Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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 NBT-PABA test, an oral pancreatic function test, was performed in 67 patients with proven chronic pancreatitis (secretin pancreozymin test or intraoperatively) and was pathological in 60 (89.6%). Prolongation of urinary collection period from 6 to 9 hours did not improve the diagnostic value. In comparison with the NBT-PABA test the sensitivity of trypsin and chymotrypsin determination in stool was 40.6% and 62.2%, respectively. In severe exocrine pancreatic insufficiency when pathological fecal fat excretion was demonstrable (steathorrhea) the accuracy of fecal enzyme determination was clearly higher (59.1% and 91.8%, respectively). Thus the NBT-PABA test is an alternative diagnostic tool for exocrine pancreatic insufficiency when the secretin-pancreozymin test, and fecal enzyme and fecal fat determination are too complicated. However, as intact absorption of NBT-PABA is possible, the test only provides a qualitative and limited quantitative evaluation of pancreatic function.
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PMID:[The NBT-PABA test in the diagnosis of exocrine pancreatic insufficiency (author's transl)]. 696 54

The efficacy of pancreatin in vivo was determined in 14 patients with advanced pancreatic insufficiency using a peroral test with 2 g of chymotrypsin substrate, 4-(N-acetyl-L-tyrosyl)aminobenzoic acid, the Lundh test meal and 1000 ml tea. Chymotrypsin hydrolysis was quantified by 4-aminobenzoic acid excreted in 6-hr or 8-hr urine samples. After a control test without pancreatin, one or two tablets of Panpur (Nordmark-700 mg of pancreatin and 50 mg of bile per tablet) were applied simultaneously with the Lundh meal on repeated examinations. The urinary excretion of 4-aminobenzoic acid was restored to normal values in 5 subjects during both sampling periods. With this method, stimulated and substituted chymotrypsin is measured at the same time. The conditions of the tests, both with and without pancreatin replacement, are fully comparable and thus the significance of factors modifying the activity of enzymic components in the digestive tube is limited. The method appears appropriate for the institution of an effect pancreatin therapy and its control in vivo.
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PMID:A new method of testing pancreatin therapy in vivo by the use of a peroral chymotrypsin substrate 4-(N-acetyl-L-tyrosyl)aminobenzoic acid. 697 Jan 59

In 25 patients with chronic exocrine pancreatic insufficiency and 37 controls, the PABA test was compared with the concentration of chymotrypsin in stool. In additional 16 patients the test could not be evaluated (rate 21%). By determination of the PABA levels in serum before and one hour after ingestion of N-benzoyl-L-tyrosyl-PABA the test can be shortened and simplified: 1 hour serum levels in 9 patients with exocrine pancreatic insufficiency were 0.5 +/- 0.5 nMol/ml compared with 8 controls with 6.4 +/- 2.0 nMol/ml. PABA serum levels correlated significantly with chymotrypsin in stool. Compared with the conventional PABA test, since it is easily applicable in outpatients and the results are not influenced by medication or food.
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PMID:[Serum paraaminobenzoic acid following the use of N-benzoyl-L-tyrosyl-paraaminobenzoic acid in the diagnosis of pancreatic insufficiency]. 697 91

Exocrine pancreatic insufficiency in the dog has been assessed by the oral administration of the synthetic peptide N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA), a specific substrate for pancreatic chymotrypsin. The subsequent assay of PABA in either the plasma or the urine clearly differentiated control animals from those with exocrine pancreatic insufficiency (EPI), the results being unaffected by combination of this pancreatic function with a xylose absorption test. Possible interference with the specificity of the peptide test for the diagnosis of EPI was examined in six animals with small intestinal disease. In a group of four animals, with features resembling chronic tropical sprue in man, the results were comparable to those of the control group. In the fifth case, however, the results were indistinguishable from those of the EPI group, the estimation of sodium PABA absorption and the assay of proteolytic activity in the duodenal juice demonstrating that this was due to defective hydrolysis of the peptide. In the sixth case, diffuse intestinal lymphosarcoma and a marked villous atrophy were associated with an apparent reduction in the absorption of sodium PABA. However, although the plasma PABA concentrations following oral BT-PABA were subnormal, they were distinctly higher than those of the EPI group. These findings suggest that small intestinal abnormalities do not affect PABA absorption sufficiently to interfere with the specificity of the peptide test for the detection of severe EPI in the dog. This insufficiency may occasionally be secondary to small intestinal disease.
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PMID:Specificity of the BT-PABA test for the diagnosis of exocrine pancreatic insufficiency in the dog. 697 20

The validity of oral pancreatic function tests (fluoresceine dilaurate-[FDL-], N-benzoyl-L-tyrosyl-para-amino-benzoic-acid-[PABA-]test) was assessed intra-individually in 67 patients in comparison with the secretin-pancreozymin test corrected for volume loss. Faecal chymotrypsin (CH-F) estimation was included in the comparison. According to the result of the secretin-pancreozymin test, patients were divided into those with normal pancreatic function (n = 28), those with borderline restricted function (n = 18), and those with manifest exocrine insufficiency (n = 21). Results show that in borderline decreased pancreatic function the diagnostic value of all screening tests is limited. The sensitivity (true pathological results) was 38% in the FDL-test, 40% in the PABA-test, and 31% in CH-F. In manifest exocrine pancreatic insufficiency FDL- and PABA-test as well as CH-F showed similar sensitivity of 67, 63, and 62%, respectively. Results show that oral pancreatic function tests, particularly the simple FDL-test, represent a diagnostic alternative to the relatively complicated CH-F assessment. However, none of the tests are able to replace the secretin-pancreozymin test as the most valid diagnostic investigation.
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PMID:[Screening of exocrine pancreatic function (author's transl)]. 697 59

