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BioMed Research International 2021Pancreatic enzyme replacement therapy (PERT) and fat predigestion are key in ensuring the optimal growth of patients with cystic fibrosis. Our study attempted to...
Pancreatic enzyme replacement therapy (PERT) and fat predigestion are key in ensuring the optimal growth of patients with cystic fibrosis. Our study attempted to highlight differences between fat predigestion and conventional PERT on body composition of young pigs with exocrine pancreatic insufficiency (EPI). EPI and healthy pigs were fed with high-fat diet for six weeks. During the last two weeks of the study, all pigs received additional nocturnal alimentation with Peptamen AF (PAF) and were divided into three groups: H-healthy pigs receiving PAF; P-EPI pigs receiving PAF+PERT; and L-EPI pigs receiving PAF predigested with an immobilized microbial lipase. Additional nocturnal alimentation increased the body weight gain of EPI pigs with better efficacy in P pigs. Humerus length and area in pigs in groups L and P were lower than that observed in pigs in group H ( value 0.005-0.088). However, bone mineral density and strength were significantly higher in P and L as compared to that of H pigs ( value 0.0026-0.0739). The gut structure was improved in P pigs. The levels of neurospecific proteins measured in the brain were mainly affected in P and less in L pigs as compared to H pigs. The beneficial effects of the nocturnal feeding with the semielemental diet in the prevention of EPI pigs' growth/development retardation are differently modified by PERT or fat predigestion in terms of growth, bone properties, neurospecific protein distribution, and gut structure.
Topics: Animals; Astrocytes; Body Composition; Bone and Bones; Diet; Enzyme Replacement Therapy; Exocrine Pancreatic Insufficiency; Feeding Behavior; Gastrointestinal Tract; Lipase; Nerve Tissue Proteins; Neurons; Pancrelipase; Swine; Weight Gain
PubMed: 34307664
DOI: 10.1155/2021/6647734 -
Animal Nutrition (Zhongguo Xu Mu Shou... Jun 2021The objective of this study was to investigate the effects of natural capsicum extract (NCE, containing 2% natural capsaicin, the rest is carrier) replacing...
Natural capsicum extract replacing chlortetracycline enhances performance via improving digestive enzyme activities, antioxidant capacity, anti-inflammatory function, and gut health in weaned pigs.
The objective of this study was to investigate the effects of natural capsicum extract (NCE, containing 2% natural capsaicin, the rest is carrier) replacing chlortetracycline (CTC) on performance, digestive enzyme activities, antioxidant capacity, inflammatory cytokines, and gut health in weaned pigs. A total of 108 weaned pigs (Duroc × [Landrace × Yorkshire], initial body weight = 8.68 ± 1.34 kg; weaned on d 28) were randomly allotted into 3 treatments with 6 replicate pens per treatment (3 barrows and 3 gilts per pen). The treatments include a corn-soybean meal basal diet as a control group (CON), a CTC group (basal diet + CTC at 75 mg/kg), and a NCE group (basal diet + NEC at 80 mg/kg). Compared with CON and CTC, NCE had increased ( < 0.05) average daily gain in phase 2 (d 15 to 28) and overall (d 1 to 28), and higher ( < 0.05) apparent total tract digestibility of gross energy, dry matter, crude protein, and organic matter in phase 1 (d 1 to 14). These pigs also had increased ( < 0.05) pancrelipase activity in pancreas, α-amylase, lipase and protease activities in the jejunal mucosa, and lipase activity in the ileal mucosa on d 28. Moreover, NCE had increased ( < 0.05) the contents of growth hormone, β-endorphin, 5-hydroxytryptamine, total antioxidant capacity, total superoxide dismutase, catalase, and IL-10, as well as decreased ( < 0.05) contents of malondialdehyde, tumor nuclear factor-α, interferon-γ, and interleukin-6 in serum on d 28 compared with CON and CTC. NCE showed higher ( < 0.05) propionic acid, butyric acid and total volatile fatty acids (VFA) contents, and increased ( < 0.05) relative abundance of in colon, as well as higher ( < 0.05) propionic acid and total volatile fatty acids in cecum on d 28 compared with CON. In conclusion, NCE replacing CTC could enhance performance via improving digestive enzyme activities, antioxidant capacity, anti-inflammatory function, gut VFA composition and microbiota community in weaned pigs, and it could be used as a potential target for the development of feed additives.
PubMed: 34258418
DOI: 10.1016/j.aninu.2020.12.004 -
BMJ Case Reports Mar 2021A 61-year-old man was transferred to our facility from an outside hospital due to refractory neutropaenia of unknown aetiology. The patient presented to the referring...
