Editorial on amylase and the acini-islet-acinar reflex: A new frontier in metabolic health research.

This editorial comments on the study by Pierzynowska et al investigating the acini-islet-acinar (AIA) reflex, which integrates the exocrine and endocrine functions of the pancreas. The study investigates whether exogenous amylase introduced to the interstitial fluid surrounding pancreatic islets can inhibit insulin release. Historically, high serum amylase levels were associated with pancreatitis, but recent findings suggest that low amylase levels are more linked to metabolic diseases like diabetes and obesity. In their experiment, six pigs were used to examine the effects of amylase infusion on insulin release during an intravenous glucose tolerance test. The pigs received different treatments (amylase, saline, or bovine serum albumin), and blood samples were taken over two hours to measure insulin and glucose levels. The results showed amylase delayed glucose-stimulated insulin release, whereas bovine serum albumin increased insulin levels supporting the existence of the AIA reflex and suggesting amylase as a key metabolic regulator. Enzyme supplementation, particularly with α-amylases, may offer therapeutic benefits in preventing and managing metabolic disorders, including diabetes and obesity. Further research is warranted to explore the full scope of amylase's role in metabolic health and its therapeutic potential.