The role of pancreatin in supplement therapy.

1. 11/13/15
enzyme pancreatin –
supplementation
therapy
Presented by,
V.Venkatramanan
B.Tech(biotechnology)
KSRCT.

2. Introduction
Pancreatin is a mixture of multiple digestive
enzymes produced by the exocrine cells of the
pancreas.
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3. Composition of pancreatin
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Enzyme Optimal pH Range Action
Proteolytic Enzymes:
Trypsinogen (trypsin) (EC 3.4.21.4)
Chymotrypsinogen (chymotrypsin)
(EC 3.4.21,1)
Carboxypolypeptidase(EC 3.4.17.1)
7.9-9.7 Trypsin and chymotrypsin break
down proteins into polypeptides and
dipeptides carboxypolypeptidase
splits peptides into individual amino
acids
Pancreatic amylase
(EC 3.2.1.1)
6.7-7.2 Hydrolyzes starches, glycogen, and
other carbohydrates (other than
cellulose) into disaccharides and
some trisaccharides
LipolyticEnzymes:
Lipase (EC 3.1.1.3)
Phosphalipase (EC 3.1.1.4)
8.0 Lipase hydrolyzes fats into fatty
acids and monoglycerides;
phospholipases split fatty acids
from phospholipids

4. Pancreatic enzyme insufficiency
• Normal pancreatic function ensures effective digestion and absorption of
nutrients.
• Clinical exocrine pancreatic insufficiency occurs when secretions of the
pancreas do not maintain normal digestive function resulting in nutrition
malabsorption and other symptoms such as diarrhea, which in turns affects
quality of life and malnutrition.
• The leading cause of pancreatic insufficiency is chronic pancreatitis which is
estimated to affect 0.4 – 5% of the world population.
• The most common cause of pancreatic insufficiency in kids is cystic fibrosis.
• Pet animals such as dogs and cats are highly affected by pancreatic
insufficiency.
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5. Cystic fibrosis pancreatitis
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6. 11/13/15

7. ENZYME SUPPLEMENTATION THERAPY
• Chymotrypsin, trypsin and pancrelipase, either individually or in
combination, are the key components of most common pancreatic
supplements used in health care and are primarily extracted from porcine
or bovine sources.
• Lipase may also be synthesized from microbial sources, such as Aspergillus
oryzae.
• U.S. Pharmacopoeia (U.S.P.) grade chymotrypsin and trypsin are
crystallized from ox pancreas gland extract.
• The activity and concentration of these enzymes are determined by
multiple factors, including the animal’s species, age and sex, as well as
husbandry practices.
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8. Activity of main pancreatic enzymes in
normal humans*
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enzyme Units
(infants)
Units
(adults)
lipase 1061 ± 101 1454 ± 95
phospholipase 16.7 ± 1.9 24.4 ± 1.53
trypsin 27 - 113 13 - 138
chymotrypsin 93 ± 9 147 ± 11
amylase 2 - 37 31 - 840
* Stated as per fieker et al, 2011.

9. Baseline activity of the main pancreatic enzymes
in irreversible pancreatic inefficiency*
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enzyme Units
(infants)
Units
(adults)
lipase 378 458 ± 83
phospholipase 2.5 – 9 20 - 25
trypsin 5.2 – 8.6 16 - 72
chymotrypsin 0 - 82 31 - 52
amylase 4.3 10 - 760
* Stated as per fieker et al, 2011.

10. Dosage of pancreatin *
• The typical indications for starting enzyme
replacement are progressive weight loss and
steatorrhea.
• Atleast 7 to 15g of fecal fat per day.
• 25,000 to 40,000 IU per meal, 5000 to 25,000 IU
per snack are recommended.
• 50,000, 100,000 and 150,000 IU per day will
reduce steatorrhea by 45%, 60% and 70%.
11/13/15 * Stated as per ferroni et al, 2007.

11. General comparison of microbial
enzymes and pancreatin*
Enzyme Microbe derived Pancreatin
Amylase 100 units ≈ 89 units
Protease 500 units ≈ 197 units
lipase 100 units ≈ 80 units
11/13/15 * Stated as per mario et al, 2008.

12. Effectiveness of pancreatin in reducing
fecal nitrogen and fat loss – dog model
• By Tilden et al., it has been proved that
pancreatin in adequate dose was effective in
appreciably reducing fecal nitogen loss.
• The study was conducted using 12 dog.
• The dogs were given daily diet of 80 calories.
• The pancreatin administrated was 10 grams/day
• The loss of nitrogen and fat was reduced up to
2.8%
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13. conclusion
• Pancreatin plays an important role in digestion
of food.
• The insufficiency of pancreatin due to several
diseases could be managed by supplementation.
• The studies stated that the fecal loss of nitrogen
and fat in dogs could be treated by
administration of pancreatin.
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14. references
• TildenC.Everson.,annals of surgery
march,1952: 406-410.
• Aarson Fieker, Jassica philpott, Martine
Armand.,dove medical press 2011:55-70.
• Mario Roxas.,Alternative Medi.Rev, Vol
13,November 4 ,2008
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