A 61-year-old man was transferred to our facility from an outside hospital due to refractory neutropaenia of unknown aetiology. The patient presented to the referring hospital with a 5-day history of worsening diarrhoea and abdominal pain. Initial lab results at presentation showed severe neutropaenia with an absolute neutrophil count of 0. Investigations included a bone marrow biopsy which showed slightly hypocellular marrow with near absence of granulocytic precursors. A CT without contrast showed evidence of chronic pancreatitis and acute colitis. The patient's neutropaenia persisted despite granulocyte colony-stimulating factor therapy. The patient was, thus, transferred to our facility for a higher level of care. At our facility, the patient had rapid correction of neutropaenia after discontinuation of pancrelipase therapy. The patient's abdominal pain and diarrhoea also improved while off pancrelipase. Neutropaenia has completely resolved 6 weeks after discharge without any further therapy.
Topics: Granulocyte Colony-Stimulating Factor; Granulocytes; Humans; Leukocyte Count; Male; Middle Aged; Neutropenia; Pancrelipase
PubMed: 33753395
DOI: 10.1136/bcr-2021-241799 -
Pancreas Feb 2021The aim of this study was to evaluate whether improvement in coefficient of fat absorption (CFA) with pancreatic enzyme replacement therapy correlates with clinical...
OBJECTIVE
The aim of this study was to evaluate whether improvement in coefficient of fat absorption (CFA) with pancreatic enzyme replacement therapy correlates with clinical symptoms in patients with chronic pancreatitis with moderate to severe exocrine pancreatic insufficiency.
METHODS
Data were pooled from 2 randomized double-blind trials of the effects of 1 week of pancrelipase (n = 59) versus placebo (n = 57) on CFA and stool frequency, stool consistency, abdominal pain, and flatulence; 1 trial included a 51-week open-label pancrelipase treatment period (n = 34).
RESULTS
Compared with placebo, significantly more patients receiving pancrelipase reported decreased stool frequency at week 1 (72% vs 38%; P < 0.001). Although 30% of patients receiving pancrelipase and 20% receiving placebo reported improved stool consistency, changes in stool consistency, abdominal pain, and flatulence were not different between groups. Mean CFA absolute change from baseline was significantly greater with pancrelipase versus placebo (24.7% vs 6.4%; P < 0.001). Improvements in stool consistency and frequency correlated with CFA improvement. Symptom improvements persisted or further improved through 52 weeks of treatment.
CONCLUSIONS
Pancrelipase significantly improved exocrine pancreatic insufficiency maldigestive symptoms. Improvements in objective stool symptoms with pancreatic enzyme replacement therapy correlated with CFA improvement at 1 week.
Topics: Abdominal Pain; Adolescent; Adult; Aged; Defecation; Exocrine Pancreatic Insufficiency; Feces; Female; Flatulence; Gastrointestinal Agents; Humans; Intestinal Absorption; Lipid Metabolism; Male; Middle Aged; Pancreatitis, Chronic; Pancrelipase; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome; Young Adult
PubMed: 33560089
DOI: 10.1097/MPA.0000000000001733 -
Chinese Journal of Natural Medicines May 2020Pancreatic lipase (PL), a crucial enzyme in the digestive system of mammals, has been proven as a therapeutic target to prevent and treat obesity. The purpose of this...
Pancreatic lipase (PL), a crucial enzyme in the digestive system of mammals, has been proven as a therapeutic target to prevent and treat obesity. The purpose of this study is to evaluate and characterize the PL inhibition activities of the major constituents from Fructus Psoraleae (FP), one of the most frequently used Chinese herbs with lipid-lowering activity. To this end, a total of eleven major constituents isolated from Fructus Psoraleae have been obtained and their inhibition potentials against PL have been assayed by a fluorescence-based assay. Among all tested compounds, isobavachalcone, bavachalcone and corylifol A displayed strong inhibition on PL (IC < 10 μmol·L). Inhibition kinetic analyses demonstrated that isobavachalcone, bavachalcone and corylifol A acted as mixed inhibitors against PL-mediated 4-methylumbelliferyl oleate (4-MUO) hydrolysis, with the K values of 1.61, 3.77 and 10.16 μmol·L, respectively. Furthermore, docking simulations indicated that two chalcones (isobavachalcone and bavachalcone) could interact with the key residues located in the catalytic cavity of PL via hydrogen binding and hydrophobic interactions. Collectively, these finding provided solid evidence to support that Fructus Psoraleae contained bioactive compounds with lipid-lowering effects via targeting PL, and also suggested that the chalcones in Fructus Psoraleae could be used as ideal leading compounds to develop novel PL inhibitors.
Topics: Animals; Chalcones; Drugs, Chinese Herbal; Enzyme Inhibitors; Flavones; Fruit; Lipase; Pancrelipase; Psoralea; Swine
PubMed: 32451094
DOI: 10.1016/S1875-5364(20)30043-1 -
International Journal of Biological... May 2020The inhibitory activity of taxifolin on three digestive enzymes were investigated in both vitro and vivo. Taxifolin exhibited inhibitory effect on α-glucosidase,...
