Pancreatic enzyme supplements to suppress pancreatic exocrine secretion relieve pain in some patients.
췌장 효소 공급이 복통을 감소시키는 기전
Pancreatic exocrine secretion을 자극하는 CCK은 CCK-releasing factors에 의해 조절됩니다.
CCK-releasing factors는 pancreatic digestive enzymes에 의해 분해되므로 췌장 효소가 부족하면 CCK-releasing factors에 의한 CCK 자극, pancreatic exocrine secretion이 증가하여 복통이 유발됩니다. 췌장 효소를 공급해 주면 CCK-releasing factors가 분해되고 CCK 자극, pancreatic exocrine secretion이 감소하여 복통이 감소합니다.
Rationale for this therapy is based upon suppression of feedback loops in the duodenum that regulate the release of cholecystokinin (CCK), the hormone that stimulates digestive enzyme secretion from the exocrine pancreas. CCK-release from the duodenum is regulated by CCK-releasing factors, and these factors are destroyed by pancreatic digestive enzymes. Reduction of intraduodenal free enzyme activity by increasing undigested proteins, protease inhibitors, or inadequate pancreatic enzyme secretion in pancreatic diseases allows the CCK releasing factors to survive protease digestion, stimulate CCK release, and stimulate the pancreas. As a result, increasing intraduodenal enzyme activity may reduce stimulation-associated pancreatic pain.
REF. UpToDate 2019.07.07
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