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:3.4.21.4 (trypsin)
42,187 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A modified secretin-pancreozymin test was performed for the quantitative determination of both the pancreatic exocrine function and the biliary secretion of total bile acids followed by exogenous (secretin and pancreozymin) and endogenous (L-phenylalanine) stimulation of the pancreatic and biliary secretion. The outputs of lipase, alpha-amylase, trypsin, bicarbonate and total bile acids were estimated and the ratio of glycine to taurine conjugated bile acids was measured by thin layer chromatography. Polyethylene glycol 4,000 was used as a nonabsorbable marker for the correction of aspirated volumes. 40 patients were studied: 10 control subjects; 10 control subjects with previous cholecystectomy; 10 patients with chronic pancreatitis and 10 cholecystectomized patients with chronic pancreatitis. In cholecystectomized probands, not only the total bile acid output but also the output of bicarbonate, trypsin and lipase were diminished compared to the control subjects with a intact gallbladder. In noncholecystectomized and cholecystectomized patients with chronic pancreatitis both, the pancreatic secretion and the biliary bile acid secretion were significantly decreased. The ratio of glycine/taurine conjugated bile acids was found to be significantly higher in these patients compared to the controls.
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PMID:[Secretin-pancreozymin test with volume correction in the functional diagnosis of pancreatobiliary secretion]. 343 86

We evaluated the behavior of serum cationic trypsinogen (SCT), an enzyme of solely pancreatic origin, in 30 patients with chronic pancreatitis and 25 healthy subjects as a control, after secretin and bombesin stimulation. After both the stimulations, serum cationic trypsinogen is unable to distinguish between the healthy control subjects and the patients with chronic pancreatitis. On the other hand, after secretin, the enzyme is able to separate chronic pancreatitis patients with different levels of exocrine function insufficiency. It does so with a greater statistical significance than that obtained by the rapid injection of bombesin and equal to that of trypsin into the duodenal juice during duodenal intubation. For these reasons, as well as the absence of any side-effects, secretin is preferred to bombesin stimulation in the evaluation of the exocrine pancreatic function in patients with chronic pancreatitis.
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PMID:Different responses of serum cationic trypsinogen to secretin and bombesin in normal subjects and patients with chronic alcoholic pancreatitis. 343 9

The present investigation provides follow-up data (up to 36 months) of exocrine and endocrine pancreatic function, inflammatory activity, pain, and body weight in 23 chronic pancreatitis patients submitted to Whipple's procedure plus intraoperative Ethibloc occlusion of the remaining pancreatic duct system between January 1983 and February 1984. Clinically, Whipple's procedure plus intraoperative pancreatic duct occlusion resulted in almost complete and continuous cessation of pain as well as significant (p less than 0.05) increase in body weight. With regard to exocrine pancreatic function (Secretin-Pancreozymin test, plasma amino acid consumption test, Pankreolauryl test, fecal chymotrypsin determination), intraoperative pancreatic duct occlusion was shown to induce high-grade insufficiency and thus exocrine parenchymal atrophy in all patients. Simultaneously, the inflammatory process (represented by serum levels of trypsin, lipase, and pancreatic isoamylase) was terminated in all 23 patients. Endocrine pancreatic function, evaluated by serum levels of insulin and C-peptide measured under fasting conditions and subsequent maximal combined beta-cell stimulation as well as corresponding integrated hormone releases, was reduced by partial pancreas resection by about 50%, while there was no further impairment during the 36-month follow-up period in consequence of additional intraoperative pancreatic duct occlusion. Altogether, Whipple's procedure plus intraoperative Ethibloc occlusion of the residual pancreatic duct system seems suitable for termination of the inflammatory process and thus preservation of residual endocrine pancreatic function in chronic pancreatitis.
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PMID:Whipple's procedure plus intraoperative pancreatic duct occlusion for severe chronic pancreatitis: clinical, exocrine, and endocrine consequences during a 3-year follow-up. 343 10

