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 specific and sensitive radioimmunoassay (R.I.A.) has been developed which makes possible the determination of serum or plasma trypsin concentrations despite the presence of trypsin inhibitors, which have invaldiated previously available enzymatic techniques. The assay was most precise at about 300 microng trypsin standard Ag5 per litre of serum, a value comparable with the mean in 76 healthy volunteers (273 microng/1) and in 20 hospital patients with non-pancreatic disease (266 microng/1). Markedly raised concentrations (970-6500 microng/1) were found in all 14 patients with acute pancreatitis and in 8 patients with chronic renal failure (580-1360 microng/1). Abnormal concentrations were found in 11 of 16 patients (69%) with pancreatic cancer (8 high, 3 low) and in 15 of 23 patients (65%) with chronic pancreatitis (3 high, 12 low). Patients with jaundice had normal or marginally lower than normal concentrations unless pancreatic disease or common-duct gallstones were present.
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PMID:Diagnostic importance of changes in circulating concentrations of immunoreactive trypsin. 6 50

Acid hydrolases (lysosomal enzymes) were analyzed and compared with trypsin in duodenal juice obtained after a test meal (Lundh test). The possible diagnostic role of acid hydrolases in pancreatic disease was investigated. In all patients with chronic pancreatitis normal values of acid hydrolases but subnormal trypsin activities were found. In pancreatic cancer normal values of acid hydrolases and normal trypsin values were seen in three patients with small tumors, whereas five patients with more advanced cancer of the pancreas had decreased trypsin activity and three of them high activities of acid hydrolases in duodenal juice. In five patients operated on with a gastroenteroanastomosis acid hydrolases were markedly increased. Five patients had no activity of acid hydrolases in the aspirate, probably reflecting technical failure with dislodgement of the catheter from the duodenum to the stomach. In conclusion the assay of acid hydrolases does not seem to increase the diagnostic value of the conventional Lundh test (trypsin).
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PMID:Intestinal lysosomal enzymes in the diagnosis of pancreatic disease. 11 5

Precise relationships between pancreatic ductal obstruction and pancreatic secretory capacity have not been established. In this study, we describe the quantitative relationships between the lengths of opacified ducts obtained at retrograde pancreatography and the secretory capcity of the gland for volume, bicarbonate, lipase, and trypsin. Forty-five patients (17 with pancreatic cancer, 6 pancreatitis, 5 other malignancies, and 17 nonmalignant, nonpancreatic disease found at laparotomy) were studied with a method of duodenal intubation and perfusion with basal saline perfusion alone or with continuous intravenous infusion of secretin or of cholecystokinin-pancreozymin. Secretory outputs of volume, bicarbonate, and enzymes compared with the length of opacified ducts showed a significant (P less than 0.05) linear relationship for patients with pancreatic cancer, pancreatitis, and other cancers. The resulting data imply that obstruction of the pancreatic duct is important in decreasing secretion of the pancreas in pancreatic disease. The relationship between obstruction and pancreatic secretion demonstrates that a decrease in exocrine pancreatic secretion cannot be detected until more than 60% of the total length of the main pancreatic duct has been obstructed.
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PMID:The relationships between pancreatic ductal obstruction and pancreatic secretion in man. 43 Nov 21

Levels of immunoreactive trypsin were measured in pure pancreatic juice obtained endoscopically from 44 patients with suspected pancreatic disease. Patients with pancreatic cancer all had low trypsin concentrations (median 3.6 micrograms/ml, range 0.6--12.0), but those with chronic pancreatitis had very variable levels (median 14.2 micrograms/ml, range 3.2--76.8), showing a considerable overlap with patients without pancreatic disease (median 37.1 micrograms/ml, range 10.4--66.0). When levels of lactoferrin in pancreatic juice were measured, all patients with chronic pancreatitis were found to have much higher levels (all greater than 900 ng/ml) than control subjects or patients with pancreatic cancer (all less than 400 ng/ml). The combined measurement of trypsin and lactoferrin in pure pancreatic juice appeared to be more promising than any other currently available test for the separation of patients with pancreatic cancer from those with chronic pancreatitis.
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PMID:Trypsin and lactoferrin levels in pure pancreatic juice in patients with pancreatic disease. 52 74

