臨牀消化器内科 Vol.14 No.6(5-4)


特集名 消化器疾患とNO
題名 消化器疾患とNO (4) NOと膵,膵疾患
発刊年月 1999年 06月
著者 小泉 勝 東北大学医学部第三内科
【 要旨 】 構成型NO合成酵素(cNOS)は膵ラ島のAとD細胞に,また膵外分泌部の血管内皮,神経線維,神経節に存在する.血管作動性腸管ポリペプチド(VIP)やコレシストキニン(CCK),食事などの刺激による膵酵素分泌にNOは部分的に関与する.遊離膵腺房ではNOは直接作用せず,おもに血管拡張による血流増加を介して膵外分泌を亢進する.cNOSによるNOは浮腫性膵炎を軽減させ防御的に働く.すべてのNOSを阻害するとセルレイン膵炎は悪化する.重症急性膵炎ではiNOSによる膵組織中のNOxが上昇し,NO産生を抑制すると生存率が改善した.NOはインスリン分泌を抑制した.インスリン依存性糖尿病(IDDM)ではサイトカインがiNOSを誘導し,過剰のNOが膵B細胞を障害し壊死とアポトーシスに陥る.
Theme Gastrointestinal Diseases and NO
Title Nitric Oxide and Pancreas
Author Masaru Koizumi Third Department of Internal Medicine, Tohoku University School of Medicine
[ Summary ] Nitric oxide synthase (NOS)-immunoreactivity and/or NADPH-diaphorese-immunoreactivity were localized in nerve fibers, nerve cell bodies and the vascular endothelium in the exocrine pancreas, and in alpha cells and delta cells in the endocrine pancreas. But they were not detectable in exocrine cells and beta cells in the pancreas. NO failed to affect basal and secretagogue stimulated amylase release in the dispersed acini. NO playsa permissive role in spontaneous and CCK- or VIP- and meal-stimulated pancreatic secretion, perhaps via the maintenance and increase of adequate blood flow. In cerulein-induced pancreatitis, NO produced from CNOS might attenuate pancreatic injury. Inhibition of nuclear factor-kappa B activation caused suppression of iNOS and improved the survival of rats with severe necrotizing pancreatitis which, showed an increase in serum NOx. Endogenous NO inhibited glucose-induction and insulin secretion. Production of NO, resulting from the expression of the cytokine-inducible isoforms of NOS is thought to be important in initiating or maintaining apoptosis and necrosis of beta cells associated with autoimmune diabetes.
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