to be isolated until 1952.2


Insulin Secretion Vasoactive Intestinal Peptide Vagal Stimulation Vasoactive Intestinal Polypeptide Pancreatic Polypeptide 
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Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Susan M. Wood
    • 1
  1. 1.Department of MedicineHammersmith HospitalLondonUK

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