Deficiency pancreatic function

Corn seed-derived dog gastric lipase is under development by Meristem Therapeutics for the treatment of gastric lipase deficiency (steatorrhea), neonatal deficient pancreatic function, or when pancreatic function is compromised by diseases such as cystic fibrosis or chronic alcoholism [159]. The absence of gastric lipase in steatorrhea patients prevents the digestion of food lipids. Pre-term infants have difficulty digesting lipids and, unless they are breast-fed, have no access to this enzyme. 

Mechanism of Action An antioxidant that prevents oxidation of vitamins A and C, protects fatty acids from aff ack by free radicals, and protects RBCs from hemolysis by oxidizing agents. Therapeutic Effect Prevents and treats vitamin E deficiency. Pharmacokinetics Variably absorbed from the GI tract (requires bile salts, dietary fat, and normal pancreatic function). Primarily concentrated in adipose tissue. Metabolized in the liver. Primarily eliminated by biliary system. 

Tocopherols (vitamin E) occur in many food substances that are consumed as part of the normal diet. The daily nutritional requirement has not been clearly defined but is estimated to be 3.0-20.0 mg. Absorption from the gastrointestinal tract is dependent upon normal pancreatic function and the presence of bile. Tocopherols are widely distributed throughout the body, with some ingested tocopherol metabolized in the liver excretion of metabolites is via the urine or bile. Individuals with vitamin E deficiency are usually treated by oral administration of tocopherols, although intramuscular and intravenous administration may sometimes be used. 

Lyman, R. L., and Wilcox, S. S., Effect of acute amino acid deficiencies on carcass composition and pancreatic function in the force-fed rat. I. Efficiencies of valine, lysine, tryptophan, leucine, and isoleucine, /. Nutr., 79, 37, 1963. 

Xenobiotic-induced pancreatitis may be accompanied by gross plasma lipid changes that may result from marked changes of carbohydrate metabolism (see Chapter 9). The observation of the presence of gross macroscopic fecal fat content (steatorrhea) can indicate effects on pancreatic function, biliary dysfunction, or intestinal malabsorption. In longer-term studies, malabsorption of fat-soluble vitamins may be reflected by the clinical condition of vitamin-deficient animals. 

CF-related diabetes shares characteristics of both type 1 and type 2 diabetes mellitus but is categorized separately. The primary cause of CFRD is insulin deficiency resulting from both reduced functional pancreatic islet cells and increased islet amyloid deposition. Insulin secretion is delayed in response to glucose challenge, and absolute insulin secretion over time is reduced. Some insulin resistance may also be present in CFRD however, sensitivity may be increased in CF patients without diabetes.8... 

As patients lose exocrine function of the pancreas, they have decreased ability to absorb lipids and protein ingested with normal dietary intake. Weight loss from nutritional malabsorption is a common symptom of chronic pancreatitis not often seen in acute pancreatitis. Fatty- or protein-containing stools are also common carbohydrate absorption is usually unaffected. Even though patients with chronic pancreatitis have decreased ability to absorb lipid from the gastrointestinal tract, there does not appear to be an increased incidence of fat-soluble vitamin deficiency in these patients.34... 

In addition to steatorrhea and nutritional deficiencies, patients with pancreatic exocrine insufficiency also develop symptoms such as postprandial pain, cramps, bloating, and distention. These are caused by profound alterations of upper gastrointestinal secretory and motor functions in response to increased nutrient delivery to the distal small intestine, particularly the ileum. In the first 5-10 years of chronic pancreatitis, overt malabsorption is usually neither detected nor a major clinical problem, although enzyme output may decrease by 60%-90%. Still, there is evidence that, even in the early stages of chronic pancreatitis, the site of maximal nutrient digestion and absorption is shifted from the duodenum to the more distal small intestine. 

Singh, M, (1982). Effect of thiamin deficiency on pancreatic acinar cell function. Am. ]. Cfj n. jVjdr. 36, 50O-51H. 

Cystic fibrosis is the most common lethal genetic disease among the white population of the United States. Eccrine and exocrine gland function are affected. Pulmonary disease and pancreatic insufficiency frequently occur. Food, particularly fats and proteins, may be only partially digested, and nutritional deficiencies result. 

Blockage of the bile duct caused by problems such as cholesterol-containing gallstones or duodenal or pancreatic tumors can lead to an inadequate concentration of bile salts in the intestine. Digestion and absorption of dietary lipids is diminished. Certain diseases that affect the pancreas can lead to a decrease in bicarbonate and digestive enzymes in the intestinal lumen. (Bicarbonate is required to raise the intestinal pH so that bile salts and digestive enzymes can function.) If dietary fats are not adequately digested, steatorrhea may result. Malabsorption of fats can lead to caloric deficiencies and lack of fat-soluble vitamins and essential fatty acids. 

Lipoprotein lipase deficiency Reduced levels of functional LPL 1 Pancreatitis... 

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