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Pancreatic enzymes in chronic pancreatitis

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References

  1. DiMagno EP, Go VLW, Summerskill WHJ. Relationsbetween pancreatic enzyme outputs and malabsorption insevere pancreatic insufficiency.N Engl J Med 1973; 288: 813–815.

    PubMed  CAS  Google Scholar 

  2. Hiele M, Ghoos Y, Rutgeerts P, Vantrappen G. Starchdigestion in normal subjects and patients with pancreaticdiseases, using a13CO2 breath test.Gastroenterology 1989; 96: 503.

    PubMed  CAS  Google Scholar 

  3. Layer P, Zinsmeister AR, DiMagno EP. Effects ofdecreasing intraluminal amylase activity on starch digestion and postprandial gastrointestinal function in humans.Gastroenterology 1986; 91: 41–48.

    PubMed  CAS  Google Scholar 

  4. Borgström B, Dahlqvist A, Lundh G, Sjövall J. Studies ofintestinal digestion and absorption in the human.J ClinInvest 1957; 36: 1521–1536.

    Google Scholar 

  5. Layer P, Go VLW, DiMagno EP. Fate of pancreaticenzymes during aboral small intestinal transit in humans.Am J Physiol 1986; 251: G475-G480.

    PubMed  CAS  Google Scholar 

  6. Layer P, Jansen JBMJ, Cherian L, Lamers CBHW, Goebell H. Feedback regulation of human pancreatic secretion:Effects of protease inhibition on duodenal delivery andsmall intestinal transit of pancreatic enzymes.Gastroenterology 1990; 98: 1311–1319.

    PubMed  CAS  Google Scholar 

  7. Granger M, Abadie B, Marchis-Mouren G. Limited actionof trypsin on porcine pancreatic amylase: characterizationof the fragments.FEBS Lett 1975; 56 (2): 189–193.

    Article  PubMed  CAS  Google Scholar 

  8. Layer P, Baumann J, Hellmann C, vd Ohe M, Gröger G, Goebell H. Effect of luminal protease inhibition on prandial nutrient digestion during small intestinal chymetransit.Pancreas 1990; 5: 718.

    Google Scholar 

  9. Kelly DG, Sternby B, DiMagno EP. How to protect humanpancreatic enzyme activities in frozen duodenal juice.Gastroenterology 1991; 100: 189–195.

    PubMed  CAS  Google Scholar 

  10. Holtmann G, Kelly DG, Sandberg RJ, Bentley KJ, Magocsi L, DiMagno EP. Is the survival of human lipolyticactivity (LA) during aboral transit affected by the amountof calories, nutrient, chymotrypsin (CT) or bile acid (BA)entering the duodenum.Gastroenterology 1991; 100: A276.

    Google Scholar 

  11. Thiruvengadam R, DiMagno EP. Inactivation of humanlipase by proteases.Am J Physiol 1988; 255(GastrointestLiver Physiol 18): G476-G481.

    PubMed  CAS  Google Scholar 

  12. Layer P, Hellmann C, Baumann J, vd Ohe M, Gröger G, Goebell H. Modulation of physiologic fat malabsorptionin humans.Digestion 1990; 46: 153.

    Google Scholar 

  13. DiMagno EP, Malagelada JR, Go VLW. Relationshipbetween alcoholism and pancreatic insufficiency.NYAcadSci 1975; 252: 200–207.

    Article  CAS  Google Scholar 

  14. DiMagno EP, Layer P. Human exocrine pancreatic enzymesecretion, inThe Pancreas: Biology, Pathobiology, and Diseases, Go VLW et al, eds., 2nd ed., Raven, New York,1993; pp. 275–300.

    Google Scholar 

  15. DiMagno EP, Go VLW, Summerskill WHJ. Relationsbetween pancreatic enzyme outputs and malabsorption insevere pancreatic insufficiency.N Engl J Med 1973; 288: 813–815.

