Comparative Trial of Nutrizym in Chronic Pancreatic Insufficiency

Abstract

Summary: A cross-over trial of pancreatic replacement therapy was carried out in 12 adults with chronic pancreatic insufficiency. The standard enteric-coated preparation, Pancrex V forte, was compared with Nutrizym, which has an enteric-coated core of pancreatic extract and a shell of bromelains-a mixture of proteolytic enzymes derived from the stem of the pineapple.Nutrizym was significantly more effective than Pancrex V forte in improving fat absorption, and reduced faecal weight. Protein digestion was assessed by measuring the urinary excretion of hydroxyproline after a gelatin meal. Nutrizym produced an earlier and significantly higher peak in hydroxyproline excretion than Pancrex V forte, but the cumulative effect was similar. The value of bromelains was investigated by including a period on the Nutrizym core alone. This was similar to Pancrex V forte in improving fat absorption but had less effect on protein digestion, suggesting that the beneficial effect of Nutrizym compared with Pancrex V forte was due to the added bromelains, and not to differences in enzyme content or enteric coating.

Cysteine Proteases

“…A wide range of therapeutic benefits are claimed for bromelain, introduced as a therapeutic compound since 1957. Bromelain's principle activities include: the reversible inhibition of platelet aggregation (Morita et al, 1979), fibrinolytic activity (Maurer et al, 2000), anti-inflammatory action (Inoue et al, 1994), the modulation of cytokines and immunity (Desser et al, 1994;Munzig et al, 1995), skin debridement of burns (Rosenberg et al, 2004), anti-tumour activity (Batkin et al, 1988), enhanced absorption of other drugs (Tinozzi and Venegoni, 1978), mucolytic properties (Hunter et al, 1957), a digestion aid (Knill-Jones et al, 1970), enhanced wound healing (Tassman et al, 1965) and cardiovascular and circulatory improvement (Taussig and Nieper, 1979). In addition to the cysteine protease, bromelain preparations also contains other biologically active compounds such as peroxidase, acid phosphatase, several protease inhibitors and organically bound calcium.…”

Effects of bromelain supplementation on growth performance, nutrient digestibility, blood profiles, faecal microbial shedding, faecal score and faecal noxious gas emission in weanling pigs

“…Because of its wide pH range, bromelain has activity in the stomach as well as the small intestine. It has also been shown to be an adequate replacement for pepsin and trypsin in cases of deficiency (Knill-Jones et al 1970).…”

PRESERVATION OF NATURAL STABILITY OF FRUIT “BROMELAIN” FROMANANAS COMOSUS(PINEAPPLE)

“…Less abundant enzymes are glucosidases and cellulases. Though it is widely used to aid digestion (Knill‐Jones et al. 1970; Balakrishnan et al.…”

“…Less abundant enzymes are glucosidases and cellulases. Though it is widely used to aid digestion (Knill-Jones et al 1970;Balakrishnan et al 1981), it can effectively reduce inflammation (Tassman et al 1964(Tassman et al , 1965 and swelling (Masson 1995), and has even been identified experimentally as an effective anti-cancer agent (Gerard 1972;Nieper 1974;Taussig et al 1985;Batkin et al 1988). Bromelain also modulates T cell responses (Engwerda et al 2001).…”