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Transplant International : Official... 2022
Topics: Abdomen; Humans; Pancreas; Pancrelipase; Reperfusion; Research Design
PubMed: 35497885
DOI: 10.3389/ti.2022.10038 -
Molecules (Basel, Switzerland) Nov 2019Enzymatic inhibitions of crude extracts and their constituents from Zingiberaceae against both rat intestinal α-glucosidase and porcine pancreatic lipase were...
Enzymatic inhibitions of crude extracts and their constituents from Zingiberaceae against both rat intestinal α-glucosidase and porcine pancreatic lipase were investigated. Structure-activity relationships using their derivatives were also investigated. The rhizomes extract of mango ginger, showed remarkable inhibitory activity in the screening test. Two natural labdane diterpenes and and a drimane sesquiterpene were major constituents isolated from this hexane extract. Among them, ()-labda-8(17),12-diene-15,16-dial () was the most prominent compound and showed inhibitory activity against both α-glucosidase and lipase. Derivatives - from compound were prepared and evaluated using inhibitory assays with these enzymes. The reduced derivative maintained α-glucosidase inhibitory activity, but had decreased pancreatic lipase inhibitory activity compared with parent compound . Other tested derivatives of compound , including acetates - and oxidative derivatives , had very weak α-glucosidase inhibitory activity. Most of these compounds showed moderate pancreatic lipase inhibitory activity. However, only sesquiterpene albicanal () showed drastically decreased pancreatic lipase activity compared with . These findings suggested that molecular size was essential for enzymatic inhibitory activities of these compounds. These results demonstrated that mango ginger may be useful for the prevention of obesity and being overweight.
Topics: Animals; Diterpenes; Enzyme Activation; Enzyme Inhibitors; Zingiber officinale; Glycoside Hydrolase Inhibitors; Molecular Structure; Pancrelipase; Plant Extracts; Rats; alpha-Glucosidases
PubMed: 31717689
DOI: 10.3390/molecules24224071 -
Pancreas Sep 2019Reliable pancreatic function tests in patients with chronic pancreatitis (CP) are needed. This cohort study identified malabsorption in people with CP compared with...
Pancreatic Function in Chronic Pancreatitis: A Cohort Study Comparing 3 Methods of Detecting Fat Malabsorption and the Impact of Short-term Pancreatic Enzyme Replacement Therapy.
OBJECTIVES
Reliable pancreatic function tests in patients with chronic pancreatitis (CP) are needed. This cohort study identified malabsorption in people with CP compared with healthy people and then investigated short-term pancreatic enzyme replacement therapy (PERT) and fat malabsorption, nutritional status, and quality of life (QOL).
METHODS
Subjects with CP were evaluated before and after PERT and compared with the healthy cohort using coefficient of fat absorption (CFA), stool bomb calorimetry, and the malabsorption blood test (MBT). Anthropometrics, micronutrients, and QOL data were collected. Group means at baseline and after PERT were analyzed.
RESULTS
The 24 subjects with CP had greater stool energy loss (5668 cal/g [standard deviation {SD}, 753] vs 5152 cal/g [SD, 418], P < 0.01), reduced triglyceride absorption (MBT, 8.3 mg·h/dL [SD, 4.3] vs 17.7 mg·h/dL [SD, 10.3], P < 0.001), lower fat intake, and poorer QOL. Differences in CFA were not significant (90.9% [SD, 12.8] vs 95.4% [SD, 9.3]). After PERT, triglyceride absorption (Δ = 1.7 [SD, 3], P < 0.05) and QOL increased.
CONCLUSIONS
The MBT detected changes in triglyceride absorption in the absence of CFA changes. The MBT may be helpful in guiding PERT initiation in patients with CP before significant morbidity.
Topics: Adult; Cohort Studies; Enzyme Replacement Therapy; Exocrine Pancreatic Insufficiency; Fats; Female; Humans; Malabsorption Syndromes; Male; Middle Aged; Nutritional Status; Outcome Assessment, Health Care; Pancreas; Pancreatic Function Tests; Pancreatitis, Chronic; Pancrelipase; Quality of Life; Triglycerides
PubMed: 31404029
DOI: 10.1097/MPA.0000000000001381 -
Plants (Basel, Switzerland) Feb 2024In the present study, different intensities of UV-A were applied to compare their effects on growth, bioactive compounds and hypoglycemia-related enzyme activities in...
In the present study, different intensities of UV-A were applied to compare their effects on growth, bioactive compounds and hypoglycemia-related enzyme activities in broccoli and radish sprouts. The growth of sprouts was decreased after UV-A irradiation. A total of 12 W of UV-A irradiation resulted in the highest content of anthocyanin, chlorophyll, polyphenol and ascorbic acid in broccoli and radish sprouts. The highest soluble sugar content was recorded in sprouts under 8 W of UV-A irradiation, while no significant difference was obtained in soluble protein content among different UV-A intensities. Furthermore, 12 W of UV-A irradiation induced the highest glucosinolate accumulation, especially glucoraphanin and glucoraphenin in broccoli and radish sprouts, respectively; thus, it enhanced sulforaphane and sulforaphene formation. The α-amylase, α-glucosidase and pancrelipase inhibitory rates of two kinds of sprouts were enhanced significantly after UV-A irradiation, indicating UV-A-irradiation-treated broccoli and radish sprouts have new prospects as hypoglycemic functional foods.