    PubMed  CAS  Google Scholar 

  16. Di Magno EP, Clain JE, Layer P. Chronic pancreatitis, inThe Pancreas: Biology, Pathobiology, and Diseases, Go VLW et al., eds., 2nd ed., Raven, New York, 1993; pp.665–706.

    Google Scholar 

  17. Read NW, McFarlane A, Kinsman RJ, Bates TE, Blackhall NW, Farrar GBJ, Hall JC, Moss G, Morris AP, O’Neill B,Welch I, Lee Y, Bloom SR. Effect of infusion of nutrientsolutions into the ileum on gastrointestinal transit andplasma levels of neurotensin and enteroglucagon.Gastroenterology 1984; 86: 274–280.

    PubMed  CAS  Google Scholar 

  18. Spiller RC, Trotman IF, Higgins BE et al. The ileal brakeinhibition of jejunal motility after ileal fat perfusion in man.Guf 1984; 25: 365–374.

    CAS  Google Scholar 

  19. Layer P, Peschel S, Schlesinger T, Goebell H. Humanpancreatic secretion and intestinal motility: effects of ilealnutrient perfusion.Am J Physiol 1990; 258(GastrointestLiver Physiol 21): G196-G201.

    PubMed  CAS  Google Scholar 

  20. Layer P, Schlesinger T, Goebell H. Modulation of periodicinterdigestive gastrointestinal motor and pancreatic function by the ileum.Pancreas 1993; 8: 426–432.

    Article  PubMed  CAS  Google Scholar 

  21. Jain NK, Boivin M, Zinsmeister AR, DiMagno EP. Theileum and carbohydrate mediated feedback regulation ofpostprandial pancreaticobiliary secretion in normal humans.Pancreas 1991; 6: 495–505.

    Article  PubMed  CAS  Google Scholar 

  22. Bond JH, Levitt MD. Fate of soluble carbohydrate in thecolon of rats and man.J Clin Invest 1976; 57: 1158–1164.

    Article  PubMed  CAS  Google Scholar 

  23. Bond JH, Currier BE, Buchwald H, Levitt MD. Colonicconservation of malabsorbed carbohydrate.Gastroenterology 1980; 78: 444–447.

    PubMed  CAS  Google Scholar 

  24. Stephen AM, Haddad AC, Phillips SF. Passage of carbohydrate into the colon.Gastroenterology 1983; 85: 589–595.

    PubMed  CAS  Google Scholar 

  25. Flourie B, Florent C, Jouany JP et al. Colonic breakdownof 50 g wheat starch in healthy man: effect on symptomsand fecal outputs.Gastroenterology 1986; 90: 111–119.

    PubMed  CAS  Google Scholar 

  26. Mackie RD, Levine AS, Levitt MD. Malabsorption ofstarch in pancreatic insufficiency.Gastroenterology 1981; 80: 1220.

    Google Scholar 

  27. Patel VP, Jain NK, Agarwal N, GeeVarghese PJ,Pitchumoni CS. Comparisons of bentiromide test and richflour breath hydrogen test in the detection of exocrinepancreatic insufficiency.Pancreas 1986; 1: 172.

    Article  PubMed  CAS  Google Scholar 

  28. Kerlin P, Wong L, Harris B, Capra S. Rice flour, breathhydrogen, and malabsorption.Gastroenterology 1984; 87: 578.

    PubMed  CAS  Google Scholar 

  29. Sternby B, Holtmann G, Kelly DG, DiMagno EP. Effect of gastric or duodenal nutrient infusion on gastricand pancreatic lipase secretion.Gastroenterology 1992; 102: A292.

    Google Scholar 

  30. DiMagno EP, Malagelada JR, Go VLW, Moertel CG. Fateof orally ingested enzymes in pancreatic insufficiency:comparison of two dosage schedules.N Engl J Med 1977; 296: 1318–1322.

    PubMed  CAS  Google Scholar 

  31. Layer P, vd Ohe M, Gröger G, Dicke D, Goebell H. Luminal availability and digestive efficacy of substitutedenzymes in pancreatic insufficiency.Pancreas 1992; 7: 745.

