Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Review

Volume 12, Number 5, October 2019, pages 233-244

Functional, Diagnostic and Therapeutic Aspects of Gastrointestinal Hormones

**Table 1.** Classification of GI Hormones
GI: gastrointestinal; GIP: gastric inhibitory peptide; VIP: vasoactive intestinal peptide.
1. Gastrin-cholecystokinin family	Gastrin and cholecystokinin
2. Secretin family	Secretin, glucagon, glicentin, VIP and GIP
3. Somatostatin family	Somatostatin
4. Motilin family	Motilin, gherlin, obestatin
5. Substance P	Substance P

Table 1. Classification of GI Hormones

GI: gastrointestinal; GIP: gastric inhibitory peptide; VIP: vasoactive intestinal peptide.

1. Gastrin-cholecystokinin family

Gastrin and cholecystokinin

2. Secretin family

Secretin, glucagon, glicentin, VIP and GIP

3. Somatostatin family

Somatostatin

4. Motilin family

Motilin, gherlin, obestatin

5. Substance P

Substance P

**Table 2.** GI Hormones With Cells, Sites of Origin, Diagnostic and Therapeutic Uses
GI hormone	Cells and sites of origin	Diagnostic use	Therapeutic use
GI: gastrointestinal; CCK: cholecystokinin; ERCP: endoscopic retrograde cholangiopancreatography; ESWL: extracorporeal shockwave lithotripsy; MRCP: magnetic resonance cholangiopancreatography; CIPO: chronic intestinal pseudo-obstruction; GRP: gastrin-releasing peptide; GIP: gastric inhibitory peptide; GLP: glucagon-like peptide; NAFLD: non-alcoholic fatty liver disease; SBS: short bowel syndrome; NK-1: neurokinin-1; GC-C: guanylate cyclase-C; IBS-C: irritable bowel syndrome with predominant constipation; CIC: chronic idiopathic constipation.
Gastrin	G cells in gastric antrum.	1) Fasting serum gastrin and secretin suppression test to evaluate hypergastrinemia. 2) Pentagastrin stimulation test for early diagnosis of medullary carcinoma of thyroid. 3) Pentagastrin stimulation test for assessment of completeness of vagotomy.
CCK	I cells within crypts of Lieberkuhn of duodenum and jejunum.	1) Diagnosis of gallbladder dyskinesia. 2) Identification of ampulla of Vater during ERCP.	Endoscopic clearance of choledocholithiasis after ESWL.
Secretin	S cells within crypts of Lieberkuhn of duodenum and jejunum.	1) Secretin test to diagnose pancreatic exocrine insufficiency. 2) Secretin-enhanced MRCP for the diagnosis of pancreatic divisum, early chronic pancreatitis and exocrine pancreatic insufficiency.
Somatostatin	D cells in islets of Langerhans of pancreas and GI tract.	Octreotide scan to detect and monitor the progress of treatment of neuroendocrine tumors that have somatostatin receptors.	1) Esophageal variceal bleeding 2) CIPO 3) Pancreatic fistula 4) Refractory and secretory diarrhea 5) Carcinoid crisis 6) Hepato-renal syndrome 7) VIPoma 8) Acromegaly 9) Sulfonylurea poisoning
Motilin	Mo cells within crypts of Lieberkuhn of duodenum and jejunum.		Motilin receptor agonist (erythromycin) is used off-label for the treatment of gastroparesis.
Ghrelin or lenomorelin	Ghrelinergic cells in gastric fundus, small intestine, colon, pancreas, lungs, brain.
Obestatin	Gastric mucosa
GRP	Submucosa and myenteric plexus of stomach and intestine, intrapancreatic ganglia, hypothalamus and brain stem.
GIP	K cells in mucosa of duodenum and jejunum.
GLP-1	L cells in distal ileum and colon, some in proximal intestine.		1) GLP-1 mimetics are used in patients with type II diabetes mellitus. 2) Novel agent for the treatment of NAFLD.
GLP-2	L cells in distal ileum and colon.		GLP-2 analogue teduglutide is used for the treatment SBS.
Glicentin	L cells in intestine
Gastric leptin	Gastric chief cells.
Neurotensin	N cells in ileum and enteric neurons in myenteric plexus.
Substance P	Myenteric plexus in gut and vagus nerve.		Substance P/NK-1 receptor antagonist aprepitant is used in chemotherapy-induced nausea and vomiting.
Oxyntomodulin	L cells in intestine.
Uroguanylin	Enterochromaffin cells in duodenum and jejunum		GC-C receptor agonists linaclotide and plecanatide are used in IBS-C and CIC.

