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)

A new test using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (N-BT-PABA) for an evaluation of exocrine pancreatic function was compared with a pancreozymin-secretin test in 38 subjects. Urinary recovery of PABA, which is absorbed from the intestine and conjugated in the liver after an oral administration of N-BT-PABA, depends mainly on chymotrypsin activity. The recovery rate of PABA in urine decreases in chronic pancreatitis, in which chymotrypsin activity in the duodenal juice is disturbed. The recovery rate of PABA in calcifying chronic pancreatitis was 40.2 +/- 15% and significantly less than 81.2 +/- 7.4% in normal subjects (P less than 0.01). The amount of PABA in urine during eight hours was correlated with parameters of volume output- bicarbonate concentration and amylase output stimulated by injections of pancreozymin and secretin (P-S test). The new test using N-BT-PABA is useful for the evaluation of exocrine pancreatic function in general practice.
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PMID:Oral administration of chymotrypsin labile peptide for a new test of exocrine pancreatic function (PET) in comparison and pancreozymin-secretin test. 30 13

32 patients with proven chronic pancreatitis and 56 controls without evidence of pancreatic disease were studied by the PABA test, the fecal chymotrypsin method and the fecal fat method. The sensitivity of the fecal chymotrypsin method for detection of pancreatic disease was significantly higher (p less than 0.005). The sensitivity of the PABA test and the fecal fat method were comparable. The specificity of the PABA test and the fecal chymotrypsin method was of the same order.
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PMID:[PABA test versus chymotrypsin and fat determinations in the stool in pancreatic functional diagnosis]. 31 46

To evaluate the predictive value of the evocative test (E.T.) in the diagnosis of pancreatitis, the E.T. was performed in 35 healthy subjects (group I), 65 patients with a presumptive clinical of chronic pancreatitis (group II), and 52 patients with proved chronic pancreatitis (group III). In group I, false positive results were obtained in 11,4% of the patients, the increase in lipase above the upper limit of normal was relatively small. The patients of group II gave abnormal E.T.'s in 63%, reduced faecal chymotrypsin activities being found in 40%, and steatorrhea in 28% of the cases. Positive E.T.'s were associated with abnormal chymotrypsin and faecal fat determinations in 51% and 27%, respectively. In group III,, a positive E.T. was obtained in 60%, the test results show a signifikant negative correlation with the extent of pancreatic exocrine insufficiency. In group of patients with confirmed chronic pancreatitis but without steatorhea, the E.T. was positive in 72%. The E.T. has a limited value in the diagnosis of early stages of chronic pancreatitis.
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PMID:[The significance of the evocative test in the diagnosis of chronic pancreatitis (author's transl)]. 67 58

The pancreatic exocrine secretory response to different combinations of the pancreozymin-like peptide caerulein and secretin was studied in 110 healthy control subjects and 32 patients with pancreatic disease. A combination of 0-5 CU/kg-h secretin and 75 ng/kg-h caerulein provided maximal or near-maximal stimulation of the secretion of both bicarbonate and pancreatic enzymes. The combination of stimulant peptides in the above doses was found to give excellent separation between the secretion of bicarbonate, lipase, and chymotrypsin of the control group and patients with chronic pancreatitis. A combination of caerulein and secretin represents a safe, reliable, and effective mean of stimulating pancreatic exocrine secretion for the purpose of testing pancreatic function.
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PMID:Use of caerulein with submaximal doses of secretin as a test of pancreatic function in man. 95 98

The chymotrypsin in the stool test was used to monitor adequate enzymatic substitution in treating exocrine pancreatic insufficiency with 18 patients (16 suffering from chronic pancreatitis and 2 having passed duodenopancreatectomy due to pancreatic cancer). This test helps to identify pancreatic insufficiency and can be successfully used in monitoring the adequate amount of pancreatic substitute, which, we have found, differs from patient to patient. The dosage can be higher in cases of chronic pancreatitis than in those required after duodenopancreatectomy.
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PMID:Adequate enzymatic substitution in treating exocrine pancreatic insufficiency. 136 80

187 patients were checked up over 4 years by the secretin-ceruletide test. Independently of the test results they were assigned to various disease groups on the basis of clinical assessment. 131 subjects were divided in a pilot investigation into: subjects with a healthy pancreas (n = 55); subjects with chronic pancreatitis (n = 50); subjects whose pancreatic condition could not be classified clearly (n = 26). 8 parameters were compared by univariate and multivariate statistical procedures in order to confirm or rule out the presence of chronic pancreatitis. The discriminatory power of the following parameters in duodenal fluid proved to be sufficiently high, with less than 15% frequency of misclassification: chymotrypsin (activity) and/or; lipase (activity) and/or; amylase (activity); viscosity. Under routine conditions measurement of the activity of two of these enzymes is sufficient. Their contribution to discrimination proved to be approximately equal. The diagnostic sensitivity and specificity of the parameters bicarbonate, lipase (concentration), trypsin (activity) and volume of duodenal fluid are lower. The classification rules derived from the above pilot group were confirmed by a diagnostic study under routine condition in a test group of 38 patients. Limitation to examining only volume and a maximum of 3 parameters which proved best in distinguishing between patients with chronic pancreatitis and healthy subjects, together with the omission of the first-hour samples after a secretin bolus, considerably reduced laboratory workload without altering the discriminatory power of the secretin-ceruletide test.
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PMID:[Diagnosis of chronic pancreatitis. Studies of duodenal juice after stimulation with the secretin-ceruletide test. Decision limits and evaluation of various parameters]. 137 50