The comparative sensitivity of 4 tubeless pancreatic function tests was evaluated in 125 patients with proved chronic pancreatitis associated with various degrees of pancreatic insufficiency. NBT-PABA, immunoreactive trypsin (IRT), and pancreatic isoamylase (P-iso) were studied in relation to the fecal chymotrypsin test (FCT) and steatorrhea. In advanced insufficiency (steatorrhea or FCT less than 20 micrograms/g) PABA, IRT, and P-iso were pathologically low in only 70-85% of patients. In less severe pancreatic insufficiency (FCT 21-120 micrograms/g) these tests yielded pathological results in 35-53% of patients. Thus the sensitivity of the three tests was comparable and rather low. IRT values (and P-iso) were constantly low or progressively decreasing in 64% of patients (30/47) studied repeatedly over an average of 17 months. The serum enzyme tests seem, therefore, to be valuable for monitoring pancreatic insufficiency, like the FCT. This is particularly important for the differential diagnosis of acute (reversible) and chronic (progressive) pancreatitis.
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PMID:Comparative diagnostic accuracy of four tubeless pancreatic function tests in chronic pancreatitis. 698 71

1. Hydrolysis of N-benzoyl-L-tyrosyl-p-aminobenzoic acid (PABA-peptide) has been measured in soluble and particulate fractions of human small intestinal mucosa. 2. Both soluble and particulate fractions contained enzymic activity capable of splitting the PABA-peptide. In the particulate fractions this activity increased threefold towards the distal small intestine. 3. Neither soluble nor particulate activity was inhibited by the chymotrypsin inhibitor 1-chloro-4-phenyl-3-L-toluene-p-sulphonamidobutan-2-one (TPCK). 4. Column chromatography on Sephacryl S-300 resolved a peak of PABA-peptide hydrolase activity that was clearly distinct from other known brush-border peptide hydrolases and from added chymotrypsin standard. 5. This PABA-peptide hydrolase thus represents a distinct intestinal enzyme, possibly bound to the brush-border membrane, which could account for the residual urinary PABA recovery observed in patients and animal models with exocrine pancreatic insufficiency.
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PMID:Non-pancreatic hydrolysis of N-benzoyl-l-tyrosyl-p-aminobenzoic acid (PABA-peptide) in the human small intestine. 704 81

In 72 patients with chronic pancreatitis results of tbe secretin-cholecystokinin test were compared with those of several indirect test of pancreatic function (faecal fat content, chymotrypsin activity in faeces, peptide-PABA test, fluorescein-dilaurate test and weight of faeces). In 46 patients with markedly impaired pancreatic secretion the indirect tests were abnormal in 56-83% of cases. In 26 patients with normal or upper-limit-of-normal excretory function the same tests were abnormal in 15-77%. These results indicate that indirect tests of pancreatic function are of only limited value in the early diagnosis of pancreatic insufficiency.
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PMID:[Excretory pancreatic function: comparison of indirect function tests with the secretin-cholecystokinin test]. 714 May 56

A patient with the clinical syndrome of cystic fibrosis characterized by chronic pulmonary disease, infection with mucoid Pseudomonas aeruginosa, sinusitis, nasal polyposis, abnormal pancreatic bicarbonate response to secretin stimulation, but normal levels of trypsin and chymotrypsin in the duodenal drainage, and a sibling with autopsy-documented cystic fibrosis, is described. Sweat chloride ranged from 20 to 44 meq/liter and sweat sodium from 36 to 55 meq/liter. Immunoglobulin deficiency, alpha 1-antitrypsin deficiency, tuberculosis and abnormalities of ciliary ultrastructure were excluded. Review of sweat electrolytes in 213 patients with cystic fibrosis revealed that patients with normal pancreatic enzyme release have significantly lower sweat sodium and chloride concentrations (p < 0.0005) than do patients with pancreatic insufficiency. Chronic pulmonary disease, pancreatic insufficiency and elevated levels of sweat electrolytes comprise the classic diagnostic triad for cystic fibrosis. The expression of these features may be variable, but the sweat test remains the cardinal laboratory confirmation of the diagnosis. Over 98 percent of patients with cystic fibrosis have sweat chloride values greater than 60 meq/liter, 1 to 2 percent between 50 and 60 meq/liter, and only about one in 1,000, like our patient, less than 50 meq/liter. Patients with cystic fibrosis with borderline sweat chloride values frequently have chronic pulmonary disease but intact pancreatic enzyme release. In such patients, family history, ancillary clinical features and systemic exclusion of other syndromes assume special diagnostic importance.
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PMID:Low sweat electrolytes in a patient with cystic fibrosis. 742 54

Forty-eight patients with chronic recurrent pancreatitis treated by resection of the head of the pancreas were restudied more than a year post-operatively. In addition to general features such as symptoms, alcohol consumption and work ability, faecal weight, its fat content, fat and fatty acid balance and faecal chymotrypsin were measured. According to the patients' own estimate, late results were good or very good in 70-90%. Faecal fat content and balance indicated high-grade exocrine pancreatic insufficiency in 80 and 90%, respectively. But it was easily controlled by drugs. In a third of the cases there was the need to supplement the diet with medium-chain triglycerides. Its components are satisfactorily absorbed even when the fat utilisation is severely abnormal.
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PMID:[Digestive function of the residual pancreas after partial duodenopancreatectomy for chronic pancreatitis (author's transl)]. 747 13


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