PubMed: 38337982
DOI: 10.3390/plants13030450 -
Pancreas Jul 2019Pancreatic cancer (PC) and its treatments can result in pancreatic exocrine insufficiency that requires pancreatic enzyme replacement therapy (PERT). Appropriate PERT...
OBJECTIVES
Pancreatic cancer (PC) and its treatments can result in pancreatic exocrine insufficiency that requires pancreatic enzyme replacement therapy (PERT). Appropriate PERT usage is during meals and snacks. The aim was to determine the frequency of appropriate use of PERT and its impact on symptom alleviation in PC through a patient-reported outcomes online platform.
METHODS
Users in the Pancreatic Cancer Action Network's Patient Registry were prompted to answer a standalone questionnaire about their experience with PERT.
RESULTS
Two hundred sixty-two users completed the PERT questionnaire (January 2016-January 2018). Patients who reported taking PERT with meals had higher alleviation of symptoms compared with those taking PERT prior to or after meals. Specifically, "feeling of indigestion," "light-colored or orange stools," and "visible food particles in stool" were significantly decreased. Patients taking PERT with meals reported weight gain and less weight loss.
CONCLUSIONS
Of the 89% of PC patients prescribed PERT, 65% were prescribed PERT appropriately with all meals and snacks. Overall compliance with PERT administration guidelines was low (50% [105/208]). Improvement in symptoms significantly correlated with appropriate use of PERT. Increase in PC patient and provider education about appropriate PERT usage and administration is warranted.
Topics: Adult; Aged; Aged, 80 and over; Enzyme Replacement Therapy; Exocrine Pancreatic Insufficiency; Female; Humans; Male; Middle Aged; Pancreas; Pancreatic Neoplasms; Pancrelipase; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome; Young Adult
PubMed: 31210656
DOI: 10.1097/MPA.0000000000001330 -
Frontiers in Medicine 2022Pancreatic Exocrine Insufficiency (PEI) is a possible cause of recurrent/persistent symptoms in celiac disease. Although pancreatic enzyme supplementation may be used to...
BACKGROUND
Pancreatic Exocrine Insufficiency (PEI) is a possible cause of recurrent/persistent symptoms in celiac disease. Although pancreatic enzyme supplementation may be used to treat non-responsive celiac disease (NRCD) in clinical practice, clinical outcomes are variable and there is limited and low quality evidence to support this practice. The aim of this study was to assess the efficacy of pancreatic enzyme supplements (PES) for improvement of gastrointestinal symptoms in NRCD.
METHODS
Prospective, randomized, placebo-controlled, double-blind, cross-over trial in adults with NRCD examining Celiac Disease-Gastrointestinal Symptom Rating Scale (CeD-GSRS) scores on PES (pancrelipase co-administered with omeprazole) versus placebo (omeprazole only) during a 10-day treatment period. The study was registered under the clinical trials registry (https://clinicaltrials.gov/ number, NCT02475369) on 18 Jun 2015.
RESULTS
Twelve participants (nine female) were included in the per-protocol analysis; one participant had low fecal elastase-1. Pancrelipase was not associated with significant change in CeD-GSRS compared to placebo (-0.03 versus -0.26; = 0.366). There was a significant decrease in mean values of total CeD-GSRS scores (3.58 versus 2.90, = 0.004), abdominal pain (2.92 versus 2.42, = 0.009), and diarrhea sub-scores (3.44 versus 2.92, = 0.037) during the run-in period with omeprazole.
CONCLUSION
In this prospective, cross-over randomized, placebo-controlled study, PES did not improve symptoms in patients with NRCD. It is unclear whether this is a trial effect or related to administration of omeprazole.
PubMed: 36687454
DOI: 10.3389/fmed.2022.1001879 -
Internal Medicine (Tokyo, Japan) Sep 2023We herein report two cases of rapidly progressive fatty liver (FL) disease due to pancreatic exocrine insufficiency (PEI) without a surgical history. Two women, 59 and...
We herein report two cases of rapidly progressive fatty liver (FL) disease due to pancreatic exocrine insufficiency (PEI) without a surgical history. Two women, 59 and 72 years old, with no history of abdominal surgery presented to our hospital with severe anorexia and nausea persisting for one week. Examinations revealed progressive, marked FL disease with hepatomegaly and PEI, for which pancreatic enzyme replacement therapy was effective. Commonly known causes of PEI include chronic pancreatitis, abdominal surgery (e.g. pancreaticoduodenectomy), pancreatic cancer, and obstruction of the pancreatic duct, none of which were present in either of these two cases.