Economic function of the exocrine pancreas is based on non-parallel synthesis, transport and secretion of pancreatic enzymes during basal state and postprandially. Reserve capacity of acinar cells is also augmented by adaptation to the diet as well as by regeneration. In mild pancreatic insufficiency complex dietetic considerations help to maintain the necessary secretory capacity of the pancreas. In severe cases effective substitution therapy is mandatory and increasing lipase survival by dietetic maneuvers, by optimizing trypsin and chymotrypsin levels as well as acid and bile secretion can significantly ameliorate results of replacement therapy of steatorrhea. However, in painful chronic pancreatitis high protease activities seem to be beneficial. Individual replacement therapy with pancreatin preparations adapted to the requirements of the patient has to be chosen in difficult cases.
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PMID:[New trends in the treatment of exocrine pancreas deficiency]. 143 12

The aim of the present study was to evaluate in 56 patients (48 M, 8 F) with chronic pancreatitis: a) the diagnostic validity of fecal chymotrypsin (FCT) assay, performed both on random samples and from previously homogenized samples collected over 3 days; b) the correlation between chymotrypsin and fecal fat excretion. CTF was measured using Kaspar's colorimetric method and fecal fats using the Van de Kamer method. Mean values of chymotrypsin measured on random samples were very similar to those measured on previously homogenized feces, 17.9 +/- 16.7 U/g vs 17.1 +/- 15.3 U/g respectively. There was a highly significant correlation between these values (r = 0.77 p less than 0.0003) and a highly significant inverse correlation between fecal fat and chymotrypsin excretion, both when the latter was measured on random and on previously homogenized samples (p less than 0.0001). FCT assay was fairly good sensitive (54%) for the whole group of patients with chronic pancreatitis, but very good (91%) for the group of patients with steatorrhea. The results show that the fecal chymotrypsin assay on random fecal samples is as valid as that carried out on homogenized feces and that there is a good correlation between fecal chymotrypsin values and steatorrhea of pancreatic origin.
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PMID:[Fecal chymotrypsin and steatorrhea in chronic pancreatitis]. 152 Jul 49

Immunoreactive lipase (IRL) was measured in 368 stool samples from 231 individuals by means of a new enzyme-linked immunoabsorbent assay technic, to test its validity as an indicator of exocrine pancreatic insufficiency. Ninety-seven stool samples from 64 healthy volunteers showed a logarithmically normal distribution of IRL values and a median IRL concentration of 17 micrograms/g (range, 2.75-117.3 micrograms/g) with a statistically calculated lower normal limit of 4 micrograms/g. In 100 stool samples from patients with chronic pancreatitis and proven steatorrhea the median IRL concentration of 6 micrograms/g (range, 0.002-107 micrograms/g) was significantly lower than that of normal controls and of 52 stool samples from patients with chronic pancreatitis without steatorrhea (IRL, 40 micrograms/g; range, 0.55-302 micrograms/g), 45 stool samples from 23 patients with celiac disease (IRL, 96 micrograms/g; range, 6.05-563 micrograms/g), and 30 stool samples from 26 patients with chronic diarrhea (IRL, 57 micrograms/g; range, 4.2-573 micrograms/g). It is concluded that fecal IRL is a promising new enzyme test with low diagnostic sensitivity (34%) but excellent diagnostic specificity (98%) in chronic pancreatitis and for diagnostic study of chronic diarrheal disorders. In contrast to fecal chymotrypsin, the test results are unaffected by pancreatic enzyme replacement therapy.
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PMID:Fecal immunoreactive lipase: a new tubeless pancreatic function test. 158 7

In patients exhibiting chronic alcohol abuse, the accumulation of fat droplets in pancreatic acinar cells, as well as changes in pancreatic secretion, can be interpreted as early signs of pancreatic damage. Using rats, (the animals were fed for 9 +/- 1 months with a solution of 20% v/v ethanol, combined with either a normal or a fat enhanced diet) we tested whether or not these symptoms are related both to each other and to morphological lesions of the tissue. Based on six separate histological criteria, the lesions were classified into five stages of severity. In order to characterize the secretory capacity of the pancreas, we measured the outputs of lipase, alpha-amylase, trypsin, chymotrypsin, carboxypeptidase A, elastase, and phospholipase A. Compared with the control group, we found that the alcohol-fed animals exhibited a significantly higher degree of morphological damage to the pancreas, as well as an increased frequency of fat accumulation in the acinar cells, and, with the exception of alpha-amylase, a rise in the level of enzyme secretion. In the animals exhibiting the highest degree of tissue damage, however, both fat accumulation and hypersecretion appeared to be diminished. This diminution could possibly be interpreted as the first sign of chronic pancreatitis. Increased consumption of fat did not change either the level of fat accumulation in the acinar cells, or the level of pancreatic secretion. Within the group of alcohol-fed rats, the most pronounced levels of hypersection were found in animals exhibiting cellular fat accumulation. However, the secretion levels of the alcohol-fed animals exhibiting no such fat accumulation did not differ significantly from that of the control group. Therefore, a relationship appears to exist in rats between fat accumulation in acinar cells and the level of pancreatic secretion.
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PMID:[Correlation between acinar cell fat accumulation and secretory capacity of the rat pancreas in the early stage of alcohol-induced pancreatopathy]. 163 69


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