    Google Scholar 

  32. Regan PT, Malagelada JR, DiMagno EP, Glanzman SL,Go VLW. Comparative effects of antacids, cimetidine, andenteric coating on the therapeutic response to oral enzymesin severe pancreatic insufficiency.N Eng J Med 1977; 297: 854–858.

    CAS  Google Scholar 

  33. Heizer WD, Cleaveland CR, Iber FL. Gastric inactivationof pancreatic supplements.Bull Johns Hopkins Hosp 1965; 116: 261–270.

    PubMed  CAS  Google Scholar 

  34. Goebell H, Klotz U, Nehlsen B, Layer P. Oroileal transitof slow release 5-ASA.Gut 1993; 34: 669–675.

    Article  PubMed  CAS  Google Scholar 

  35. Code CF, Schlegel JF. The gastrointestinal interdigestivehousekeeper: Motor correlates of the interdigestive myoelectric complex of the dog, inProc 4th Int Symp on GlMotility, Daniel EE, ed., Mitchell Press, Vancouver, 1973; pp. 631–634.

    Google Scholar 

  36. Schlegel JF, Code CF. The gastric peristalsis of theinterdigestive housekeeper.Proc 5th Int Symp on GlMotility, Vantrappen G, ed., Typoff-Press, Leuven, 1975; p. 321.

    Google Scholar 

  37. Layer P, Gröger G, Dicke D, vd Ohe M, Goebell H. Enzyme pellet size and luminal nutrient digestion inpancreatic insufficiency.Digestion 1992; 52: 100.

    Google Scholar 

  38. Carroccio A, Pardo F, Montalto G, Iapichino L, Soresi M,Averna MR, lacono G, Notarbartolo A. Use of famotidinein severe exocrine pancreatic insufficiency with persistentmaldigestion on enzymatic replacement therapy.Dig DisSci 1992; 37: 1441–1446.

    Article  CAS  Google Scholar 

  39. Heijerman HG, Lamers CB, Bakker W. Omeprazoleenhances the efficacy of pancreatin (Pancrease) in cysticfibrosis.Ann Intern Med 1991; 114: 200–210.

    PubMed  CAS  Google Scholar 

  40. Kelly KA. Gastric emptying of liquids and solids: roles ofthe proximal intestinal stomach.Am J Physiol 1980; Bd.239: G71-G76.

    PubMed  CAS  Google Scholar 

  41. Azpiroz F, Malagelada JR. Pressure activity patterns in thecanine proximal stomach: response to distention.Am JPhysiol 1984; Bd. 247: G265-G272.

    CAS  Google Scholar 

  42. Azpiroz F, Malagelada JR. Gastric tone measured by anelectronic barostat in health and postsurgical gastroparesis.Gastroenterology 1987; 92: 934–943.

    PubMed  CAS  Google Scholar 

  43. Meyer JH, Ohashi H, Jehn D, Thomson JB. Size of liverparticles emptied from the human stomach.Gastroenterology 1981; 80: 1489–1496.

    PubMed  CAS  Google Scholar 

  44. Meyer JH, Elashoff J, Porter-Fink V, Dressman J, Amidon GL. Human postprandial gastric emptying of 1-3-millimeter spheres.Gastroenterology 1988; 94: 1315–1325.

    PubMed  CAS  Google Scholar 

  45. Kölbel C, Layer P, Hotz J, Goebell H. Der Einfluß einessäuregeschützten, mikroverkapselten Pankreatinpräparatsauf die pankreatogene Steatorrhö.Med Klin 1986; 81: 85–86.

    Google Scholar 

  46. Lankisch PG, Lembcke B, Göke B, Creutzfeldt W. Therapie der pankreatogenen Steatorrheo: Bietet derSaureschutz für Pankreasenzyme Vorteile?Verh dtsch GesInn Med 1983; 89: 864–867.

