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Brunner's glands | |
---|---|
Details | |
System | Digestive system |
Location | Duodenum |
Identifiers | |
Latin | glandulae duodenales |
MeSH | D002011 |
TA98 | A05.6.02.017 |
TA2 | 2957 |
FMA | 71622 |
Anatomical terms of microanatomy |
Brunner's glands (or duodenal glands) are compound tubuloalveolar submucosal glands found in that portion of the duodenum proximal to the hepatopancreatic sphincter (i.e sphincter of Oddi).[ citation needed ]
For decades, it was believed that the main function of the glands is to secrete alkaline (bicarbonate-containing) mucus in order to:[ citation needed ]
However, more recent studies have demonstrated that Brunner’s glands actually act as major modulators of the gut microbiome and systemic immunity.
They are the distinguishing feature of the duodenum, and are named for the Swiss physician who first described them, Johann Conrad Brunner.[ citation needed ]
Duodenal glands are situated within the mucosa and submucosa of the duodenum. They are most abundant near the pylorus, growing shorter and more sparse distally towards the terminal portion of the duodenum. [1]
The duodenum can be distinguished from the jejunum and ileum by the presence of Brunner's glands in the submucosa.[ citation needed ]
Their excretory cannals are tortuous, opening at the bases of the villi. [1]
Two forms of duodenal glands are distinguished: the external group (which are more voluminous and extend into the duodenal submucosa), and the internal group (which are smaller and are situated within the duodenal mucosa). [1]
They also secrete epidermal growth factor, which inhibits parietal and chief cells of the stomach from secreting acid and their digestive enzymes. [2] [ citation needed ] This is another form of protection for the duodenum.[ citation needed ]
The Brunner glands, which empty into the intestinal glands, secrete an alkaline fluid composed of mucin, which exerts a physiologic anti-acid function by coating the duodenal epithelium, therefore protecting it from the acid chyme of the stomach. Furthermore, in response to the presence of acid in the duodenum, these glands secrete pepsinogen and urogastrone, which inhibit gastric acid secretion.[ citation needed ]
More recent studies have demonstrated that Brunner’s glands are major modulators of the gut microbiome and systemic immunity. Studies conducted by Ivan De Araujo’s laboratory revealed that Brunner’s gland secretions promote the proliferation of probiotics and protect the host against foreign pathogens. [3]
Hyperplasia of Brunner glands with a lesion greater than 1 cm was initially described as a Brunner gland adenoma. Several features of these lesions favor their designation as hamartomas, including the lack of encapsulation; the mixture of acini, smooth muscles, adipose tissue, Paneth cells, and mucosal glands; and the lack of any cell atypia. These hamartomas are rare, with approximately 150 cases described in the literature. It is estimated that they represent approximately 5–10% of benign duodenal tumors. They are variable in size, typically 1–3 cm, with only a few reported cases of lesions larger than 5 cm.[ citation needed ]
Most patients with Brunner gland hamartomas are asymptomatic or have nonspecific complaints such as nausea, bloating, or vague abdominal pain.[ citation needed ]
Most reports in the literature describe local surgical resection of Brunner gland hamartoma via duodenotomy. Increasingly, successful endoscopic resection has been reported and is primarily used for pedunculated Brunner gland hamartomas. The endoscopic approach in selective cases appears to be safe, less invasive, and less costly.[ citation needed ]
Consistent with the more recent idea that Brunner’s glands influence systemic immunity via the microbiome, patients who had the duodenal bulb removed (where the glands are mostly located) showed greater alterations in immune factors compared to patients having more distal parts of the duodenum removed. [3]
The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e., it has both an endocrine and a digestive exocrine function. 99% of the pancreas is exocrine and 1% is endocrine. As an endocrine gland, it functions mostly to regulate blood sugar levels, secreting the hormones insulin, glucagon, somatostatin and pancreatic polypeptide. As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach; and digestive enzymes, which break down carbohydrates, proteins and fats in food entering the duodenum from the stomach.
The stomach is a muscular, hollow organ in the upper gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach is involved in the gastric phase of digestion, following the cephalic phase in which the sight and smell of food and the act of chewing are stimuli. In the stomach a chemical breakdown of food takes place by means of secreted digestive enzymes and gastric acid.
The gastrointestinal tract is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as faeces. Gastrointestinal is an adjective meaning of or pertaining to the stomach and intestines.
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In mammals, it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest part of the small intestine.
The ileum is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may be used instead of ileum. Its main function is to absorb vitamin B12, bile salts, and whatever products of digestion that were not absorbed by the jejunum.
The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pancreatic duct to aid in digestion. The small intestine is about 5.5 metres long and folds many times to fit in the abdomen. Although it is longer than the large intestine, it is called the small intestine because it is narrower in diameter.
Digestion is the breakdown of large insoluble food compounds into small water-soluble components so that they can be absorbed into the blood plasma. In certain organisms, these smaller substances are absorbed through the small intestine into the blood stream. Digestion is a form of catabolism that is often divided into two processes based on how food is broken down: mechanical and chemical digestion. The term mechanical digestion refers to the physical breakdown of large pieces of food into smaller pieces which can subsequently be accessed by digestive enzymes. Mechanical digestion takes place in the mouth through mastication and in the small intestine through segmentation contractions. In chemical digestion, enzymes break down food into the small compounds that the body can use.