Pancreatic secretory abnormalities develop in most persons with pancreatic cancer and have been attributed to ductal obstruction. These experiments investigated whether abnormal secretion results instead from carcinogen-induced changes in the secreting cells. Fifty male Syrian Golden hamsters (40 to 100 grams) received weekly injections of di-isopropyl-nitrosamine (250 mg/kg, subcutaneously), and survivors and age-matched controls were studied after 3.5 to 6.5 months of treatment. Pancreatic secretion was stimulated by secretin or cholecystokinin (2 units/kg, intravenously, as a bolus). After each stimulus four 15-minute collections of pancreatic juice were analyzed for HCO3- and Cl- or total protein, amylase, trypsin, and chymotrypsin. The organs were examined histologically. Pancreatic ductal adenocarcinoma developed in 30% of the animals at 5 months, 56% at 5.5 months, and 100% at 6.5 months. The animals without cancer either had hyperplasia of the duct epithelium or were histologically normal. The histologic appearance of acinar tissue and protein secretion were normal in all groups. The tumors did not obstruct the major ducts. In all treated animals the pancreatic secretory response to secretin was of low volume, low maximal [HCO3-] and HCO3- output, and low [Cl- + HCO3-]; these changes progressed with time. The secretory abnormalities antedated the appearance of the neoplasms and were not caused by obstruction.
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PMID:Pancreatic secretion in hamsters with pancreatic cancer. 87 54

We undertook to test the recent suggestion that measurement of immunoreactive carcinoembryonic antigen (CEA) in pancreatic secretion may be useful in diagnosis of pancreatic cancer. Using duodenal intubation and a perfusion method in 57 cases, we measured the rate of pancreatic CEA secretion into the duodenum under basal saline perfusion, alone and with continuous intravenous infusion of secretin (2 clinical units per kg per hr) and of cholecystokinin-pancreozymin (CCK, 15 Crick-Harper-Raper units per kg per hr); and we compared the CEA output with secretion of trypsin, lipase, and bicarbonate under the same conditions. Subsequent laparotomy revealed pancreatic carcinoma in 25 patients, pancreatitis in 7, other intraabdominal malignancies in 6, and benign nonpancreatic disorders in 19. CEA output rates did not differentiate all pancreatic-cancer patients from other patients in any test condition. However, pancreatic enzyme outputs were abnormal with almost 90% of cancers of the pancreatic head and with 75% of cancers of the pancreatic body and tail. For detection of pancreatic cancer, enzyme and bicarbonate outputs in response to CCK are more accurate than pancreatic CEA or bicarbonate outputs in response to secretin. Since CCK-stimulated enzyme outputs can be related accurately to malabsorption (not reported here), we prefer them to bicarbonate output for assessment of pancreatic function.
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PMID:Prospective evaluation of the pancreatic secretion of immunoreactive carcinoembryonic antigen, enzyme, and bicarbonate in patients suspected of having pancreatic cancer. 89 42

The amylase-creatinine clearance ratio was first proposed as a useful tool in the diagnosis of acute pancreatitis, and later it was claimed that trypsin creatinine clearance ratio was a sensitive and accurate test of pancreatic cancer. More recent observations have undermined the role of both clearances in the diagnosis of acute pancreatitis, and their utility in patients with chronic pancreatic diseases has largely been ignored. Three orders of factors, (a) the physicochemical characteristics of the protein, (b) the glomerular filtration rate variations, and (c) renal tubular damage, may have a role in determining the changes in the plasma-urine transfer of enzymes such as amylase and trypsin. Amylase urinary output is related both to variations in amylase serum levels (since this enzyme probably is not intensively reabsorbed by the tubule) and to the presence of renal tubular damage. Trypsin plasma-urine transfer changes depend greatly on the presence of tubular alterations. Elastase 1 and phospholipase A2 urinary outputs can also be predicted on the basis of the presence of tubular damage. Renal tubular alteration in pancreatic diseases may depend on the damaging effect of toxic substances (proteolytic enzymes, for example) released by the inflamed pancreas; the role of liver damage and of extrahepatic jaundice, which are frequent findings in chronic pancreatic diseases, should also be considered. However, toxic compounds such as ethanol, which can alter the pancreas and possibly the kidney, could also have a key role in the genesis of urinary findings in pancreatic diseases.
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PMID:Urinary enzymes excretion in pancreatic diseases. Clinical role and pathophysiological considerations. 137 38