The data of clinical, laboratory-biochemical and immunological investigations conducted in 75 patients with chronic pancreatitis have been analyzed. The patients who received diet therapy were investigated under clinical conditions and during dispensary follow-up (6-9 months after the discharge from the clinic). The ration, sparing mechanically and chemically the digestive organs, included on an average 120 g protein, 85 g fat and 350 g carbohydrates. The main clinical symptoms of the disease diminished under the influence of the diet therapy. Improvement of the pancreas function was recorded in the absolute majority of the patients (normalization of activity of proteolytic enzymes assayed in the blood serum: trypsin, trypsin-inhibitor, amylase, lipase). Favourable changes were also observed in immunological parameters. When the patients followed the dietetic recommendations at home, the positive effect of the diet therapy was enhanced. A conclusion has been made that patients with chronic pancreatitis should be given diet therapy not only under clinical but also under dispensary conditions, thus inhibiting the disease progressing.
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PMID:[Effects of diet therapy on the course of chronic pancreatitis: ambulatory follow-up data]. 343 66

The effect on intraluminal postprandial concentrations of different pancreatic enzymes and on fat absorption were studied in 35 patients with advanced chronic pancreatitis with pancreatic insufficiency. Different regimes were studied: commercial Pankreatin (III) alone or in combination with Cimetidine, Pancrease, dispensed in microspheres, and commercial Pankreatin III compared to an equivalent uncoated preparation (Pankreatin I). Pankreatin induced significant increase in the intestinal concentration of amylase, lipase, and trypsin. Pretreatment with Cimetidine did not increase the enzyme concentrations further. The amount of enzymes in Pancrease capsules are rather small, no effect on concentrations of enzymes could be detected but treatment with Pancrease decreased significantly the fat excretion in faeces. The uncoated Pankreatin I induced a significantly higher increase in enzyme concentrations in the intestine compared to Pankreatin III but the overall effect tested on faecal fat excretion was identical with the two preparations. The results indicate that the estimation of concentration of enzyme at one level of the small intestine without and with enzyme substitution not necessarily gives information on the therapeutical effect of the enzymes.
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PMID:Exocrine pancreatic substitution: facts and controversies. 347 Sep 19

In patients with chronic pancreatitis, the development of exocrine pancreatic failure is generally thought to be an irreversible process. We found evidence to the contrary in a prospective study of 70 patients who were evaluated by endoscopic retrograde cholangiopancreatography and sequential measurements of stool fat, percent urinary PABA excretion, and serum trypsin during a follow-up time period of 1-4 yr. Initial p-aminobenzoic acid (PABA) testing showed exocrine failure in 51 patients, 35 of whom had low serum trypsin levels while 14 (27%) disclosed unexpectedly high trypsin concentrations. Ductal morphology was similar in patients with low and high trypsin values. In 8 of the latter cases, steatorrhea improved and pancreatic function tests became normal after pancreaticojejunostomy in 4 patients, alcohol abstinence in 3 patients, and spontaneous resolution of a pseudocyst in 1 patient. Pancreatic cancer was present in a further 3 patients. Of the 37 patients with low PABA and low trypsin at the outset, there was no improvement of exocrine function in 17 of 18 who were surgically treated. Conservative treatment had a similar effect in another 6 patients who were available for follow-up in this group. The mean duration of symptomatic disease was shorter (p less than 0.001) in patients with low PABA and high trypsin levels (1.4 +/- 1.2 yr) than in those with low PABA and low trypsin levels (4.5 +/- 1.3 yr). The results show that up to 20% of patients with chronic pancreatitis have exocrine pancreatic failure, which is apparently due to early ductal obstruction of a gland with preserved function; this situation can be suspected when low urinary PABA excretion and high serum trypsin levels are simultaneously found; and (c) exocrine failure may be reversible in these patients by using a pancreatic drainage procedure or alcohol abstinence. Such a peculiar pattern of pancreatic function tests may also suggest pancreatic cancer.
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PMID:Reversibility of exocrine pancreatic failure in chronic pancreatitis. 348 91