The inhibitory activity of taxifolin on three digestive enzymes were investigated in both vitro and vivo. Taxifolin exhibited inhibitory effect on α-glucosidase, α-amylase and pancreatic lipase with IC50 values of 0.038, 0.647 and 0.993 mg/mL, respectively. Inhibitory kinetics indicated that taxifolin was more like a competitive inhibitor of α-glucosidase and α-amylase, while it was a non-competitive inhibitor of pancreatic lipase. The binding of taxifolin caused the quenching of intrinsic fluorescence intensity of enzymes, and the binding constant (lgK) and the number of binding site (n) were further calculated through fluorescence titration. The values of lgK were in the range of 4.93-6.65, and the values of n were all close to 1. Molecular docking indicated that taxifolin could interact with α-glucosidase and α-amylase through many kinds of secondary interaction, such as hydrogen bond, π-π stack, etc. In vivo study revealed that pre-administration with taxifolin can significantly improve the postprandial hyperglycemia in rat. Furthermore, its can also decrease triglyceride absorption through the inhibition of pancreatic lipase.
Topics: Animals; Enzyme Activation; Enzyme Inhibitors; Female; Glucose; Glycoside Hydrolase Inhibitors; Kinetics; Lipid Metabolism; Molecular Docking Simulation; Molecular Dynamics Simulation; Pancrelipase; Quercetin; Rats; Structure-Activity Relationship; alpha-Amylases; alpha-Glucosidases
PubMed: 32035149
DOI: 10.1016/j.ijbiomac.2020.02.027 -
Journal of Human Nutrition and... Apr 2020Little is known about adults' experience of living with cystic fibrosis (CF) specifically in relation to the gut. However, their unique perspectives may be meaningful to...
BACKGROUND
Little is known about adults' experience of living with cystic fibrosis (CF) specifically in relation to the gut. However, their unique perspectives may be meaningful to children with CF and inform the understanding and practice of dietitians. The present study aimed to explore adults' lived experience of the CF gut and how they learnt to manage the gut as they were growing up.
METHODS
Semi-structured interviews were conducted with adult inpatients (n = 10). Interviews were audio-recorded, transcribed verbatim and accounts analysed using interpretative phenomenological analysis.
RESULTS
Three super-ordinate themes were identified: taking Creon, the learning process and this much I (now) know. Participants accounts of how CF affects the gut predominantly focused on taking Creon (pancreatin, Mylan). Various strategies were employed for coping with peer responses to taking Creon at school. Several participants reached adulthood before they understood and/or accepted that taking Creon consistently needed to be normal for them. Knowledge and understanding developed over time, with 'CF experience' and was shaped by family, CF care teams and other children with CF. All had unmet information needs when growing up. Having key explanations earlier, to make connections between eating, taking Creon, gaining weight and growth, did or would have helped most participants. Participants urged children to be assertive, ask questions and not only be involved in managing their diet and gut, but also begin to take control of this aspect of their CF.
CONCLUSIONS
Supporting development of knowledge, skills and confidence to manage diet and the gut needs to be integral to care throughout childhood.
Topics: Adult; Cystic Fibrosis; Diet; Female; Gastrointestinal Agents; Gastrointestinal Diseases; Health Knowledge, Attitudes, Practice; Humans; Inpatients; Male; Pancrelipase; Qualitative Research
PubMed: 31763740
DOI: 10.1111/jhn.12703 -
Journal of Pain and Symptom Management Apr 2020Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is...
Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is available via www.palliativedrugs.com. The series editors welcome feedback on the articles.
Topics: Hospice Care; Humans; Palliative Care; Pancrelipase
PubMed: 31760143
DOI: 10.1016/j.jpainsymman.2019.11.008 -
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 -
Surgical Case Reports Oct 2019Pancreatic exocrine insufficiency (PEI) is known to occur after total gastrectomy. We experienced a case of PEI occurring 18 years after surgery, leading to a...
BACKGROUND
Pancreatic exocrine insufficiency (PEI) is known to occur after total gastrectomy. We experienced a case of PEI occurring 18 years after surgery, leading to a potentially fatal condition of capillary leak syndrome (CLS).
CASE PRESENTATION
The case is a 58-year-old man on a healthy diet who underwent total gastrectomy 18 years before. He was admitted for a 3-month history of anasarca, steatorrhea, and hypoalbuminemia. An episode of fever occurred during workup, followed by pulmonary edema and shock. The patient was transferred to the intensive care unit and was started on fluid management with albumin infusion. A multidisciplinary team meeting was held, and a clinical diagnosis of PEI resulted in CLS was made and we started administration of oral pancrelipase to show clinical improvement. The patient was discharged, and he remained asymptomatic for 13 months.
CONCLUSION
In a post-gastrectomy patient with malnutrition, PEI should be suspected regardless of the period since surgery. When recognized, immediate replenishment of albumin and pancreatic enzymes should be initiated to prevent clinical deterioration.
PubMed: 31650279
DOI: 10.1186/s40792-019-0721-7