Langman 13E 2015

The pancreas is formed by two buds, dorsal and ventral, originating from the endodermal lining
of the duodenum (Fig. 15.19). Whereas the dorsal pancreatic bud is in the dorsal mesentery,
the ventral pancreatic bud is close to the bile duct (Fig. 15.19). When the duodenum rotates to
the right and becomes C-shaped, the ventral pancreatic bud moves dorsally in a manner similar
to the shifting of the entrance of the bile duct (Fig. 15.19). Finally, the ventral bud comes to lie
immediately below and behind the dorsal bud (Fig. 15.20). Later, the parenchyma and the duct
systems of the dorsal and ventral pancreatic buds fuse (Fig. 15.20B). The ventral bud forms the
uncinate process and inferior part of the head of the pancreas. The remaining part of the gland is
derived from the dorsal bud. The main
pancreatic duct (of Wirsung) is formed by the distal part of the dorsal pancreatic duct and the
entire ventral pancreatic duct (Fig. 15.205). The proximal part of the dorsal pancreatic duct either
is obliterated or persists as a small channel, the accessory pancreatic duct (of Santorini). The
main pancreatic duct, together with the bile duct, enters the duodenum at the site of the major
papilla; the entrance of the accessory duct (when present) is at the site of the minor papilla. In
about 10% of cases, the duct system fails to fuse, and the original double system persists.
In the third month of fetal life, pancreatic islets (of Langerhans) develop from the
parenchymatous pancreatic tissue and scatter throughout the pancreas. Insulin secretion begins
at approximately the fifth month. Glucagon- and somatostatin-secreting cells also develop from
parenchymal cells. Visceral mesoderm surrounding the pancreatic buds forms the pancreatic
connective tissue.
Molecular Regulation of Pancreas Development
FGF2 and ACTIVIN (a TGF-(3 family member) produced by the notochord and endothelium of
the dorsal aorta repress SHH expression in gut endoderm destined to form the dorsal pancreatic
bud. The ventral bud is induced by visceral mesoderm. As a result, expression of the
PANCREATIC AND DUODENAL HOMEO- BOX1 (PDX) gene is upregulated. Although all of
the downstream effectors of pancreas development have not been determined, it appears that
expression of the paired homeobox genes PAX4 and PAX6 specifies the endocrine cell lineage,
such that cells expressing both genes become
3 (insulin), 8 (somatostatin), and 7 (pancreatic polypeptide) cells; whereas those expressing
only PAX6 become a (glucagon) cells.
Translate:
Pancreasul este format din doi muguri, dorsal si ventral, ce origineaza din “marginea”
endodermica a duodenului (Fig. 15.19). In timp ce mugurele pancreatic dorsal se afla in
mezenterul dorsal, mugurele pancreatic ventral se situeaza in ductul biliar (Fig. 15.19). Din punct
de vedere evolutiv, duodenul se roteste spre dreapta si capata forma literei “C”, in acelasi timp in
care mugurele pancreatic ventral se deplaseaza posterior intr-o maniera similara deplasarii caii de
intrare a ductului biliar (Fig. 15.19). Prin urmare, mugurele ventral se va situa in raport imediat
postero-inferior fata de mugurele dorsal. Mai tarziu, parenchimul, impreuna cu ductele biliare ale
mugurilor pancreatice dorsal si ventral, vor fuziona (Fig. 15.20B). Mugurele ventral formeaza
procesul uncinat si segmentul inferior al capului de pancreas. Restul glandei deriva din mugurele
dorsal. Ductul pancreatic principal (al lui Wirsung) este format de segmentul distal al ductului
pancreatic dorsal si intregul duct pancreatic ventral (Fig. 15.20B). Segmentul proximal al
ductului pancreatic dorsal poate fi obliterat, alteori persista sub forma de canalicul, denumit duct
pancreatic accesor (al lui Santorini). Ductul pancreatic principal, impreuna cu ductul biliar,