Table 2. GI Hormones With Cells, Sites of Origin, Diagnostic and Therapeutic Uses

GI hormone

Cells and sites of origin

Diagnostic use

Therapeutic use

GI: gastrointestinal; CCK: cholecystokinin; ERCP: endoscopic retrograde cholangiopancreatography; ESWL: extracorporeal shockwave lithotripsy; MRCP: magnetic resonance cholangiopancreatography; CIPO: chronic intestinal pseudo-obstruction; GRP: gastrin-releasing peptide; GIP: gastric inhibitory peptide; GLP: glucagon-like peptide; NAFLD: non-alcoholic fatty liver disease; SBS: short bowel syndrome; NK-1: neurokinin-1; GC-C: guanylate cyclase-C; IBS-C: irritable bowel syndrome with predominant constipation; CIC: chronic idiopathic constipation.

Gastrin

G cells in gastric antrum.

1) Fasting serum gastrin and secretin suppression test to evaluate hypergastrinemia.
2) Pentagastrin stimulation test for early diagnosis of medullary carcinoma of thyroid.
3) Pentagastrin stimulation test for assessment of completeness of vagotomy.

CCK

I cells within crypts of Lieberkuhn of duodenum and jejunum.

1) Diagnosis of gallbladder dyskinesia.
2) Identification of ampulla of Vater during ERCP.

Endoscopic clearance of choledocholithiasis after ESWL.

Secretin

S cells within crypts of Lieberkuhn of duodenum and jejunum.

1) Secretin test to diagnose pancreatic exocrine insufficiency.
2) Secretin-enhanced MRCP for the diagnosis of pancreatic divisum, early chronic pancreatitis and exocrine pancreatic insufficiency.

Somatostatin

D cells in islets of Langerhans of pancreas and GI tract.

Octreotide scan to detect and monitor the progress of treatment of neuroendocrine tumors that have somatostatin receptors.

1) Esophageal variceal bleeding
2) CIPO
3) Pancreatic fistula
4) Refractory and secretory diarrhea
5) Carcinoid crisis
6) Hepato-renal syndrome
7) VIPoma
8) Acromegaly
9) Sulfonylurea poisoning

Motilin

Mo cells within crypts of Lieberkuhn of duodenum and jejunum.

Motilin receptor agonist (erythromycin) is used off-label for the treatment of gastroparesis.

Ghrelin or lenomorelin

Ghrelinergic cells in gastric fundus, small intestine, colon, pancreas, lungs, brain.

Obestatin

Gastric mucosa

GRP

Submucosa and myenteric plexus of stomach and intestine, intrapancreatic ganglia, hypothalamus and brain stem.

GIP

K cells in mucosa of duodenum and jejunum.

GLP-1

L cells in distal ileum and colon, some in proximal intestine.

1) GLP-1 mimetics are used in patients with type II diabetes mellitus.
2) Novel agent for the treatment of NAFLD.

GLP-2

L cells in distal ileum and colon.

GLP-2 analogue teduglutide is used for the treatment SBS.

Glicentin

L cells in intestine

Gastric leptin

Gastric chief cells.

Neurotensin

N cells in ileum and enteric neurons in myenteric plexus.

Substance P

Myenteric plexus in gut and vagus nerve.

Substance P/NK-1 receptor antagonist aprepitant is used in chemotherapy-induced nausea and vomiting.

Oxyntomodulin

L cells in intestine.

Uroguanylin

Enterochromaffin cells in duodenum and jejunum

GC-C receptor agonists linaclotide and plecanatide are used in IBS-C and CIC.