    Google Scholar 

  47. Dutta SK, Rubin J, Harvey J. Comparative evaluation ofthe therapeutic efficacy of a pH-sensitive enteric-coatedpancreatic enzyme preparation with conventional pancreatic enzyme therapy in the treatment of exocrinepancreatic insufficiency.Gastroenterology 1983; 84: 476–482.

    PubMed  CAS  Google Scholar 

  48. Hendeles L, Dorf A, Stecenko A, Weinberger M. Treatment failure after substitution of generic pancrelipasecapsules. Correlation with in vitro lipase activity.JAMA 1990; 263: 2459–2461.

    Article  PubMed  CAS  Google Scholar 

  49. Ihse I, Lilja P, Lundquist I. Feedback regulation of pancreatic enzyme secretion by intestinal trypsin in man.Digestion 1977; 15: 303–308.

    Article  PubMed  CAS  Google Scholar 

  50. Krawisz BR, Miller LJ, DiMagno EP, Go VLW. In theabsence of nutrient pancreatic-biliary secretions in thejejunum do not exert feedback control of human pancreaticor gastric function.J Lab Clin Med 1980; 95: 13–18.

    PubMed  CAS  Google Scholar 

  51. Hotz J, Ho SB, Go VLW, DiMagno EP. Short-term inhibition of duodenal tryptic activity does not affect humanpancreatic, biliary or gastric function.J Lab Clin Med 1983; 101: 488–495.

    PubMed  CAS  Google Scholar 

  52. Slaff J, Jacobson D, Tillmann CR, Curington C, Toskes PP. Protease-specific suppression of pancreatic exocrinesecretion.Gastroenterology 1984; 87: 44–52.

    PubMed  CAS  Google Scholar 

  53. Owyang C, Louie DS, Tatus D. Feedback regulation ofpancreatic enzyme secretion. Suppression of cholecystokinin release by trypsin.J Clin Invest 1986; 77: 2042–2047.

    Article  PubMed  CAS  Google Scholar 

  54. Owyang C, May D, Louie DS. Trypsin suppression ofpancreatic enzyme secretion. Differential effect on chole-cystokinin release and the enteropancreatic reflex.Gastroenterology 1986; 91: 637–643.

    PubMed  CAS  Google Scholar 

  55. Adler G, Reinshagen M, Koop I, Göke B, Schafmayer A, Rovati LC, Arnold R. Differential effects of atropine and acholecystokinin receptor antagonist on pancreatic secretion.Gastroenterology 1989; 96: 1158–1164.

    PubMed  CAS  Google Scholar 

  56. Mossner J, Stange JH, Ewald M, Kestel W, Fischbach W. Influence of exogenous application of pancreatic extracton endogenous pancreatic enzyme secretion.Pancreas 1991; 6: 637–644.

    Article  PubMed  CAS  Google Scholar 

  57. Isaksson F, Ihse I. Pain reduction by an oral pancreaticenzyme preparation in chronic pancreatitis.Dig Dis Sci 1983; 28: 97–102.

    Article  PubMed  CAS  Google Scholar 

  58. Halgreen H, Thorsgaard Pedersen N, Worning H. Symptomatic effect of pancreatic enzyme therapy in patientswith chronic pancreatitis.Scand J Gastroent 1986; 21: 104–108.

    Article  PubMed  CAS  Google Scholar 

  59. Mossner J, Secknus R, Meyer J, Niederau C, Adler G. Treatment of pain with pancreatic extracts in chronicpancreatitis: Results of a prospective placebo-controlledmulticenter trial.Digestion 1992; 53: 54–66.

    PubMed  CAS  Google Scholar 

  60. Kiihnelt P, Mundlos S, Adler G. Einfluss der Pelletgrösseeines Pankreasenzympraparates auf die duodenale lipolytische Aktivitat.ZGastroenterol 1991; 29: 417–421.

