Marek Kardas

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

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.

Consumption of milk and milk products in the population of the Upper Silesian agglomeration inhabitants

Background Providing the appropriate amount of nutrients at every stage of life is a key element determining the proper development and functioning of the body. Objective Because of the nutritional value and resulting position of milk and milk products in the daily diet, this study was undertaken to assess the consumption of milk and milk products among the inhabitants of the Upper Silesian agglomeration. Design The survey covered 600 people, including 339 women (56.5%) and 261 men (43.5%) aged 18–78 years. To assess the consumption of milk and milk products, as a research tool an original survey with the closed-ended and open-ended questions was used. The questions concerned the characteristics of the surveyed group and various aspects of the consumption of milk and milk products. The results obtained were subjected to statistical analysis using the Statistica 10.0 program with a chi-square test for quality features. Results The level of consumption of milk and milk products among the Upper Silesian agglomeration inhabitants is insufficient in relation to nutrition recommendations. However, despite many controversies surrounding milk, the respondents also claimed that it played an important role in their daily diet. Conclusions The most frequently consumed type of milk in the surveyed group is ultra heat treated (UHT) milk with average fat content.

Novel potential of pancreatic-like enzymes of microbial origin in exocrine pancreatic insufficiency – study on a pig model

Introduction. The standard porcine-derived pancreatic enzyme replacement therapy (PERT) is a lifesaving treatment for patients with diseases causing exocrine pancreatic insufficiency (EPI). An attempt to replace PERT with microbial enzymes were undertaken. The aim was to highlight whether the mode of application, mixed with food or applied directly to the stomach, of pancreatic-like enzymes of microbial origin (PLEM) can affect their activity along the gastrointestinal tract. Materials and method. The activity of amylase, lipase and proteinase in the stomach, duodenum and ileum were tested in EPI pigs (n=6) after supplementation of PLEM, either orally – before and during feed consumption – or via the stomach – before and during feed consumption. Healthy pigs not treated with PLEM (n=3) served as controls. Activity of the enzymes measured in the chyme were obtained together with the digesta pH. Activity of the enzymatic residues in the stool samples was also checked. Results. The highest pancreatic enzyme activities were found in the duodenum of the healthy pigs (amylase 162,68 kU/ mL, lipase 507,34 kU/mL and protolitic (trypsin) activity 357,60 kU/mL). Nevertheless, the microbial enzymes remained also active along the entire length of the GIT – including stomach in EPI pigs, regardless of their route of administration. However, activity level was significantly lower. Discussion. Results indicate that the activity pattern of PLEM in the small intestine mimics the activity of the natural endogenous pancreatic enzymes in healthy pigs. The most physiological features of PLEM were observed when enzymes were offered orally. The magnitude of PLEM activity in the stomach of EPI pigs was essential and significantly higher than that measured in healthy pigs, thus being somewhat not physiological, and for health reasons of the patients should be further explored. Interestingly, specific trypsin-like activity was measured in all parts of the GIT after PLEM application. However, proteolytic activity of the experimental proteaze in in vitro studies did not exhibit trypsin-like activity.