Sistema Digestório: Integração Básico-Clínica

Fisiologia das Secreções Salivares e Gastrintestinais

Lima, Vilma; Melo, Iracema Matos; Araújo, Vilana Maria Adriano; Diniz Filho, Jairo;

Resumo:

A função do sistema digestório consiste em prover nutrientes para o corpo enquanto o alimento transita pelo tubo digestivo desde a boca, seguindo pelo esôfago, o estômago e os intestinos, antes de ser esvaziado. O trato gastrointestinal realiza a digestão dos alimentos, porém não digere a si mesmo. Abriga grande quantidade de bactérias, mais que o próprio número de células do corpo humano, sendo que o ácido clorídrico gástrico, bem como o muco, previnem a multiplicação anormal da microbiota e acúmulo de seus produtos, prevenindo danos aos órgãos. Os mecanismos por trás dessas habilidades variam, mas uma das principais razões refere-se às suas secreções glandulares (Johansson et al., 2013).Assim, as glândulas secretoras desempenham duas funções primárias: a secretora, com a produção de enzimas e muco, e a função de proteção do tubo digestivo. As secreções das glândulas do trato gastrintestinal e órgãos associados ocorrem em resposta aos alimentos que trafegam ao longo do tubo digestivo, tornando-os, portanto, passíveis de serem absorvidos. Desse modo, para cada tipo de secreção é importante compreender sua composição e sua função no organismo, além de sua formação e seu controle (Fry, 2009).

0:

Download (PDF)

Palavras-chave:

