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A review : Pancreatic enzymes in the treatment of chronic pancreatic insufficiency in companion animals

Szkopek, Dominika ; Pierzynowski, Stefan G. LU ; Pierzynowska, Kateryna LU orcid ; Zaworski, Kamil LU ; Kondej, Agata ; Wychowański, Piotr ; Konieczka, Paweł ; Seklecka, Blanka ; Donaldson, Janine and Jank, Michał , et al. (2024) In Journal of Veterinary Internal Medicine
Abstract

The purpose of this review was to analyze the scientific literature on exocrine pancreatic insufficiency (EPI) in dogs and cats and our own research on porcine model to compare animal- and microbial-derived enzymes in the treatment of animals with this disease. Clinical signs of EPI occur when more than 85% of the pancreatic parenchyma is non-functional. EPI can be a consequence of various diseases. The insufficient activity or deficiency of pancreatic enzymes leads to impaired digestion and absorption, and consequently, to malnutrition. The primary treatment for enzyme insufficiency is pancreatic enzyme replacement therapy (PERT). PERT in animals with EPI is a lifetime therapy. Most commercially available products are of animal origin... (More)

The purpose of this review was to analyze the scientific literature on exocrine pancreatic insufficiency (EPI) in dogs and cats and our own research on porcine model to compare animal- and microbial-derived enzymes in the treatment of animals with this disease. Clinical signs of EPI occur when more than 85% of the pancreatic parenchyma is non-functional. EPI can be a consequence of various diseases. The insufficient activity or deficiency of pancreatic enzymes leads to impaired digestion and absorption, and consequently, to malnutrition. The primary treatment for enzyme insufficiency is pancreatic enzyme replacement therapy (PERT). PERT in animals with EPI is a lifetime therapy. Most commercially available products are of animal origin (processed pancreata obtained from a slaughter house) and contain lipases, alpha-amylase, and proteases. Enzymes of microbial and plant origin seem to be a promising alternative to animal-derived enzymes, but to date there are no registered preparations containing all enzymes simultaneously for use in clinical practice to treat EPI. Results from some previous studies have highlighted the “extra-digestive” functions of pancreatic enzymes, as well as the actions of pancreatic-like microbial enzymes. For example, trypsin activates protease-activated receptor and provokes maturation of enterocytes and enterostatin inhibits fat absorption. It has been postulated that intrapancreatic amylase is the main component of the acini-islet-acinar axis—the reflex which down regulates insulin release, while gut and blood amylase exhibit anti-incretin actions “per se.” Additionally, high but still physiological blood amylase activity coincide with physiological glucose homeostasis and a lack of obesity.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
animal-derived enzymes, exocrine pancreatic insufficiency, microbial-derived enzymes, pancreatic replacement therapy
in
Journal of Veterinary Internal Medicine
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85192528037
  • pmid:38721836
ISSN
0891-6640
DOI
10.1111/jvim.17096
language
English
LU publication?
yes
id
85994465-16c3-44c4-a9cd-8fe5478bd721
date added to LUP
2024-06-10 13:38:11
date last changed
2024-06-24 15:34:47
@article{85994465-16c3-44c4-a9cd-8fe5478bd721,
  abstract     = {{<p>The purpose of this review was to analyze the scientific literature on exocrine pancreatic insufficiency (EPI) in dogs and cats and our own research on porcine model to compare animal- and microbial-derived enzymes in the treatment of animals with this disease. Clinical signs of EPI occur when more than 85% of the pancreatic parenchyma is non-functional. EPI can be a consequence of various diseases. The insufficient activity or deficiency of pancreatic enzymes leads to impaired digestion and absorption, and consequently, to malnutrition. The primary treatment for enzyme insufficiency is pancreatic enzyme replacement therapy (PERT). PERT in animals with EPI is a lifetime therapy. Most commercially available products are of animal origin (processed pancreata obtained from a slaughter house) and contain lipases, alpha-amylase, and proteases. Enzymes of microbial and plant origin seem to be a promising alternative to animal-derived enzymes, but to date there are no registered preparations containing all enzymes simultaneously for use in clinical practice to treat EPI. Results from some previous studies have highlighted the “extra-digestive” functions of pancreatic enzymes, as well as the actions of pancreatic-like microbial enzymes. For example, trypsin activates protease-activated receptor and provokes maturation of enterocytes and enterostatin inhibits fat absorption. It has been postulated that intrapancreatic amylase is the main component of the acini-islet-acinar axis—the reflex which down regulates insulin release, while gut and blood amylase exhibit anti-incretin actions “per se.” Additionally, high but still physiological blood amylase activity coincide with physiological glucose homeostasis and a lack of obesity.</p>}},
  author       = {{Szkopek, Dominika and Pierzynowski, Stefan G. and Pierzynowska, Kateryna and Zaworski, Kamil and Kondej, Agata and Wychowański, Piotr and Konieczka, Paweł and Seklecka, Blanka and Donaldson, Janine and Jank, Michał and Woliński, Jarosław}},
  issn         = {{0891-6640}},
  keywords     = {{animal-derived enzymes; exocrine pancreatic insufficiency; microbial-derived enzymes; pancreatic replacement therapy}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Veterinary Internal Medicine}},
  title        = {{A review : Pancreatic enzymes in the treatment of chronic pancreatic insufficiency in companion animals}},
  url          = {{http://dx.doi.org/10.1111/jvim.17096}},
  doi          = {{10.1111/jvim.17096}},
  year         = {{2024}},
}