Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.1 (chymotrypsin)
 10,938 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The primary objective of this study was to evaluate the accuracy of the bentiromide test in differentiating between dogs with exocrine pancreatic insufficiency (EPI) and those with primary intestinal disease (PID). A secondary objective was to correlate the results of the commonly used diagnostic techniques with the results of the bentiromide test. This test consists of the oral administration of a synthetic peptide that is cleaved only by chymotrypsin. A subsequent rise in the plasma concentration of p-aminobenzoic acid (PABA) indicates the degree of cleavage, providing an in vivo assessment of chymotrypsin activity. Fourteen dogs with EPI and five dogs with PID were categorized on the basis of clinical signs, laboratory evaluations, and histologic examination of intestinal biopsies. Six normal dogs served as controls. The bentiromide test clearly identified the dogs with EPI and distinguished them from the dogs with PID and the control dogs. The results of the bentiromide test correlated well with the results of the clinical and laboratory evaluations. On the basis of these observations and conclusions, recommendations for the pragmatic application of the bentiromide test are offered.
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PMID:Further evaluation of bentiromide in the diagnosis of canine exocrine pancreatic insufficiency. 387 51

Bentiromide is a synthetic peptide, N-benzoyl-L-tyrosyl-p-aminobenzoic acid, which has been used as a test for exocrine pancreatic function. Following oral administration, bentiromide is hydrolyzed by chymotrypsin to yield free p-aminobenzoic acid (PABA) which is absorbed, conjugated and excreted in the urine. The PABA conjugates reach their peak levels in blood in 90-120 min. Healthy individuals have higher levels of PABA than patients with pancreatic insufficiency. A simple, accurate, and precise method for the determination of PABA in blood has been developed and validated. The plasma (1 ml) is deproteinized by perchloric acid. The conjugates are hydrolyzed and the total PABA is determined colorimetrically by the Bratton-Marshall test. The standard curve in plasma is linear up to 8 micrograms/ml of PABA. A similar semimicro method using 200 microliter of plasma suitable for pediatric samples shows comparable results. Average analytical recovery is 97% and precision studies of pooled within-run and total between-run showed CV% of 5.0 and 5.7%, respectively.
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PMID:Colorimetric plasma assay for the bentiromide test (BT-PABA) for exocrine pancreatic insufficiency. 387 41

The indirect estimation of chymotrypsin by the tubeless ALTAB-test was performed in 17 patients with well-defined exocrine pancreatic insufficiency, 10 of them after operation for chronic pancreatitis. In comparison with 12 healthy subjects the test proved to be a non-expensive, certain and specific method for detection of moderate and severe exocrine insufficiency. It exists positive correlations with the secretin-pancreocymine-test and with the maximal stimulable secretion of insulin. Therefore the ALTAB-test after operations with modified anatomy of the gastro-intestinal tract especially is able to substitute extensive testing of secretion in screening and controlling of progression. The value of the 3-hour serum level of PABA corresponds to the urine output within 6 hours. There are such advantages like independence from the kidney-function, avoidance of incomplete urine-collection and a considerable reduced test-time too.
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PMID:[Modified ALTAB test in the diagnosis of exocrine pancreatic insufficiency]. 387 16

Total plasma amino acids were determined by the ninhydrin method in 37 controls and 30 patients with chronic pancreatitis and normal (n = 7) pancreatic enzyme output or mildly (n = 6), moderately (n = 8), and severely (n = 9) reduced pancreatic enzyme output. Intravenous injection of synthetic secretin did not change plasma amino acid levels. During a combined intravenous infusion of secretin (1 CU/kg X h) and pancreozymin (1 Ivy dog unit/kg X h), amino acid concentrations decreased maximally by 31% +/- 19% (mean +/- SD) in controls, but only by 6.3% +/- 4.7% in patients with exocrine pancreatic insufficiency (p less than 0.001 vs. controls). At a cutoff limit of less than or equal to 12% for the decrease in total amino acids, mild exocrine insufficiency (20%-40% of mean normal chymotrypsin output) was identified with a sensitivity of 67%, whereas moderately to severely impaired function was detected in every case (overall sensitivity 91%). Pancreatic function, as assessed by duodenal intubation and the tubeless amino acid test, was significantly correlated (e.g., rs = 0.73 for chymotrypsin output, p much less than 0.001). In 15 controls and 13 patients with mildly (n = 5) to severely impaired pancreatic function, individual amino acids were estimated. Plasma serine kinetics completely distinguished both groups. Kinetics of serine, valine, isoleucine, and histidine correlated even better with pancreatic function than those of total amino acids.
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PMID:Decrease in plasma amino acid level after secretin and pancreozymin as an indicator of exocrine pancreatic function. 394 4

Fecal chymotrypsin (FCT) was determined in stool specimens of healthy children and those with gastro-intestinal disease, by a new photometric method. The values are comparable with chymotrypsin concentrations found by pH-stat method. The new test is cheap, reliable and easy to perform. For this reasons and for the sensitivity of all tubeless pancreatic function tests (NBT-PABA, FDL, FCT) is rather low (60-70%), the FCT-test may be preferred as diagnostic marker for differential diagnosis of exocrine pancreatic insufficiency.
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PMID:[Determination of chymotrypsin in the feces by a new photometric method]. 403 16