DOI: 10.5151/9788580391893-19

Referências bibliográficas
  • ANDRETTA, M.; TREGNAGHI, A.; PROSENIKLIEV, V.; STAFFIERI, A. Current opinions in sialolithiasis diagnosis and treatment.Acta Otorhinolaryngol Ital. 25: 145-149, 2005.
    ARRESE, M.; TRAUNER, M. Molecular aspects of bile formation and cholestasis. Trends Mol. Med. 9: 558-564.
    BANKS, M. R.; FARTHING, M. J. Fluid and electrolyte transport in the small intestine. Curr. Opin. Gastroenterol. 18(2): 176-181, 2002.
    BERTOLOTTI, M.; GABBI, C.; ANZIVINO, C.; CRESTANI, M.; MITRO, N.; ET AL. Age-related changes in bile acid synthesis and hepatic nuclear receptor expression. Eur. J. Clin. Invest. 37: 501-508, 2007.
    BRITES, D.; TIRIBELLI, C. Metabolismo das bilirrubinas. Mecanismos celulares da secreção biliar. Patogenia da icterícia e da colestase. In: GAYOTTO, L. C.; AVANCINI, V. (eds.). Doenças do Fígado e das Vias Biliares. São Paulo: Atheneu, 2001.
    BUTCHER, G. P. Jaundice and Liver Disease. In: Gastroenterology. Churchill Livingstone, 2003.
    CATALÁN, M. A.; NAKAMOTO, T.; MELVIN, J. E. The salivary gland fl uid secretion mechanism.The Journal of Medical Investigation. 56: 192-196, 2009.
    CHANDRA, R.; LIDDLE, R. A. Neural and hormonal regulation of pancreatic secretion. Curr. Opin. Gastroenterol. 25(5): 441-446, 2009.
    CHANDRA, R.; LIDDLE, R. A. Recent advances in the regulation of pancreatic secretion. Curr. Opin. Gastroenterol. 30(5): 490-494, 2014.
    CHIANG, J. Y. L. Bile acids: regulation of synthesis. J. Lipid. Res. 50(10): 1955– 1966, 2009.
    CHOI, S. Y.; LI, J.; JO, S. H.; LEE, S. J.; OH, S. B.; KIM J. S.; LEE, J. H.; PARK, K. Desipramine inhibits Na+/H+ exchanger in human submandibular cells. J. Dent. Res. 85(9): 839-843, 2006.
    CHOI, E.; ROLAND, J. T.; BARLOW, B. J.; O’NEAL, R.; RICH, A. E.; NAM, K. T.; SHI, C.; GOLDENRING, J. R. Cell lineage distribution atlas of the human stomach reveals heterogeneous gland populations in the gastric antrus. Gut. 63(11): 1711-1720, 2014.
    CHOWDHURY-R, N.; LU, Y.; CHOWDHURY-R, J. Functions of the liver. In: RODÉS, J.; BENHAMOU, J. P.; BIEL, A.; REICHEN, J.; RIZZETTO, M. Textbook of hepatology. Principles from Basic Science to Clinical Practice. Blackwell Publishing, 2007.
    CHU, S.; SCUBERT, M. L. Gastric secretion. Curr. Opin. Gastroenterol. 28(6): 587-593, 2012.
    CIANCIO, S. G. Medication´s impact on oral health. J. Am. Dent. Assoc. 135(10): 1440-1448, 2004.
    CLOUSE, R. E.; DIAMANT, N. E. Motor Function of the Esophagus. In: Physiology of the Gastrointestinal Tract. Elsevier, 2006.
    CORREA, P. R. A. V.; NATHANSON M. H. Functions of the liver. In: RODÉS J; BENHAMOU J-P; BIEL A; REICHEN J; RIZZETTO M. Textbook of hepatology. Principles from Basic Science to Clinical Practice. Blackwell Publishing, 2007.
    COSTA PINHO, A.; PINTO-DE-SOUSA, J.; BAPTISTA, M. ET AL. Brunner´s gland hyperplasia: na usual cause of hemorragic shock. J. Surg. Case Rep. 2011: 1-2, 2011.
    CROOG, S. H.; ELIAS, M. F.; COLTON, T.; BAUME, R. M.; LEIBLUM, S. R. Effects of Antihypertensive Medications on Quality of Life in Elderly Hypertensive Women. American Journal of Hypertension. 7(4): 329-339, 1994.
    DODDSA, M. W. J.; JOHNSONB, D. A.; CHIH-KO, Y. Health benefi ts of saliva: a review. Journal of Dentistry. 33: 223-233, 2005.
    DING, X. K.; HAKANSON, R. Evaluation of the specifi city and potency of a series of cholecystokinin-B/gastrin receptor antagonists in vivo. Pharmacol. Toxicol. 79(3): 124-130, 1996.
    FREEMAN, H. J.; THOMSON, A. B. R.The Small Intestine. In: THOMSON, A. B. R.; SCHAFFER, E. A. (eds.). First principles of gastroenteroly. Janssen- Ortho, 2005.
    FREUDENREICH, O. Review Drug-induced sialorrhea. 41(6): 411-418, 2005.
    FRY, C. Secretions of the salivary glands and stomach. Surgery. 27(12): 503-506, 2009.
    GAVAGHAN, M. Anatomy and Physiology of the Esophagus. AORN Journal. 69(2), 1999.