Chyme or chymus is the semi-fluid mass of partly digested food that is expelled by the stomach, through the pyloric valve, into the duodenum.
The pylorus connects the stomach to the duodenum. The pylorus is considered as having two parts, the pyloric antrum and the pyloric canal. The pyloric canal ends as the pyloric orifice, which marks the junction between the stomach and the duodenum. The orifice is surrounded by a sphincter, a band of muscle, called the pyloric sphincter. The word pylorus comes from Greek πυλωρός, via Latin. The word pylorus in Greek means "gatekeeper", related to "gate" and is thus linguistically related to the word "pylon".
Gastric acid or stomach acid is the acidic component – hydrochloric acid of gastric juice, produced by parietal cells in the gastric glands of the stomach lining. With a pH of between one and three, gastric acid plays a key role in the digestion of proteins by activating digestive enzymes, which together break down the long chains of amino acids of proteins. Gastric acid is regulated in feedback systems to increase production when needed, such as after a meal. Other cells in the stomach produce bicarbonate, a base, to buffer the fluid, ensuring a regulated pH. These cells also produce mucus – a viscous barrier to prevent gastric acid from damaging the stomach. The pancreas further produces large amounts of bicarbonate and secretes bicarbonate through the pancreatic duct to the duodenum to neutralize gastric acid passing into the digestive tract.
Digestive enzymes take part in the chemical process of digestion, which follows the mechanical process of digestion. Food consists of macromolecules of proteins, carbohydrates, and fats that need to be broken down chemically by digestive enzymes in the mouth, stomach, pancreas, and duodenum, before being able to be absorbed into the bloodstream. Initial breakdown is achieved by chewing (mastication) and the use of digestive enzymes of saliva. Once in the stomach further mechanical churning takes place mixing the food with secreted gastric acid. Digestive gastric enzymes take part in some of the chemical process needed for absorption. Most of the enzymatic activity, and hence absorption takes place in the duodenum.
Gut-associated lymphoid tissue (GALT) is a component of the mucosa-associated lymphoid tissue (MALT) which works in the immune system to protect the body from invasion in the gut.
In histology, an intestinal gland is a gland found in between villi in the intestinal epithelial lining of the small intestine and large intestine. The glands and intestinal villi are covered by epithelium, which contains multiple types of cells: enterocytes, goblet cells, enteroendocrine cells, cup cells, myofibroblast, tuft cells, and at the base of the gland, Paneth cells and stem cells.
Gastric glands are glands in the lining of the stomach that play an essential role in the process of digestion. Their secretions make up the digestive gastric juice. The gastric glands open into gastric pits in the mucosa. The gastric mucosa is covered in surface mucous cells that produce the mucus necessary to protect the stomach's epithelial lining from gastric acid secreted by parietal cells in the glands, and from pepsin, a secreted digestive enzyme. Surface mucous cells follow the indentations and partly line the gastric pits. Other mucus secreting cells are found in the necks of the glands. These are mucous neck cells that produce a different kind of mucus.
The submucosa is a thin layer of tissue in various organs of the gastrointestinal, respiratory, and genitourinary tracts. It is the layer of dense irregular connective tissue that supports the mucosa and joins it to the muscular layer, the bulk of overlying smooth muscle.
Enteroendocrine cells are specialized cells of the gastrointestinal tract and pancreas with endocrine function. They produce gastrointestinal hormones or peptides in response to various stimuli and release them into the bloodstream for systemic effect, diffuse them as local messengers, or transmit them to the enteric nervous system to activate nervous responses. Enteroendocrine cells of the intestine are the most numerous endocrine cells of the body. They constitute an enteric endocrine system as a subset of the endocrine system just as the enteric nervous system is a subset of the nervous system. In a sense they are known to act as chemoreceptors, initiating digestive actions and detecting harmful substances and initiating protective responses. Enteroendocrine cells are located in the stomach, in the intestine and in the pancreas. Microbiota play key roles in the intestinal immune and metabolic responses in these enteroendocrine cells via their fermentation product, acetate.
Foveolar cells or surface mucous cells are mucus-producing cells which cover the inside of the stomach, protecting it from the corrosive nature of gastric acid. These cells line the gastric mucosa and the gastric pits. Mucous neck cells are found in the necks of the gastric glands. The mucus-secreting cells of the stomach can be distinguished histologically from the intestinal goblet cells, another type of mucus-secreting cell.
The nervous system, and endocrine system collaborate in the digestive system to control gastric secretions, and motility associated with the movement of food throughout the gastrointestinal tract, including peristalsis, and segmentation contractions.
The gastrointestinal wall of the gastrointestinal tract is made up of four layers of specialised tissue. From the inner cavity of the gut outwards, these are the mucosa, the submucosa, the muscular layer and the serosa or adventitia.
The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion. Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. The process of digestion has three stages: the cephalic phase, the gastric phase, and the intestinal phase.
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