Triglyceride digestion

In response to a meal, cholecystokinin is released from the intestine and causes relaxation of the sphincter of Oddi and contraction of the gallbladder (see Chapter 48). This allows a concentrated solution of micelles (consisting of bile salts, lecithin, and cholesterol) to enter the intestine. In the intestinal lumen, dietary cholesterol and the products of triglyceride digestion (predominantly free fatty acids and monoglycerides) are incorporated into mixed micelles. Micelles deliver lipolytic products to the mucosal surface. To carry out these functions, a critical micellar bile acid concentration of 2ramoI/L is necessary. 

The biochemical processes involved in triglyceride digestion and absorption have recently been targeted... 

What happens to the products of triglyceride digestion as they pass into the cells of the intestinal mucosa ... 

This fundamental role of bile salts in the intestinal absorption of sterols is a reflection of the potential requirements for this cholesterol metabolites in various steps of intraluminal and epithelial cell mechanisms of cholesterol absorption (Figure 1), These include solubilization of cholesterol in the intestinal lumen by mixed micelles, containing biliary bile salts and phospholipids, and the products of triglyceride digestion modification of the intestinal surface barriers to cholesterol transfer, including the un-stirred water layer" and the mucin "coat" and the cellular esterification of cholesterol prior to incorporation of the resulting esters into the lipoprotein core lipids. 

Pancreatic enzyme supplements should be taken immediately prior to meals to aid in the digestion and absorption of food. Alternately, patients can supplement their diet with medium chain triglycerides (MCTs) or ingest foods rich in MCTs since they do not require pancreatic enzymes for absorption. An appropriate regimen incorporates the successful doses of each enzyme (amylase, lipase, and protease) from the starting non-enteric-coated regimen. As with the previous example, a patient stabilized on Viokase-8, six tablets with each meal, can be transitioned to Pancrease MT-16 three tablets with meals. The famotidine can then be discontinued. 

Note The role of lingual lipase in the digestion of dietary lipids is minor because it accounts for less than 10% of the enzymatic breakdown of triglycerides. 

Hydrolases, which catalyze the hydrolysis of various bonds. The best-known subcategory of hydrolases are the lipases, which hydrolyze ester bonds. In the example of human pancreatic lipase, which is the main enzyme responsible for breaking down fats in the human digestive system, a lipase acts to convert triglyceride substrates found in oils from food to monoglycerides and free fatty acids. In the chemical industry, lipases are also used, for instance, to catalyze the —C N —CONH2 reaction, for the synthesis of acrylamide from acrylonitril, or nicotinic acid from 3-pyridylnitrile. 

Figure 8.15 Cartoon showing how proteins, polysaccharides and surfactants (emulsifiers) might be distributed at the triglyceride-water interface. Inter-facial complexation in vivo between adsorbed protein and charged polysaccharide in the gastrointestinal tract could affect digestion of protein and fat by forming structures that inhibit the accessibility and activity of enzymes (proteases and lipases). Reproduced from Dickinson (2008) with permission.

An adult ingests about 60 to 150 g of lipids per day, of which more than n nety percent is normally triacylglycerol (formerly called triglyceride). Uhe remainder of the dietary lipids consists primarily of cholesterol, cholesteryl esters, phospholipids, and unesterified ("free") fatty acids. "The digestion of dietary lipids is summarized in Figure 15.2. 

Enzymatic hydrolysis is a nondestructive alternative to saponification for removing triglycerides in vitamin K determinations. For the simultaneous determination of vitamins A, D, E, and K in milk- and soy-based infant formulas and dairy products fortified with these vitamins (81), an amount of sample containing approximately 3.5-4.0 g of fat was digested for 1 h with lipase at 37°C and at pH 7.7. This treatment effectively hydrolyzed the glycerides, but only partially converted retinyl palmitate and a-tocopheryl acetate to their alcohol forms vitamin D and phyllo-quinone were unaffected. The hydrolysate was made alkaline in order to precipitate the fatty acids as soaps and then diluted with ethanol and extracted with pentane. A final water wash yielded an organic phase containing primarily the fat-soluble vitamins and cholesterol. 

Kaukonen, A.M. et al. (2004) Drug solubilization behavior durimgitro digestion of simple triglyceride lipid solution formulationsPharm. Res., 21 245-253. 

Porter, C.J.H. et al. (2004) Useimfvitro lipid digestion data to explain tliB vivo performance of triglyceride-based oral lipid formulations of poorly water-soluble drugs studies with halofanttiifiSiarm. Sci.,... 

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