Role of the trigeminal system in pancreatic innervation: new concept and challenge – a narrative review

INTRODUCTION: The pancreas is innervated by a complex network including vagal, sympathetic, and spinal sensory pathways but recent studies suggest that the trigeminal system, known for its role in sensory perception, may also contribute to pancreatic innervation. METHODS: This review explores the hypothesis that the trigeminal system, via sensory neuropeptides such as calcitonin gene-related peptide and substance P, plays a role in pancreatic sensory innervation. Several hypotheses are proposed to explain this potential role, including embryological development, antidromic activity, and neurotransmitter actions. RESULTS: Neuropeptides, found in pancreatic tissues, may influence blood flow, inflammation, and pain perception, as well as modulate pancreatic functions such as enzyme secretion and insulin release. Understanding the interplay between the trigeminal system and the pancreas could provide insights into the pathophysiology of conditions like pancreatitis and diabetes. DISCUSSION: Targeting these pathways might offer new therapeutic strategies for managing pancreatic disorders, especially pain control and inflammation.