Enzyme replacement therapy for pancreatic insufficiency: present and future.Report as inadecuate

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* Corresponding author 1 Division of Digestive Diseases Division of Digestive Diseases 2 -Nutrition Humaine et Lipides- Nutrition humaine et lipides : Biodisponibilité, métabolisme et régulation

Abstract : Pancreatic enzyme replacement therapy is currently the mainstay of treatment for nutrient malabsorption secondary to pancreatic insufficiency. This treatment is safe and has few side effects. Data demonstrate efficacy in reducing steatorrhea and fat malabsorption. Effective therapy has been limited by the ability to replicate the physiologic process of enzyme delivery to the appropriate site, in general the duodenum, at the appropriate time. The challenges include enzyme destruction in the stomach, lack of adequate mixing with the chyme in the duodenum, and failing to deliver and activate at the appropriate time. Treatment is begun when clinically significant malabsorption occurs resulting in steatorrhea and weight loss. Treatment failure is addressed in a sequential fashion. Current research is aimed at studying new enzymes and delivery systems to improve the efficiency of action in the duodenum along with developing better means to monitor therapy.

Keywords : pancreatic enzyme replacement therapy lipase lipids chronic pancreatitis cystic fibrosis exocrine pancreatic insufficiency

Author: Aaron Fieker - Jessica Philpott - Martine Armand -

Source: https://hal.archives-ouvertes.fr/


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