Topics: Humans; Female; Middle Aged; Aged; Exocrine Pancreatic Insufficiency; Pancreas; Non-alcoholic Fatty Liver Disease; Pancreatitis, Chronic; Pancreatic Neoplasms; Enzyme Replacement Therapy
PubMed: 36754408
DOI: 10.2169/internalmedicine.0775-22 -
BMC Gastroenterology Jul 2019Cystic fibrosis (CF) is a genetic disorder of the epithelial CFTR apical chloride channel resulting in multi-organ manifestations, including pancreatic exocrine...
BACKGROUND
Cystic fibrosis (CF) is a genetic disorder of the epithelial CFTR apical chloride channel resulting in multi-organ manifestations, including pancreatic exocrine secretion. In the pancreas, CFTR abnormality results in abnormally viscous secretions that obstruct proximal ducts leading to fibrotic injury and ultimately pancreatic insufficiency in 85% of the CF population. CFTR modulators, including the potentiator ivacaftor, augment channel gating to restore 30-50% of CFTR-mediated anion transport. While CFTR modulation has been shown to alkalinize the pH of the alimentary tract and potentially augment pancreatic enzyme activity, the effect of ivacaftor on recurrent pancreatitis is emerging. Here we describe a case of a patient with CF (R117H/7 T/F508del) who presented with recurrent pancreatitis who was effectively treated with ivacaftor in the absence of respiratory symptoms.
CASE PRESENTATION
A 24-year-old white male with past medical history of recurrent acute pancreatitis presented for evaluation following a referral from an outside hospital. The patient reported a lifetime of gastrointestinal symptoms requiring over 20 hospitalizations for pancreatitis in the last 10 years. Prior U/S and CT imaging for pancreatitis ruled out gallstones or anatomical etiologies. Family history included a brother with CF carrier status who suffered from recurrent acute pancreatitis. Sweat chloride testing was suggestive of CFTR dysfunction (57 mmol/L). Genetic testing demonstrated disease causing CFTR mutations: R1117H/7 T/F508del. Patient was prescribed pancrelipase, however, he reported worsened gas and diarrhea symptoms. Pancrelipase was discontinued and the patient was prescribed ivacaftor 150 mg BID. After 6 weeks of ivacaftor treatment, patient reported improved gastrointestinal symptoms. For an additional 19 months, patient reported no episodes of pancreatitis until he discontinued ivacaftor. Over the next 3 weeks, patient experienced progressive nausea and sharp epigastric pain and laboratory studies confirmed pancreatitis. Patient was subsequently lost to follow up.
CONCLUSIONS
These findings support a possible relationship between the use of CFTR modulators, such as ivacaftor, in the management of recurrent pancreatitis in the setting of patients with cystic fibrosis and a CFTR mutation with residual CFTR activity or otherwise known to be responsive in vitro. Ivacaftor may be useful for recurrent pancreatitis, even in the absence of respiratory morbidity.
Topics: Aminophenols; Cystic Fibrosis; Cystic Fibrosis Transmembrane Conductance Regulator; Humans; Male; Pancreatitis, Chronic; Quinolones; Recurrence; Treatment Outcome; Young Adult
PubMed: 31296159
DOI: 10.1186/s12876-019-1044-7 -
BMC Cancer Oct 2019Patients with metastatic renal carcinoma frequently have pre-existing renal impairment and not infrequently develop worsening renal function as a complication of their...
BACKGROUND
Patients with metastatic renal carcinoma frequently have pre-existing renal impairment and not infrequently develop worsening renal function as a complication of their treatment. The presence of pancreatic metastases in patients with metastatic renal carcinoma, often confers a more favourable prognosis and as a consequence this patient group may be exposed to such treatments for more prolonged periods of time. However, the development of renal failure may also be a consequence of the cancer itself rather than its treatment.
CASE PRESENTATION
We present an 84-year-old patient receiving the tyrosine kinase inhibitor (TKI) pazopanib for metastatic renal carcinoma who developed oxalate nephropathy as a consequence of pancreatic exocrine insufficiency resulting from pancreatic metastases.
CONCLUSIONS
This case demonstrates the importance of investigating unexpected toxicities and highlights the potential consequences of pancreatic insufficiency and its sequelae in patients with pancreatic metastases.
Topics: Acetates; Aged, 80 and over; Calcium Compounds; Carcinoma, Renal Cell; Exocrine Pancreatic Insufficiency; Gastrointestinal Agents; Humans; Indazoles; Kidney Failure, Chronic; Kidney Neoplasms; Male; Oxalates; Pancreatic Neoplasms; Pancrelipase; Protein Kinase Inhibitors; Pyrimidines; Renal Dialysis; Sulfonamides; Treatment Outcome
PubMed: 31623580
DOI: 10.1186/s12885-019-6215-y