    GORSKY, M.; EPSTEIN, J. B.; PARRY, J.; EPSTEIN, M. S.; LE, N. D.; SILVERMAN, S. The effi cacy of pilocarpine and bethanechol upon saliva production in cancer patients with hyposalivation following radiation therapy. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 97(2): 190-195, 2004.
    GUYTON, A. C.; HALL, J. E. Funções secretoras do trato alimentar. In: Tratado de Fisiologia Médica. Elsevier, 2011.
    HATTORI, T.; WANG, P. L. Calcium antagonists cause dry mouth by inhibiting resting saliva secretion. Life Schi. 81(8): 683-90, 2007.
    HOU, W.; SCUBERT, M. L. Gastric secretion. Curr. Opin. Gastroenterol. 22(6): 593-598, 2006.
    HYLEMON, P. B.; ZHOU, H.; PANDAK, W. M.; REN, S.; GIL, G.; DENT, P. Bile acids as regulatory molecules. J. Lipid. Res. 50: 1509–1520, 2009.
    ISHIGURO, H.; YAMAMOTO, A.; NAKAKUKI, M.; YI, L.; ISHIGURO, M.; YAMAGUCHI, M.; KONDO, S.; MOCHIMARU, Y. Physiology and pathophysiology of bicarbonate secretion by pancreatic duct epithelium. Nagoya J. Med. Sci. 74(1-2): 1-18, 2012.
    JOHANSSON, M. E. V.; AMBORT, D.; PELASEYED, T. ET AL. Composition and function role of the mucus layers in the intestine. Cellular and Molecular Life Sciences. 68: 3635-3641, 2011.
    JOHANSSON, M. E. V.; SJÖVALL, H.; HANSON, G. C. The gastrointestinal mucus system in health and disease. Nat. Rev. Gastroenterol. Hepatol. 10(6): 352-361, 2013.
    KAGNOFF, M. F.; ECKMANN, L. Epithelial cells as sensors for microbial infection. J. Clin. Invest. 100: 259-263, 1997.
    KATZUNG, B. G.; MASTERS, S. B.; TREVOR, A. J. Farmacologia Básica e Clínica. 12 ed. Rio de Janeiro: McGraw-Hill, 2014
    KIM, J. H.; PARK, S. H.; MOON, Y. W.; HWANG, S.; KIM, D.; ET AL. Histamine H1 receptor induces cytosolic calcium increase and aquaporin translocation in human salivary gland cells. J. Pharmacol. Exp. Ther. 330(2): 403-12, 2009.
    KRALL, J. Bile acids, chaperones, and mammalian longevity. Rejuvenation Research. 15(2): 210-212, 2012.
    KRAUSE, W. J. Brunner´s glands: a structural, histochemical and pathological profi le. Prog. Histochem. Cytochem. 35(4): 259-367, 2000.
    KULLAK-UBLICK, G. A.; STIEGER, B.; MEIER P. J. Enterohepatic bile salt transporters in normal physiology and liver disease. Gastroenterology. 126(1): 322-342, 2004.
    KUNTZ, E.; KUNTZ, H. D. Biochemistry and Functions of the Liver. In: Hepatology. Principles and Pratic. Springer, 2006b.
    ______. Biochemistry and Functions of the Liver. In: Hepatology. Principles and Pratic. Springer, 2006c.
    ______. Morphology of the Liver. In: Hepatology. Principles and Pratic. Springer, 2006a.
    KUROKI, R.; WEAVER, L. H.; MATTHEWS, B. W.A covalent enzyme-substrate intermediate with saccharide distortion in a mutant T4 lysozyme. Science. 262(5142): 2030-2033, 1993.
    LAKRAJ, A. A.; MOGHIMI, N.; JABBARI, B. Sialorrhea: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins. Toxins. 5: 1010-1031, 2013.
    LEE, M. G.; OHANA, E.; PARK, H. W.; YANG, D.; MUALLEM, S. Molecular mechanism of pancreatic and salivary gland fl uid and HCO-3 secretion. Physiol. Rev. 92: 39-74, 2012.
    LI, Q.; LUO, X.; ZENG, W.; MUALLEM, S. Cell-specifi c behavior of P2X7 receptors in mouse parotid acinar and duct cells. J. Biol. Chem. 278: 47555- 47561, 2003.
    LIDDLE, R. A. Cholescystokinin cells. Annu. Rev. Physiol. 59: 221-242, 1997.
    LIMA, D. P.; DINIZ, D. G.; MOIMAZ, S. A. S.; SUMIDA, D.H.; OKAMOTO, A. C. Saliva: refl ection of the body. International Journal of Infectious Diseases. 14: 184-188, 2010.
    LIU, H.; ZHEN, Q.; FARLEY, J. M. Antimuscarinic actions of antihistamines on the heart. Journal of Biomedical Science. 13(3): 395-401, 2006.
    LONG, J. D.; ORLANDO, R. C. Esophageal Submucosal Glands: Structure and Function. The American Journal of Gastroenterology. 94(10): 2818-2824, 1999.
    MALATHI, N.; MYTHILI, S; VASANTHI, H. R. Salivary Diagnostics: A Brief Review. ISRN Dentistry. 2014, Article ID 158786, 8 pages.
