| VIVO Pathophysiology | Endocrine Pancreas |
Amylin
The mature, monomeric form of amylin is a 37 amino acid peptide that is co-expressed with insulin from pancreatic β-cells. It was discovered in extracts of pancreatic tissue from humans and cats with type 2 diabetes mellitis. In certain pathologic states such as diabetes, individual amylin molecules aggregate within cells into fibrils or a type of amyloid that can have adverse effects on β-cells. Amylin is also produced in smaller amounts in several other tissues.
Amylin is secreted from the pancreas in response to the elevated concentration of nutrients in blood - glucose, amino acids, and fatty acids - that occurs shortly after consumption of a meal. During the fasting state, amylin secretion is shut off but following a meal its secretion increases markedly. There are multiple receptors for amylin and they are present in numerous tissues including areas of the brain. Amylin has several well documented physiologic effects that have been documented most commonly in rodents, but also in other animals including humans:
- Suppression of secretion of glucagon from α cells in pancreatic islets. This sesult in suppression of glycogenolysis and gluconeogenesis, thereby stabilizing blood glucose concentrations.
- Delay of gastric emptying, which delays delivery of nutrients into the small intestine for absorption and thus preventing sharp in increases in blood levels of glucose and other energy sources.
- Acting on specific areas of the brain, amylin acts in concert with other peptide hormones to inhibit further intake of food - it acts as a satiation factor. Interestingly, in mice, amylin actually reduces their normal preference for a high-fat diet.
The effects of amylin on energy metabolism, food intake and gastric emptying may sound familiar. Secretion of several other hormones is also stimulated by feeding and nutrient uptake, and have similar effects to amylin. These include leptin, glucose-dependent insulinotropic peptide, and glucagon-like peptides 1 and 2. It is clear that an entire orchestra of hormones is involved in control of food intake and body weight. Considering the numerous adverse health effects of obesity and the associated problem of insulin-resistant diabetes, here is great excitement about exploiting our knowledge of these hormones to control those two disorders. Indeed, several analogs of amylin have been produced and are in clinical trials to manage obestity and as adjunct therapy for obestity and diabetes.
References
Secher A, Lutz TA, Raun K. The story of amylin: from physiology to therapy. Nat Metab. 2026 8:299-312.
Volčanšek Š, Koceva A, Jensterle M, Janež A, Muzurović E. Amylin: From Mode of Action to Future Clinical Potential in Diabetes and Obesity. Diabetes Ther. 2025; 16:1207-1227.
Walker CS, Aitken JF, Vazhoor Amarsingh G, Zhang S, Cooper GJS. Amylin: emergent therapeutic opportunities in overweight, obesity and diabetes mellitus. Nat Rev Endocrinol. 2025; 21(8:482-494.
 Endocrine Pancreas: Introduction and Index |
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