Lipase Supplementation Therapy: Standards, Alternatives, and Perspectives

@article{Layer2003LipaseST,
  title={Lipase Supplementation Therapy: Standards, Alternatives, and Perspectives},
  author={Peter Layer and Jutta Keller},
  journal={Pancreas},
  year={2003},
  volume={26},
  pages={1-7}
}
Treatment of steatorrhea by lipase supplementation therapy has become more successful in the last decade due to better understanding of the physiology and pathophysiology of the digestive process. Porcine lipase has been the therapeutic standard for several decades and will continue to be the treatment of choice in pancreatic exocrine insufficiency. Modern therapeutic concepts recommend administration of 25,000–40,000 units of porcine lipase per meal using pH-sensitive pancreatin microspheres… Expand
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There is no current standard test for evaluating adequacy of therapy in CP patients and studies have shown that optimization of therapy based on symptoms may be inadequate, so goals of therapybased on overall patient presentation and specific laboratory tests rather than mere correction of steatorrhea are needed. Expand
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TLDR
Although all pancreatin preparations contain the declared lipase units and are acid-stable, a wide variation was observed in the particle size, surface, acid resistance, release of enzymes, pharmacokinetics and batch consistency. Expand
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Pancreatic exocrine insufficiency (PEI) is often observed in patients with pancreatic diseases, including chronic pancreatitis, cystic fibrosis, and tumors, or after surgical resection. PEI oftenExpand
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TLDR
The yeast lipase YLLIP2 is stable and has high levels of activity against test meal triglycerides in a large pH range, with and without bile, and was highly stable and poorly degraded by pepsin. Expand
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