    MATSUO, R.; GARRETT, J. R.; PROCTOR, G. B.; CARPENTER, G. H. Refl ex secretion of proteins into submandibular saliva in conscious rats, before and after preganglionic sympathectomy. Journal of Physiology. 527: 175-184, 2000.
    MAZZUCCHELLI, L.; MAUREEY, C. C. Anatomy. In: JOHNSON, L. R. Encyclopedia of Gastroenterology. Academic Press. 3 ed. 1: 408-412, 2003.
    MESE, H.; MATSUO, R..Salivary secretion, taste and hyposalivation. Journal of Oral Rehabilitation. 34(10): 711-723, 2007.
    MIRANDA-RIUS, J.; BRUNET-LLOBET, L.; LAHOR-SOLER, E.; FARRÉ, M. Salivary secretory disorders, inducing drugs, and clinical management. Int. Med. Sci. 12(10): 811-824, 2015.
    MO, J. Z.; WANG, C. D. Effects of the gut hormones on gastricemptying. Biomedical Research-Tokyo. 15(2): 127-131, 1994.
    NAKAMOTO, T.; BROWN, D. A.; CATALAN, M. A.; GONZALEZ-BEGNE, M.; ROMANENKO, V. G.; MELVIN, J. E. Purinergic P2X7 receptors mediate ATP-induced saliva secretion by the mouse submandibular gland. J. Biol. Chem. 285: 4815-4822, 2009.
    NANCI, A. Ten Cate Histologia Oral: Desenvolvimento, Estrutura e Função. Elsevier, 2008.
    NAPEÑAS, J. J.; BRENNAN, M. T.; FOX, P. C. Diagnosis and treatment of xerostomia (dry mouth). Odontology. 97: 76-83, 2009.
    NEDERFORS, T.; NAUTOFTE, B.; TWETMAN, S. Effects of furosemide and bendrofl umethiazide on saliva fl ow rate and composition. Arch. Oral. Biol. 49(7): 507-513, 2004.
    OSTROW, J. D. Overview of bile pigment metabolism. In: OSTROW, J. D. (ed.). Bile pigments and jaundice: molecular, metabolic and medical aspects. New York: Marcel Dekker, 1986.
    PATTI, M. G.; GANTERT, W.; WAY, L. W. Surgery of the esophagus: Anatomy and Physiology. Surgical Clinics of North America. 77(5): 959-970, 1997.
    PLEUVRY, B. J. Gastric disorders: modifi cations of gastric content, antacids and drugs infl uencing gastric secretions and motility. Anesthesia and Intensive Care Medicine. 10(7): 351-354, 2009.
    PRASANTHI, B.; KANNAN, N.; PATIL, R. Effects of Diuretics on Salivary Flow, Composition and Oral Health Status: A clinic-biochemical study. Ann. Med. Health Sci. Res. 4(4): 549-553, 2014.
    PROCTOR, G. B.; CARPENTER, G. H. Review: Regulation of salivary gland function by autonomic nerves. Autonomic Neuroscience. 133: 3-18, 2007.
    RAGUNATH C.; MANUEL, S. G. A.; KASINATHAN, C.; RAMASUBBU, N. Structure-function relationships in human salivary α-amylase role of aromatic residues in a secondary binding site. Biologia. 63: 1028-1034, 2008.
    RANG, H. P.; DALE, M. M.; RITTER, J. M.; FLOWER, R.; HENDERSEN, G. Trato Gastrointestinal. In: Farmacologia. 7 ed. Rio de Janeiro: Elsevier, 2012.
    RESHETNYAK, V. I. Physiological and molecular biochemical mechanisms of bile formation.World J. Gastroenterol. 19: 7341-7360, 2015.
    RODRIGUES, S. S.; FONSECA, C. C.; NEVES, M. T. D. Células endócrinas do sistema gastroenteropancreático: Conceitos, distribuição, secreções, ação e controle. Arq. ciên. vet. zool. 8(2): 171-180, 2005
    RUSSEL, D. W. The enzymes, regulation, and genetics of bile acids synthesis. Annu. Rev. Biochem. 72: 137-174, 2003.
    SANNER, M. F. Python: a programming language for software integration and development. J. Mol. Graph. Model 17(1): 57-61, 1999.
    SCREEBY, L. M.; SCHWARTZ, S. S. A reference guide to drugs and dry mouth - 2nd edition. Gerodontology. 14(11): 33-47, 1997.
    SCHUBERT, M. L. Gastric secretion. Curr. Opin. Gastroenterol, v. 16, n. 6, pp. 463-468, 2000.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 17(6): 481-488, 2001.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 18(6): 639-649, 2002.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 20(6): 519-525, 2004.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 21(6): 636-643, 2005.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 23(6): 595-601, 2007.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 26(6): 598-603, 2010.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 27(6): 536-542, 2011.
