The mediators of bile action on the exocrine pancreas.

Under basal conditions, bile and bile salts applied intraduodenally influence plasma levels of several gastroenteropancreatic peptides. Besides those with stimulatory effects on exocrine pancreatic secretion, others with inhibitory or no effects are released as well. Furthermore, cholinergic and peptidergic neural mechanisms may also be activated. Secretin seems to be the most important mediator of bile- or bile salt-induced water and bicarbonate secretion. In addition, VIP released from peptidergic nerve endings in the pancreas may also be involved in the mediation of the hydrokinetic effect. With regard to water and bicarbonate secretion, cholinergic mechanisms probably are of minor importance. Cholinergic mechanisms, however, seem to be the most important mediator of bile- or bile salt-induced pancreatic enzyme secretion. CCK may act as an additional mediator of the ecbolic effect. This statement, however, is based on few results only and has to be confirmed by further studies. Gastroenteropancreatic peptides with an inhibitory action on the exocrine pancreas were also released by intraduodenal bile or bile salts. Somatostatin is released in physiologically relevant amounts to bring about a counter-regulation. Plasma PP levels are also enhanced by bile and bile salts. The amounts of PP released, however, are below those observed postprandially. In contrast to their stimulatory action on basal pancreatic secretion, bile and bile salts have no or even an inhibitory effect on pancreatic secretion stimulated by intraluminal nutrients. Accordingly, the release of gastroenteropancreatic peptides is not influenced (for example, secretin) or even reduced (for example, CCK) when bile or bile salts are added to intraluminal nutrients.(ABSTRACT TRUNCATED AT 250 WORDS)