Novel ciliate lipases for enzyme replacement during exocrine pancreatic insufficiency

  title={Novel ciliate lipases for enzyme replacement during exocrine pancreatic insufficiency},
  author={Alexander Brock and Ingo Aldag and Stella Edskes and Marcus WW Hartmann and Torsten Herzog and Waldemar Uhl and Juergen Schnekenburger},
  journal={European Journal of Gastroenterology \& Hepatology},
Aim and objectives Exocrine pancreatic insufficiency caused by inflammation or pancreatic tumors results in nutrient malfunction by a lack of digestive enzymes and neutralization compounds. Despite satisfactory clinical results with current enzyme therapies, a normalization of fat absorption in patients is rare. An individualized therapy is required that includes high dosage of enzymatic units, usage of enteric coating, and addition of gastric proton pump inhibitors. The key goal to improve… 
Endocrine and exocrine pancreatic insufficiency after acute pancreatitis: long-term follow-up study
The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine pancreatic insufficiency, and HOMA-IR, WON and insulin resistance were the independent risk factors of new onset diabetes after AP.
Engineering Strategies for Oral Therapeutic Enzymes to Enhance Their Stability and Activity.
An overview of modification technologies for oral enzymes ranging from functionalisation of native proteins, to site-specific mutation and protein-polymer engineering and microparticle and nanoparticle encapsulated enzymes for improved oral delivery are given.
Long term follow-up of a simplified and less burdened pancreatic duct ligation model of exocrine pancreatic insufficiency in Goettingen Minipigs
Pancreatic duct ligation in minipigs is an excellent method of inducing exocrine pancreatic insufficiency and has the potential to be used in long-term EPI studies with up to 100 weeks post-OP without supplementation with enzymes and vitamins.
Recent advances in oral delivery of macromolecular drugs and benefits of polymer conjugation
Abstract Oral administration of drugs is a two-edged sword – on one hand it is a non-invasive and easy-to-handle administration of drugs, on the other hand macromolecular pharmaceutical compounds


Pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency in the 21(st) century.
Approaches for improving the results of enzyme therapy are described including changing to, or adding, a different product, adding non-enteric coated enzymes, use of antisecretory drugs and/or antacids, and changing the timing of enzyme administration.
Properties of different pancreatin preparations used in pancreatic exocrine insufficiency
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.
Pancreatic enzymes: secretion and luminal nutrient digestion in health and disease.
Current knowledge about secretion and luminal fate of pancreatic enzymes and their effects on nutrient digestion in health and chronic pancreatitis are summarized and rationale, rationale, current standards, options, and future aspects of enzyme replacement therapy are discussed.
[Comparison of fungal lipase and pancreatic lipase in exocrine pancreatic insufficiency in man. Study of their in vitro properties and intraduodenal bioavailability].
Results showed that lack of degradation in acidic milieu is not the only valuable criterion for the choice of an efficient lipase preparation and the role of other potential factors such as gastric emptying as well as proteolytic degradation of the enzyme should be considered as well.
Yarrowia lipolytica Lipase 2 Is Stable and Highly Active in Test Meals and Increases Fat Absorption in an Animal Model of Pancreatic Exocrine Insufficiency.
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.
Acid resistant lipase as replacement therapy in chronic pancreatic exocrine insufficiency: a study in dogs.
A markedly diminished treatment volume, in the form of fungal lipase, is as effective in controlling steatorrhoea as pancreatin and may prove to be a potentially valuable therapy for patients with pancreatic insufficiency.
Pancreatic Enzyme Pharmacotherapy
The delivery of sufficient enzyme concentrations into the duodenal lumen simultaneously with meals can reduce nutrient malabsorption, improve the symptoms of steatorrhea, and in some cases alleviate the pain associated with chronic pancreatitis.
Therapy of pancreatogenic steatorrhoea: does acid protection of pancreatic enzymes offer any advantage?
It is concluded that therapy with acid-protected pancreatin may simplify and improve treatment of exocrine pancreatic insufficiency in the presence of gastric hyper- or normo-acidity.
Quantitative study of digestive enzyme secretion and gastrointestinal lipolysis in chronic pancreatitis.
  • F. Carrière, P. Grandval, +6 authors R. Laugier
  • Medicine
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2005
Although all pancreatic enzyme secretions are simultaneously reduced in severe CP, gastric lipase can compensate partly for the loss of pancreatic lipase but not normalize overall lipolytic activity.
Chronic pancreatitis and persistent steatorrhea: what is the correct dose of enzymes?
  • J. E. Domínguez-Muñoz
  • Medicine
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2011
The present article reviews the current evidence on therapy of exocrine pancreatic insufficiency in chronic pancreatitis patients, with special attention to different potential endpoints to select the optimal enzyme dose for individual patients.