Pancreatic-like enzymes of microbial origin restore growth and normalize lipid absorption in a pig model with exocrine pancreatic insufficiency

Abstract

IntroductionThe standard therapy for exocrine pancreatic insufficiency (EPI) is porcine-derived pancreatic enzyme replacement therapy (PERT). In the present study we tested a new approach with a mixture of pancreatic-like enzymes of microbial origin (PLEM) in a 1-week efficacy study in EPI pigs. In addition to the conventionally used coefficient of fat and nitrogen absorption (CFA and CNA), parameters that more accurately reflect the nutritional and health status, such as changes in the lipemic index (LI), plasma triglyceride (TG) and non-esterified fatty acid (NEFA) levels, and somatic growth, were determined.Material and methodsA PLEM dose containing 120 000 active lipase units, 80 000 active protease units and 12 000 active amylase units (all from Sigma, St. Louis, MO) was given as a powder, twice daily with a meal (40 g fat/meal) to 8 EPI pigs for 7 days. Ten healthy pigs were used as a comparator.ResultsThe PLEM enhanced fat and protein digestion, and reversed growth impairment in EPI pigs. With treatment, CFA and CNA increased by 59% and 43% (p < 0.05), respectively. Although fat and protein absorption were lower than in the comparator, the postprandial blood lipid profile was normal as in healthy pigs. The mucosal thickness significantly increased by 27%, 50% and 26%, in the proximal, middle, and distal jejunum (p < 0.05) with treatment and resembled that of healthy animals.ConclusionsPancreatic-like enzymes of microbial origin supported somatic growth and normalized the postprandial lipid profile. As a measure of efficacy, postprandial LI, TG and NEFA are viable endpoints to be explored in human trials.

Gut microbiome as a response marker for pancreatic enzyme replacement therapy in a porcine model of exocrine pancreas insufficiency

“…Remarkably, besides the increased abundance of some beneficial bacteria, most genera showed a diminished relative abundance. This effect supports the hypothesis that bacterial overgrowth was induced by the ligation of the pancreatic duct and the subsequent lack of the antimicrobial function of pancreatic juice [ 28 ] in our minipig study.…”

The Effect of Digestion and Digestibility on Allergenicity of Food

“…In humans, α-amylase is a product of the exocrine pancreas. Animal models suggest that microbial amylases could be supplied in pancreas insufficiency [ 18 ]. It is not known whether this will be linked to a risk for sensitization, but α-amylase per se when inhaled is a well-known occupational allergen.…”

The Positive Effects of Exogenous Pancreatin on Growth Performance, Nutrient Digestion and Absorption, and Intestinal Microbiota in Piglets

“…The addition of multi-enzyme to phytase-supplemented corn-based diet for weaned pigs could improve their growth performance and fat digestibility ( Park et al, 2020 ). Researchers manifested that the body mass in the group of exocrine pancreatic insufficiency (EPI) pigs treated with pancreatic-like enzymes of microbial origin increased by 9% compared to the baseline (10.6 ± 2.0 kg to 11.6 ± 2.5 kg, p < 0.05), resulting in a reversed growth impairment in EPI pigs ( Pierzynowska et al, 2018 ). In contrast, EPI pigs might have a similar growth status with normal pigs, which could be attributed to different ages of EPI pigs ( Fedkiv et al, 2009 ).…”