    Google Scholar 

  61. Layer P, vd Ohe M, Gröger G, Cherian L, Rolle K, Goebell H. Intraluminal proteolytic degradation of lipase and fatmalabsorption in pancreatin-treated pancreatic insufficiency.Pancreas 1992; 7: 745.

    Google Scholar 

  62. Zentler Munro PL, Assoufi BA, Balasubramanian K, Cornell S, Benoliel D, Northfield TC, Hodson ME. Therapeutic potential and clinical efficacy of acid-resistantfungal lipase in the treatment of pancreatic steatorrhoeadue to cystic fibrosis.Pancreas 1992; 7: 311–319.

    Article  PubMed  CAS  Google Scholar 

  63. Schneider MU, Knoll-Ruzicka ML, Domschke S, Heptner G, Domschke W. Pancreatic enzyme replacement therapy:comparative effects of conventional and enteric-coatedmicrospheric pancreatin and acid-stable fungal enzymepreparations on steatorrhea in chronic pancreatitis.Hepatogastroenterology 1985; 32: 97–102.

    PubMed  CAS  Google Scholar 

  64. Griffin SM, Alderson D, Farndon JR. Acid resistantlipase as replacement therapy in chronic pancreatic exocrine insufficiency: a study in dogs.Gut 1989; 30: 1012–1015.

    Article  PubMed  CAS  Google Scholar 

  65. Moreau J, Bousson M, Saint Marc Girardin MF, Pignal F, Bommelaer G, Ribet A. Comparison of fungal lipase andpancreatic lipase in exocrine pancreatic insufficiency inman. Study of their in vitro properties and intraduodenalbioavailability.Gastroenterol Clin Biol 1988; 12: 787–792.

    PubMed  CAS  Google Scholar 

  66. Carriere F, Barrowman IA, Verger R, Laugier R: Secretionand contribution to lipolysis of gastric and pancreaticlipases during a test meal in humans.Gastroenterology 1993; 105: 876–888.

    PubMed  CAS  Google Scholar 

  67. Abrams CK, Hamosh M, Dutta SK, Hubbard VS, Hamosh P. Role of nonpancreatic lipoiytic activity in exocrine pancreatic insufficiency.Gastro enter ology 1987; 92: 125–129.

    CAS  Google Scholar 

  68. Balasubramanian K, Zentler Munro PL, Batten JC, Northfield TC. Increased intragastric acid-resistant lipaseactivity and lipolysis in pancreatic steatorrhoea due tocystic fibrosis.Pancreas 1992; 7: 305–310.

    Article  PubMed  CAS  Google Scholar 

  69. Borel P, Armand M, Senft M, Andre M, Lafont H, Lairon D. Gastric lipase: evidence of an adaptive response to dietaryfat in the rabbit.Gastroenterology 1991; 100: 1582–1589.

    PubMed  CAS  Google Scholar 

  70. Hamosh M. Lingual and gastric lipases.Nutrition 1990; 6: 421–428.

    PubMed  CAS  Google Scholar 

  71. Gargouri Y, Pieroni G, Riviere C, Lowe PA, Sauniere JF, Sarda L, Verger R. Importance of human gastric lipase forintestinal lipolysis: an in vitro study.Biochim Biophys Acta 1986; 879: 419–423.

    PubMed  CAS  Google Scholar 

  72. Bodmer MW, Angal S, Yarranton GT, Harris TJR, Lyons A, King DJ, Pieroni G, Riviere C, Verger R, Lowe PA. Molecular cloning of a human gastric lipase and expressionof the enzyme in yeast.Biochim Biophys Acta 1987; 909: 237–244.

    PubMed  CAS  Google Scholar 

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  1. Division of Gastroenterology, Department of Medicine, University of Essen, Hufelandstr.55, D-45122, Essen, Germany

    Peter Layer & Gerald Holtmann

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Layer, P., Holtmann, G. Pancreatic enzymes in chronic pancreatitis. Int J Pancreatol 15, 1–11 (1994). https://doi.org/10.1007/BF02924382

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