Nd2 was a murine monoclonal antibody produced against a mucin fraction purified from xenografts of the human pancreatic cancer cell line SW1990. The reactivity of Nd2 was reduced by trypsin, but was not influenced by neuraminidase, so the epitope recognized by Nd2 may involve peptide but not sialic acid. The antigen recognized by Nd2 was present in 83% of pancreatic cancer, whereas in tissue of normal pancreas and chronic pancreatitis no reactivity was detected. By biodistribution study, tumor/blood ratio was elevated 8.27 on the 7th day after injection of 125I-labeled Nd2, while tissue/blood ratio in liver was remained 0.53. These results indicate that Nd2 had possibilities in clinical application such as radio-immunodetection and targeting therapy of pancreatic cancer.
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PMID:[Immunohistochemical study and biodistribution of monoclonal antibody (Nd2) against human pancreatic cancer]. 138 Jun 34

Pancreatic juices were collected by selective reverse catherism of the chief pancreatic duct in two patients, one free from pancreatic disease and the other having a pancreas cancer. They were analysed in detail especially in order to get information on the mechanism of enzyme excretion. The variations of the digestive enzyme activities (amylase, lipase, trypsin, chymotrypsin, carboxypeptidase A and B) were not superimposable among them or with the fluctuations of the protein concentration in the pancreatic juice samples. These results agree with a non-parallel enzyme-excretion mechanism by the pancreas. However deep electrophoresis analyses of pancreatic juice samples showed that the ratio of each digestive enzyme concentration remained almost constant in the same patient. This observation disagrees with the above conclusion and suggests that the data obtained by using classical methods for estimating digestive enzyme activities have to be considered prudently. By another way, two main significant differences were reported by analysing the ionic composition of the pancreatic juice samples following their origin. The pancreatic juice samples of the patient having a pancreas cancer had a lower and more variable Na+ concentration than those coming from the patient who was free from pancreas disease. They had a HCO3- concentration which was almost constant, contrary to what was observed for the pancreatic juice secreted by the other patient.
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PMID:[Detailed analysis of human pancreatic secretions collected by retrograde catheterization. Parallel or non-parallel excretion of digestive enzymes?]. 138 69

In order to evaluate the renal metabolism of amylase and immunoreactive trypsin (IRT) in chronic pancreatic disease, we assayed amylase, IRT and creatinine in serum and urine and gamma-glutamyl transferase (GGT) in dialyzed urine as well as alpha-glucosidase (AGL) and ribonuclease (RNase) in 24 control subjects, 34 patients with pancreatic cancer, 52 with chronic pancreatitis and 32 with extra-pancreatic diseases. Urinary amylase and IRT outputs were found to be more elevated in chronic pancreatitis than in control subjects. The levels of serum amylase, its renal inputs and outputs were correlated with the corresponding IRT values. Multiple regression analyses (dependent on amylase or IRT urinary outputs, circulating levels of the two enzymes, creatinine clearance and the excretion of GGT, AGL and RNase predictor variables) showed significant correlations. The standardized partial regression coefficients found to be significant were: GGT, RNase and serum amylase for amylase, and GGT and RNase for IRT. No difference was found between amylase and IRT outputs in patients with chronic pancreatitis, taking the presence or the absence of alcohol abuse, exocrine insufficiency and pancreatic pseudocysts into consideration. Urinary GGT excretion correlated with serum amylase and IRT levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal handling of amylase and immunoreactive trypsin in pancreatic cancer and chronic pancreatitis. 169 Oct 65


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