    ______. Gastric secretion. Curr. Opin. Gastroenterol. 30(6): 578-582, 2014.
    ______. Functional anatomy and physiology of gastric secretion. Curr. Opin. Gastroenterol. 31(6): 479-485, 2015.
    SCULLY, C. B. E. Drug effects on salivary glands: dry mouth. Oral Diseases. 9: 165-176, 2003.
    SCULLY, C.; BAGAN-SEBASTIAN, J. V. Adverse Drug Reactions in the Orofacial Region. Crit. Rev. Oral Biol. Med. 15(4): 221-240, 2004.
    SILVA, S.; AZEVEDO, L. R.; LIMA, A. A.; IGNÁCIO, S. A.; MACHADO, M. A. ET AL. Effects of fl uoxetine and venlafaxine and pilocarpine on rat parotid glands. Med. Chem. 5(5): 483-490, 2009.
    SOM, P. M.; BRANDWEIN, M. S.Anatomy and pathology of the salivary glands. In: Anatomy and Pathology Head and Neck Imaging. Elsevier, 2003.
    SONESSON, M.; ELIASSON, L.; MATSSON, L. Minor salivary gland secretion in children and adults.Archives of Oral Biology. 48(7): 535-539, 2003.
    STURM, A.; SUDERMANN, T.; SCHULTE, K-M.; GOEBELL, H.; DIGNASS, A. U. Modulation of intestinal epithelial wound healing in vitro and in vivo by lysophosphatidic acid. Gastroenterol. 117: 368-377, 1999.
    TANNA, A.; RADEMAKER, A.; STEWART W., FELDMAN, R. Meta-analysis of the effi cacy and safety of alpha2-adrenergic agonists, beta-adrenergic antagonists, and topical carbonic anhydrase inhibitors with prostaglandin analogs. Arch. Ophthalmol.128: 825–833, 2010.
    TRAUNER, M.; WAGNER, M.; FICKERT, P. ET AL. Molecular regulation of hepatobiliary transport systems: clinical implications for understanding and treating cholestasis. J. Clin. Gastroenterol. 39(4): 111-124, 2005.
    TURNER J. T.; LANDON L. A.; GIBBONS S. J.; TALAMO B. R. Salivary gland P2 nucleotide receptors. Crit. Rev. Oral Biol. Med. 10: 210-224, 1999.
    VARGA, G. Physiology of the salivary glands. Surgery (Oxford). 30(11): 578-583, 2012.
    VEERMAN, E. C. I.; VAN DEN KEIJBUS, P. A. M.; VISSINK, A.; VAN NIEUW AMERONGEN, A. Human glandular salivas: their separate collection and analysis. Eur. J. Oral Sci. 104: 346-352, 1996.
    VINAYAK, V.; RAJESHWARI, G. A.; HASHIKESH, A.P.; MITTAL, S. Adverse effects of drugs on saliva and salivary glands. Journal of Oral Sciences. 5(1): 15-20, 2013.
    WAGNER, D.; SPAHN-LANGGUTH, H.; HANAFY, A.; KOGGEL, A.; LANGGUTH, P. Intestinal drug effl ux: formulation and food effects. Advanced Drug Delivery Reviews. 50: 13-31, 2001.
    WALPNIR, R. A.; TEICHBERG, S. Regulation mechanisms of intestinal secretion: implications in nutrient absorption. Nutr. Biochem. 13(4): 190-199, 2002.
    WILLIAM, C. Y.; TA-MIN, C. Secretin, 100 years later. J. Gastroenterol. 38: 1025-1035, 2003.
    WORRELL R. T.; CUPPOLETTI, J. E.; MATTHEWS, J. B. Colonic Absorption and Secretion. In: JOHNSON, L. R. Encyclopedia of Gastroenterology.3 ed. Academic Press, 2003.
    YASUDA, S. U.; YASUDA, R. P. Affi nities of brompheniramine, chlorpheniramine, and terfenadine at the fi ve human muscarinic cloninergic receptor subtypes. Pharmacoterapy. 19(4): 447-451, 1999.
    YASUTADA, A.; JONATHAN, D. K. Duodenal Chemosensing and Mucosal Defenses. Digestion. 83: 25-31, 2011.
    YNAI-INAMURA, H.; OHTAKE, A.; NOGUCHI, Y.; HATANAKA, T.; SUZUKI, M.; UESHIMA, K.; SATO, S.; SASAMATA, M. Effects of 1-adrenoceptor antagonists on phenylephrine-induced salivar secretion and intraurethral pressure elevation in anesthetized rats. Eur. J. Pharmacol. 679(1-3): 127-131, 2012.
    YOKOYAMA, Y; NAGINO, M; NIMURA, Y. Mechanisms of hepatic regeneration following portal vein embolization and partial hepatectomy: a review. World J. Suger. 31: 367-374, 2007.
Como citar:

LIMA, Vilma; MELO, Iracema Matos; ARAúJO, Vilana Maria Adriano; DINIZ FILHO, Jairo; "Fisiologia das Secreções Salivares e Gastrintestinais", p. 479 -522. In: Sistema Digestório: Integração Básico-Clínica. São Paulo: Blucher, 2016.
ISBN: 9788580391893, DOI 10.5151/9788580391893-19