The purpose of this report is to evaluate whether a new, simple, non-invasive method for chymotrypsin measurement in stools is useful for the diagnosis of exocrine pancreatic insufficiency in cystic fibrosis (CF). A hundred children aged from 2 months to 12 years were tested: 50 children had been admitted for chronic diarrhoea, 15 for cystic fibrosis and 40 acted as controls. Chymotrypsin in stools was assayed using a kinetic measurement with Succ-Ala-Ala-Pro-Phe-pNa as substrate in a simple photometric assay. In 13 of 15 children with cystic fibrosis, stool enzyme levels were always remarkably low, while all control subjects and all children not presenting cystic fibrosis had normal stool levels of chymotrypsin. Our data suggest that stool chymotrypsin measurement is a simple and reliable "tubeless" test for the evaluation of exocrine pancreatic insufficiency in children with cystic fibrosis.
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PMID:Fecal chymotrypsin: a new diagnostic test for exocrine pancreatic insufficiency in children with cystic fibrosis. 404 20

A new approach in the diagnosis of exocrine pancreatic insufficiency has been evaluated in animals. The method involves the oral administration of a chymotrypsin-labile peptide which contains p-aminobenzoic acid (PABA) as a tracer group. In the small bowel in the presence of chymotrypsin, the PABA is split from the peptide and is rapidly absorbed. The amount of PABA (as total aromatic amines) recovered in the urine during the six hours after the dose is used as an index of exocrine pancreatic function. The procedure has been shown to be reliable in detecting surgically induced pancreatic insufficiency in rats, swine, and dogs.
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PMID:Synthetic peptides in the diagnosis of exocrine pancreatic insufficiency in animals. 463 6

In many ways diagnosis of pancreatic disorders in children is difficult. Since pancreatic parameters are age-dependent, reliable laboratory parameters are not easily established. Children are less likely than adults to endure tolerance tests and invasive test methods should therefore be used only in special situations. Estimation of chymotrypsin in faeces seems to be an earlier indicator of pancreatic insufficiency than the PABA-peptide-test. A secretin-pancreozymin test can only be advised for first diagnosis after screening has repeatedly indicated pathological values and malabsorption has more or less been ruled out. A threefold rise in serum amylase values - matched for age - suggests pancreatitis and sonography should then be applied to obtain further clarification.
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PMID:[Diagnosis of pancreatic diseases in childhood (author's transl)]. 616 3

An investigation of fecal chymotrypsin activity on spot fecal specimens was carried out in three groups of subjects, divided as follows: 45 healthy controls (group C); 36 patients with gastroenterological diseases of extrapancreatic origin (group VP); and 42 patients with chronic pancreatitis (group CP). Nineteen patients of group CP underwent pancreozymin-secretin and NBT-PABA tests. The following results, expressed as mg of chymotrypsin/g of feces, were obtained: C = 0.610 +/- 0.203; CP = 0.291 +/- 0.154, p less than 0.001; VP = 0.560 +/- 0.234. FCT showed a sensitivity rate of 78.5% and a specificity rate of 71.6%. The fecal output of chymotrypsin correlated well with the pancreatic secretion of chymotrypsin (r = 0.59, p less than 0.01) and with the percentage of recovery of urinary PABA (r = 0.44, p less than 0.05). We conclude that chymotrypsin assay by the described method on spot stool specimens is a simple, reliable technique which may be considered a good screening test for pancreatic insufficiency. The test will not detect minimal pancreatic disease or minimal pancreatic dysfunction.
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PMID:A single-specimen fecal chymotrypsin test in the diagnosis of pancreatic insufficiency: correlation with secretin-cholecystokinin and NBT-PABA tests. 633 29

PABA test has proved to be an easy and reliable test for determination of exocrine pancreatic insufficiency. N-benzoyl-L-tyrosyl-p-aminobenzoic acid or 4-(N-acetyl-L-tyrosyl) aminobenzoic acid are split by action of chymotrypsin in the small intestine. N.O-diacetyl-L-tyrosyl-p-aminobenzoic acid is converted easy in vivo in 4(N-acetyl-L-tyrosyl) aminobenzoic acid. The amount of 4-aminobenzoic acid (PABA) in urine collected for 6-10 hours is used as an index of chymotrypsin production. The concentration of PABA (and aromatic amines) is estimated in urine by the Bratton and Marshall method. p-dimethylamino cinnamaldehyde is less useful for the determination of urinary PABA. 60 min are necessary as time for acid hydrolysis of conjugated PABA metabolites. False abnormal test results are found for instance in patients with inflammatory bowel diseases, small bowel resection, impaired liver function, anorexia nervosa, lambliasis or renal insufficiency. The PABA test appears in consideration of these restrictions to be an useful simple method in the assessment of exocrine pancreatic function.
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PMID:[The PABA test]. 633 4


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