Plasma concentrations of cholecystokinin (CCK) have been reported to be elevated in patients with chronic pancreatitis. The elevations are suggested to be due to increased release of CCK from the upper small intestine secondary to the absence of protease activity (trypsin and chymotrypsin) in the intestinal lumen. We have studied plasma CCK levels before and after liquid as well as solid meals in eight patients with pancreatic insufficiency due to advanced chronic pancreatitis and in eight healthy controls. CCK concentrations were measured with a sensitive and specific radioimmunoassay using an antibody directed against the sulfated tyrosyl region of CCK. No differences in basal or maximal postprandial plasma CCK levels between patients and controls were observed. In the liquid meal study, basal CCK concentrations in patients and controls were 2.2 +/- 0.7 and 2.5 +/- 0.4 pM, respectively, with maximal postprandial concentrations of 9.6 +/- 2.2 and 11.2 +/- 1.4 pM. In the solid meal study, basal CCK concentrations in patients and controls were 2.5 +/- 0.6 and 2.6 +/- 0.4 pM, respectively, with maximal postprandial concentrations of 9.4 +/- 1.6 and 8.6 +/- 1.4 pM. The only difference observed was a significantly longer time interval to maximal plasma CCK levels in patients as compared with controls after the liquid meal. Two patients with no detectable trypsin activity in the small intestinal lumen during a Lundh test meal had basal CCK levels of 1.3 and 1.8 pM. Thus, the present study does not support the hypothesis that trypsin is involved in the regulation of CCK release.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma cholecystokinin concentrations in patients with advanced chronic pancreatitis. 356 43

Serum elastase 1 was determined in the serum of 38 patients with acute pancreatitis, using specific radioimmunoassay technique. Serving as controls were 36 healthy people, 33 patients with chronic pancreatitis, 49 patients with various GI-tract diseases, and 6 patients with pancreatic carcinoma. Sensitivity of elastase 1 for the diagnosis "acute pancreatitis" was 97% after admission to the hospital and 100% within 48 h after onset of acute pancreatitis. The determination of elastase 1 is clearly superior to that of trypsin, pancreatic lipase, or pancreatic amylase, if diagnosis has to be made more than 48 h after the onset of the disease. The specificity is restricted, because there are some cases with chronic pancreatitis and GI-diseases with raised values. There is no possibility to estimate the severity of acute pancreatitis by measuring serum elastase 1.
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PMID:Diagnostic and prognostic value of serum elastase 1 in acute pancreatitis. 364 49

The intraluminal transport of cobalamin (Cbl) remains controversial in chronic pancreatitis. We have determined the ability of intestinal juice to degrade the digestive holohaptocorrin (R binder) and the binding of endogenous Cbl in basal intestinal juice from 22 chronic pancreatitis patients and 22 controls. The intestinal juice from patients and controls degraded 34.7 +/- 32.3% and 95.2 +/- 7.2% of holohaptocorrin, respectively. This percentage was correlated with the trypsin output but not with the Schilling test. The unsaturated Cbl-binding capacity was similar in both groups. Respectively, 62.5 +/- 26.6% and 19.6 +/- 11.7% of endogenous Cbl was bound to haptocorrin in intestinal juice from patients and controls. These percentages were correlated with the Schilling test and with the ability of intestinal juice to degrade haptocorrin. We concluded that 1) the sequestration of Cbl to haptocorrin is one of the factors responsible for the malabsorption of crystalline Cbl in patients with chronic pancreatitis and 2) enterohepatic circulation of Cbl can be interrupted in some cases of chronic pancreatitis.
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PMID:In vitro and in vivo evidences that the malabsorption of cobalamin is related to its binding on haptocorrin (R binder) in chronic pancreatitis. 372 64

Different materials dissolved in 0.9% NaCl were injected into the connective, interlobular tissue of the duodenal part of the rat pancreas. Activated rat pancreatic juice or trypsin were able to induce localized necrohemorrhagic pancreatitis. Only mild edema and leukocytic infiltration were observed after injecting bovine albumin, chinese ink, trypsinogen or nonactivated pancreatic juice. The progression of histological changes was followed for 2 weeks in the trypsin-induced pancreatitis. Limited foci of severe hemorrhage, liquefaction and coagulative necrosis were observed in the first 24 h. Acinar cell degeneration and regeneration were observed 48 h after the operation, fibroblasts appearing in the interlobular spaces. Four days after injection, inter- and intralobular fibrosis, acinar cell degeneration and tubular complexes were observed, presenting a picture characteristic of chronic pancreatitis. Some minimal changes were still seen in the pancreas 1 week after injection, but by the end of the 2nd week the pancreatic histology was normal. These results demonstrate the significance of active trypsin in the pancreatic interstitium with respect to the induction of pancreatitis. This model of localized necrohemorrhagic pancreatitis is highly reproducible and without significant mortality. Following the acute process, histological changes resembling chronic pancreatitis can be observed, but they are completely reversible.
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PMID:Localized necrohemorrhagic pancreatitis in the rat after pancreatic interstitial trypsin injection. Regressive pseudochronic lesions. 373 40


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