1. KUVEMPU UNIVERSITYPancreatic Enzymes and their Assays, Duodenal Contents Under the Guidance Dr. Rajeshwari, Lecturer, Dept. of Biochemistry.Submitted By Ms. Ankitha Hirematha 3rd Sem.

2. CONTENTS1. 2. 3. 4. 5. 6. 7. 8. 9.Pancreas Pancreatic Enzymes Level of Pancreatic Enzymes Pancreatic Enzyme Assay Pancreatic Disorders Malabsorption Syndrome Duodenal Contents Conclusion References 3. Pancreas Pancreas is a glandular organ in the digestive system and endocrine system of vertebrates. Hormones like insulin, glucagon and somatostatin Pancreatic juice containing digestive enzymes. Endocrine portion contains islets of langerhans which has 4 types of cells. cells - glucagon cells - insulin cells - somatostatin cells pancreatic polypeptide Exocrine portion contains 2 types of cells: duct cells and acinar cells Acinar cells secrete digestive enzymes. 4. Pancreatic enzymes Pancreatic enzymes are natural chemicals that help break down fats, proteins and carbohydrates. A normally functioning pancreas secretes about 8 cups of fluid, called pancreatic juice, daily into the duodenum, the portion of the small intestine that connects with the stomach. This fluid contains pancreatic enzymes and helps neutralize stomach acid as it enters the small intestine. Enzyme TypeEffectsLipaseLipase works with bile from the liver toLack of needed fats and fat-solublebreak down fat molecules so they can bevitamins.absorbed andA shortage may cause:Diarrhea and/or fatty stools.used by the body. ProteaseProteases break down proteins. TheyAllergies or the formation of toxichelp keep the intestine free of parasitessubstancessuch as bacteria, yeast and protozoa.digestion of proteins. Increasedduerisktoforincompleteintestinalinfections. AmylaseAmylase breaks down carbohydratesDiarrhea due to the effects of(starch) into sugars which are moreundigested starch in the colon.easily absorbed by the body. Thisenzyme is also found in saliva. 5. Normal level of Pancreatic Enzymes Pancreatic lipase : 10-140 units per liter(U/L)Pancreatic amylase : 23-85 units per liter(U/L)Trypsin : 115-350ng/mlChymotrypsin : 2.3-51.4 U/g of stool The enzymes also include steapsin, carboxypeptidase, elastases & nucleases. 6. Pancreatic enzyme assay: 1. Plasma Enzymes We can measure the plasma trypsin by immunoassay. In pancreatic insufficiency, low level of plasma trypsin in adults is diagnosed. The children with fibrocystic disease have normal pancreatic function initially, the level of plasma trypsin may be high.In acute pancreatitis, total plasma amylase activity is usually significantly increased by release of this plasma amylase enzyme from damaged cells.2. Faecal Enzymes Faecal elastase level and faecal trypsin level is tested. Because of the bacterial degradation in the intestinal lumen, faecal trypsin level is extremely variable. In infants with diarrhoea, the absence of enzymes indicates the fibrocystic disease of the pancreas. 7. 3. Secretin Stimulation Test Secretin is a hormone made by the small intestine. Secretin stimulates the pancreas to release a fluid that neutralizes stomach acid and aids in digestion. The secretin stimulation test measures the ability of the pancreas to respond to secretin. This test may be performed to determine the activity of the pancreas in people with diseases that affect the pancreas (for example, cystic fibrosis or pancreatic cancer). During the test, a health care professional places a tube down the throat, into the stomach, then into the upper part of the small intestine. Secretin is administered by vein and the contents of the duodenal secretions are aspirated (removed with suction) and analyzed over a period of about two hours. 8. Tubeless Tests4. PABA Test A synthetic peptide labelled with PABA is taken orally and the product of its digestion by chymotrypsin, PABA, is absorbed and excreted in the urine. Urinary excretion of PABA is significantly reduced in chronic pancreatitis.5. PLT - Pancreato Lauryl Test A standard meal is taken following an overnight fast along with a test food (with PLT). One or more blood tests or a urine test is then made to see if the test food has been digested (by the pancreatic enzymes) and then absorbed. Here fluorescein dilaurate is used. 9. Disorders of the Pancreas Pancreatic disorders are rarely associated with malabsorption3 types of pancreatic disorders: 1. Acute Pancreatitis 2. Chronic Pancreatitis 3. Carcinoma of Pancreas 10. Acute Pancreatitis 11. Chronic Pancreatitis 12. Pancreatic cancerMalabsorption Syndromes 1. 2. 3. 4. 5.Intestinal malabsorption Pancreatic malabsorption Megaloblastic anaemia Steatorrhoea Malabsorption of disaccharides 13. Duodenal contents Duodenum is the first section of the small intestine in most higher vertebrates. Site for iron absorption, chemical digestion. In Latin, digitorum means twelve fingers breadth. It is a hollow jointed tube about 25 - 38 cm long, roughly horse-shoe shaped. It receives partially digested food from the stomach.and begins the absorption for nutrients. 14. CONCLUSIONSince healthy human body depends on the normal functioning of the pancreas, the pancreatic enzyme assay is needed to check the normal level of the enzymes in duodenum and blood stream. 15. REFERENCEShttp://pathology.jhu.edu/pc/BasicOverview1.php http://www.pancan.org/section_facing_pancreatic_cancer/learn_about_pan _cancer/diet_and_nutrition/Pancreatic_enzymes.php http://www.webmd.com/digestive-disorders/picture-of-the-pancreas http://www.webmd.com/digestive-disorders/pancreas-function-tests http://pancreatitis.org.uk/what_is_pancreatitis.html Lawrence A. Kalpan, Amadeo J.Pesce (2009),Clinical Chemistry,5th Ed.,Mosby Inc., Elsevier Inc. New York, 253-265.