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Pancreatic-like enzymes of microbial origin restore growth and normalize lipid absorption in a pig model with exocrine pancreatic insufficiency

Pierzynowska, Kateryna; Valverde-Piedra, Jose; Szymanczyk, Sylwia; Prykhod'ko, Olena LU ; Pieszka, Marek; Kardas, Marek; Grochowska-Niedworok, Elzbieta; Grabowski, Tomasz; Winiarczyk, Mateusz and Pierzynowski, Stefan LU (2018) In Archives of Medical Science 14(2). p.407-414
Abstract

Introduction: The standard therapy for exocrine pancreatic insufficiency (EPI) is porcine-derived pancreatic enzyme replacement therapy (PERT). In the present study we tested a new approach with a mixture of pancreatic- like enzymes of microbial origin (PLEM) in a 1-week efficacy study in EPI pigs. In addition to the conventionally used coefficient of fat and nitrogen absorption (CFA and CNA), parameters that more accurately reflect the nutritional and health status, such as changes in the lipemic index (LI), plasma triglyceride (TG) and non-esterified fatty acid (NEFA) levels, and somatic growth, were determined. Material and methods: A PLEM dose containing 120 000 active lipase units, 80 000 active protease units and 12 000 active... (More)

Introduction: The standard therapy for exocrine pancreatic insufficiency (EPI) is porcine-derived pancreatic enzyme replacement therapy (PERT). In the present study we tested a new approach with a mixture of pancreatic- like enzymes of microbial origin (PLEM) in a 1-week efficacy study in EPI pigs. In addition to the conventionally used coefficient of fat and nitrogen absorption (CFA and CNA), parameters that more accurately reflect the nutritional and health status, such as changes in the lipemic index (LI), plasma triglyceride (TG) and non-esterified fatty acid (NEFA) levels, and somatic growth, were determined. Material and methods: A PLEM dose containing 120 000 active lipase units, 80 000 active protease units and 12 000 active amylase units (all from Sigma, St. Louis, MO) was given as a powder, twice daily with a meal (40 g fat/ meal) to 8 EPI pigs for 7 days. Ten healthy pigs were used as a comparator. Results: The PLEM enhanced fat and protein digestion, and reversed growth impairment in EPI pigs. With treatment, CFA and CNA increased by 59% and 43% (p < 0.05), respectively. Although fat and protein absorption were lower than in the comparator, the postprandial blood lipid profile was normal as in healthy pigs. The mucosal thickness significantly increased by 27%, 50% and 26%, in the proximal, middle, and distal jejunum (p < 0.05) with treatment and resembled that of healthy animals. Conclusions: Pancreatic-like enzymes of microbial origin supported somatic growth and normalized the postprandial lipid profile. As a measure of efficacy, postprandial LI, TG and NEFA are viable endpoints to be explored in human trials.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Exocrine pancreatic insufficiency, Pancreatic-like enzymes of microbial origin, Pigs
in
Archives of Medical Science
volume
14
issue
2
pages
407 - 414
publisher
Termedia Publishing House
external identifiers
  • scopus:85043469095
ISSN
1734-1922
DOI
10.5114/aoms.2018.73471
language
English
LU publication?
yes
id
e800959d-58c5-49a9-b4ce-800a54adf2cc
date added to LUP
2018-04-12 14:21:47
date last changed
2019-01-06 13:51:04
@article{e800959d-58c5-49a9-b4ce-800a54adf2cc,
  abstract     = {<p>Introduction: The standard therapy for exocrine pancreatic insufficiency (EPI) is porcine-derived pancreatic enzyme replacement therapy (PERT). In the present study we tested a new approach with a mixture of pancreatic- like enzymes of microbial origin (PLEM) in a 1-week efficacy study in EPI pigs. In addition to the conventionally used coefficient of fat and nitrogen absorption (CFA and CNA), parameters that more accurately reflect the nutritional and health status, such as changes in the lipemic index (LI), plasma triglyceride (TG) and non-esterified fatty acid (NEFA) levels, and somatic growth, were determined. Material and methods: A PLEM dose containing 120 000 active lipase units, 80 000 active protease units and 12 000 active amylase units (all from Sigma, St. Louis, MO) was given as a powder, twice daily with a meal (40 g fat/ meal) to 8 EPI pigs for 7 days. Ten healthy pigs were used as a comparator. Results: The PLEM enhanced fat and protein digestion, and reversed growth impairment in EPI pigs. With treatment, CFA and CNA increased by 59% and 43% (p &lt; 0.05), respectively. Although fat and protein absorption were lower than in the comparator, the postprandial blood lipid profile was normal as in healthy pigs. The mucosal thickness significantly increased by 27%, 50% and 26%, in the proximal, middle, and distal jejunum (p &lt; 0.05) with treatment and resembled that of healthy animals. Conclusions: Pancreatic-like enzymes of microbial origin supported somatic growth and normalized the postprandial lipid profile. As a measure of efficacy, postprandial LI, TG and NEFA are viable endpoints to be explored in human trials.</p>},
  author       = {Pierzynowska, Kateryna and Valverde-Piedra, Jose and Szymanczyk, Sylwia and Prykhod'ko, Olena and Pieszka, Marek and Kardas, Marek and Grochowska-Niedworok, Elzbieta and Grabowski, Tomasz and Winiarczyk, Mateusz and Pierzynowski, Stefan},
  issn         = {1734-1922},
  keyword      = {Exocrine pancreatic insufficiency,Pancreatic-like enzymes of microbial origin,Pigs},
  language     = {eng},
  number       = {2},
  pages        = {407--414},
  publisher    = {Termedia Publishing House},
  series       = {Archives of Medical Science},
  title        = {Pancreatic-like enzymes of microbial origin restore growth and normalize lipid absorption in a pig model with exocrine pancreatic insufficiency},
  url          = {http://dx.doi.org/10.5114/aoms.2018.73471},
  volume       = {14},
  year         = {2018},
}