Conclusions

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The pancreas contains both exocrine and endocrine tissues, which possess vascular systems that are autonomous of one another. Furthermore, it seems as if changes in the blood perfusion are of importance for the pathogenesis of several pancreatic disorders.

Glossary

Diabetes mellitus: A group of diseases characterized by high blood glucose concentration and lack of insulin.

Endocrine pancreas: Consists of 1 to 2 million groups of cells, each consisting of approximately 3,000 cells, scattered throughout the pancreas. These cells produce, for example, the blood glucose lowering hormone insulin.

Exocrine pancreas: Produces enzymes released into the intestines, which help to degrade food.

Pancreatitis: An inflammation of the pancreas. The acute forms can be severe and life-threatening, and the chronic forms can be associated with intractable pain. The background of these conditions is still insufficiently known.

References

1. Lifson and Lassa (1981). Microvasc. Res. 22, 171-176.

2. Henderson and Moss (1985). Q. J. Exp. Physiol. 70, 347-356.

3. Kvietys et al. (1983). Am. J. Physiol. 245, G519-G524.

4. Brunicardi, F. C., Stagner, J., Bonner-Weir, S., Wayland, H., Kleinman, R., Livingston, E., Guth, P., Menger, M., McCuskey, R., Intaglietta, M., Charles, A., Ashley, S., Cheung, A., Ipp, E., Gilman, S., Howard, T., and Passaro, E., Jr. (1996). Microcirculation of the pancreatic islets. Diabetes 45, 385-392. Excellent and complete review on the microcirculation on pancreatic islets.

5. O'Morchoe, C. C. (1997). Lymphatic system of the pancreas. Microsc. Res. Tech. 37, 456-477. Summarizes the scanty knowledge that exists on pancreatic lymphatics.

6. Kvietys, P. R., McLendon, J. M., Bulkley, G. B., Perry, M. A., and Granger, D. N. (1982). Pancreatic circulation: Intrinsic regulation. Am. J. Physiol. 242, G596-G602. Seminal paper on exocrine pancreatic blood flow regulation.

8. Jansson, L. (1994). The regulation of pancreatic islet blood flow. Diab. Metab. Rev. 10, 407-16. Summarizes the mechanisms responsible for islet blood flow regulation.

10. Chilvers and Thomas (1986). J. Anat. 136, 339-347.

11. Jansson, L., and Carlsson P.-O. (2002). Graft vascular function after transplantation of pancreatic islets. Diabetologia 45, 749-763. Presents a theory on vascular dysfunction in grafted islets, which may help to explain why so many transplanted islets are needed to cure diabetic patients.

12. Uhlmann, D., Ludwig, S., Geissler, F., Tannapfel, A., Hauss, J., and Witzigmann, H. (2001). Importance of microcirculatory disturbances in the pathogenesis of pancreatitis. Zentralbl. Chir. 126, 873-878. A

summary on vascular derangements in both acute and chronic pancreatitis.

13. Prox et al. (2003). World J. Surg. 27, 405-411.

Further Reading

Bonner-Weir, S. (1986). The microvasculature of the pancreas, with special emphasis on that of the islets of Langerhans. In The Pancreas: Biology, Pathobiology, and Disease (V. L. W. Go, E. P. DiMagno, J. D. Gardner, E. Lebenthal, H. A. Reber, and G. A. Scheele, eds.), 2nd ed., pp. 759-768. New York: Raven Press. Provides an excellent overview on the morphology of the microvasculature, especially in the islets. All relevant older references can be found in this article. Menger, M. D., Pluszyk, T., and Vollmar, B. (2001). Microcirculatory derangements in acute pancreatitis. J. Hepatobil. Pancreat. Surg. 8, 187-194. Excellent and succinct review on the theories of circulatory causes for acute pancreatitis. Wayland, H. (1997). Microcirculation in pancreatic function. Microsc. Res. Tech. 37, 418-433. A summary on microcirculation in both the endocrine and exocrine pancreas.

Capsule Biography

All authors are from the Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.

Leif Jansson is Professor of Medical Cell Biology and Circulation Physiology. His main research interests have been the regulation of pancreatic islet blood flow in endogenous and transplanted pancreatic islets.

Arne Andersson is Professor of Diabetes Research. His research interests include the regulation of pancreatic islet growth and transplantation of insulin-producing cells.

The research interests of Orjan Kallskog, Professor of Medical Physiology and Medical Physics, include microcirculation in kidneys and pancreas.

Per-Ola Carlsson is Associate Professor of Medical Cell Biology. His research interests include the microcirculation in endogenous and transplanted pancreatic islets.

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