The Assay of Chymotrypsin in Stool as a Simple and Effective Test of Exocrine Pancreatic Activity in Cystic Fibrosis

Girella, E.; Faggionato, P; Benetazzo, D; Mastella, G

doi:10.1097/00006676-198805000-00003

Cited by 22 publications

(13 citation statements)

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“…[5][6][7][8] However, because of the colorimetric method, there is an interference with the enzyme substitution therapy. 9 Thus, pancreatic enzyme supplementation should be stopped for at least 3 days.…”

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confidence: 99%

Fecal Elastase-1 Is Superior to Fecal Chymotrypsin in the Assessment of Pancreatic Involvement in Cystic Fibrosis

Walkowiak¹,

Herzig

Strzykała³

et al. 2002

Pediatrics

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ABSTRACT.Objective. Exocrine pancreatic function in patients with cystic fibrosis (CF) can be evaluated by direct and indirect tests. In pediatric patients, indirect tests are preferred because of their less invasive character, especially in CF patients with respiratory disease. Fecal tests are noninvasive and have been shown to have a high sensitivity and specificity. However, there is no comparative study in CF patients. Therefore, the aim of the present study was to compare the sensitivity and the specificity of the fecal elastase-1 (E1) test with the fecal chymotrypsin (ChT) test in a large cohort of CF patients and healthy subjects (HS).Design. One hundred twenty-three CF patients and 105 HS were evaluated. In all subjects, E1 concentration and ChT activity were measured. In the CF group, fecal fat excretion was also determined. The sensitivity and specificity of the fecal E1 test and ChT test were compared.Results. With a cutoff level of 3 U/g, ChT specificity in HS was similar to that of E1, but E1 sensitivity in CF patients was significantly higher (90.2% vs 81.3%). With a cutoff level of 6 U/g, ChT and E1 sensitivity in CF patients was identical, but E1 specificity in HS was again significantly higher (98.1% vs 90.5%). In all CF patients with severe steatorrhea (>15 g/d), E1 concentrations were abnormal and ChT activity was lower than 3 U/g. In contrast, in pancreatic-sufficient patients and patients with mild steatorrhea (<15 g/d), the E1 sensitivity was significantly higher compared with ChT (69.2% vs 41.0%).Conclusions. The fecal E1 test is superior to fecal ChT determination in the assessment of CF pancreatic involvement in pancreatic-sufficient patients and those patients with mild steatorrhea. Pediatrics 2002;110(1). URL: http://www.pediatrics.org/cgi/content/full/110/1/e7; fecal elastase-1, fecal chymotrypsin, exocrine pancreatic function, cystic fibrosis.

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confidence: 99%

Fecal Elastase-1 Is Superior to Fecal Chymotrypsin in the Assessment of Pancreatic Involvement in Cystic Fibrosis

Walkowiak¹,

Herzig

Strzykała³

et al. 2002

Pediatrics

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“…Determination of fecal chymotrypsin has been an accepted indirect test in pediatric practice for several years [8,12]. However, it has been shown that fecal elastase-1 is far more sensitive than fecal chymotrypsin in the assessment of exocrine pancreatic function in CF [13], and we have recommended that the fecal chymotrypsin test should be replaced by the fecal elastase-1 test in the initial determination of pancreatic status in CF.…”

Section: Discussionmentioning

confidence: 99%

Unresponsive or non-compliant steatorrhea in cystic fibrosis?

Lisowska

Kamińska

Grzymisławski

et al. 2006

Journal of Cystic Fibrosis

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In 105 pancreatic insufficient CF patients (steatorrhea and low fecal elastase-1 concentrations), the effectiveness of pancreatic enzyme therapy (PET) has been assessed (fecal fat losses and coefficient of fat reabsorption). Eight unresponsive subjects were checked for PET compliance with fecal chymotrypsin assay. Three patients were documented to be non-compliant. Unresponsive patients should undergo evaluation for PET compliance.

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“…Therefore, we examined the influence of adding dietary proteins to the ED+SO diet. Since pancreatic enzymes were detected in stool (13)(14)(15)(16)(17), PC, a digestive enzyme from the porcine pancreas, could be the protease-resistant nitrogen source. We used heatdenatured PC as a source of dietary protein.…”

Section: Effects Of Dietary Proteins On Indo-induced Small Bowel Inflmentioning

confidence: 99%

“…Also, an antibody to porcine pancreatic amylase was investigated in sera from CD patients (12). Pancreatic enzymes (amylase, lipase, trypsin, and chymotrypsin) were detected in stool (13)(14)(15)(16)(17). These data suggest that proteins or enzymes from human or animal pancreas could be protease-resistant and might affect disease onset, process, and aggravation of CD.…”

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confidence: 97%

An Elemental Diet Controls Inflammation in Indomethacin-Induced Small Bowel Disease in Rats: The Role of Low Dietary Fat and the Elimination of Dietary Proteins

et al. 2005

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Elemental diets (EDs) are effective in treating Crohn's disease. We hypothesize that low dietary fat and amino acids used as the sole nitrogen source are the major contributors for the success of EDs. We examined the influences of the addition of dietary fat and protein to an ED using an indomethacin-induced inflammation model in rat small intestine. In the ED-fed rats, the intestinal damage score was decreased compared with that in the standard chow group with decreasing intestinal permeability. By supplementing an ED with soybean oil (SO), intestinal permeability was increased to a level similar to that of the standard chow group. For this group, the intestinal damage score also increased compared with that of the ED group but did not reach the levels observed in the standard chow group. The addition of dietary proteins (using heat-denatured pancreatin) resulted in intestinal damage scores that were significantly higher than those of the ED+SO-fed group. The dietary protein increased the intestinal damage score. These results suggest that EDs control inflammation by decreasing intestinal permeability and the elimination of dietary proteins.

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The Assay of Chymotrypsin in Stool as a Simple and Effective Test of Exocrine Pancreatic Activity in Cystic Fibrosis

Cited by 22 publications

References 0 publications

Fecal Elastase-1 Is Superior to Fecal Chymotrypsin in the Assessment of Pancreatic Involvement in Cystic Fibrosis

Fecal Elastase-1 Is Superior to Fecal Chymotrypsin in the Assessment of Pancreatic Involvement in Cystic Fibrosis

Unresponsive or non-compliant steatorrhea in cystic fibrosis?

An Elemental Diet Controls Inflammation in Indomethacin-Induced Small Bowel Disease in Rats: The Role of Low Dietary Fat and the Elimination of Dietary Proteins

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