Pancreatin

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Pancreatin is an enzymatically active, complex mixture of active ingredients of animal origin that are obtained from the pancreas of domestic pigs .

Extraction and composition

The active ingredient is obtained by extracting the pig pancreatic glands, purifying and drying the extract. This usually results in a brown powder that is irritating to the eyes and is partially soluble in water. The pancreatic glands required are a by-product in slaughterhouses when pork is obtained for food purposes . Like all raw materials of animal origin for the production of pharmaceuticals, the glands and the manufacturing process are subject to strict quality controls, which is why delivery bottlenecks are regular .

The main components of pancreatin are lipases , amylases and various proteases .

Therapeutics

Historical

As early as the first third of the 20th century, ointments and powder made from pancreatin were used to treat boils , erythema and burns .

In 1928 Hans Axmann (1862–1934) treated scars. At the same time, Erich Bumm (born 1899) was using pancreatin sticks to treat bone marrow inflammation . Portio carcinomas could also be cleaned with the rods after irradiation.

Inflammation in the mouth and throat were gargling agents such as Yatrobar or inflamed gums with toothpaste as Pepsodent treated. With them, too, the effect is based on pancreatin.

nowadays

Medicines to replace pancreatic enzymes in diseases of the pancreas , for example for the treatment of exocrine pancreatic insufficiency, are made from the mixture of active ingredients . A complete recovery of the digestion is not possible with it.

The most important therapeutic component of pancreatin are the lipases, which break down dietary fats and thus improve the patient's nutritional status and at the same time avoid the unpleasant side effects of poor fat digestion , such as fatty stools .

Pig pancreas lipases are acid labile. That is why pancreatin-containing drugs are coated with gastric juice-resistant coatings to protect the enzymes from gastric acid . After passage through the stomach and the change in pH value when entering the small intestine , the protective film dissolves and releases the active ingredient, which can now have an enzymatic effect in the food pulp.

Medicines containing pancreatin must be taken directly with the meal so that they reach the small intestine together with the food ingested in order to be effective there.

criticism

Treatment with pancreatin is controversial because the active ingredient is produced from pig slaughterhouse waste. Sections of the Islamic and Jewish world are critical of the extraction process. For patients who reject pork preparations for religious or ideological reasons, digestive enzymes of fungal origin ( rizoenzymes from rice mushrooms ) are a therapeutic alternative. The University Medical Center Münster and the University Medical Center of the Ruhr University Bochum as well as the biotech company Cilian are currently researching a new process based on the production of digestive enzymes by single-cell organisms .

Trade names

Medicines containing pancreatin (see also list of medicinal products ) are: Cotazym (DE), Enzym Lefax forte (DE), Kreon (DE, AT; in CH as Creon), Lipazym (DE), Mezym (DE), Ozym (DE), Pancrin ( DE, AT), Pangrol (DE), Panpur (DE), Pankreatan (DE), Pankreoflat (AT), Panzynorm (CH, DE), Panzytrat (CH, DE).

In veterinary medicine, pancreatin is sold as Astoral Almazyme and Pancrex-Vet .

Individual evidence

  1. ↑ Carolin Bauer: Pancreatin: When the sow does not deliver. Retrieved July 19, 2016 .
  2. ^ A b c Wolf-Dieter Müller-Jahncke , Christoph Friedrich , Ulrich Meyer: Medicinal history . 2nd, revised and expanded edition. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart 2005, ISBN 978-3-8047-2113-5 , p. 109 f .
  3. ^ P. Layer, J. Keller, PG Lankisch: Pancreatic enzyme replacement therapy . In: Curr Gastroenterol Rep . 3, No. 2, April 2001, pp. 101-108. doi : 10.1007 / s11894-001-0005-8 . PMID 11276376 .
  4. ↑ Data sheet Pancreas powder (protease) BRP (PDF) at EDQM , accessed on August 31, 2010.
  5. ^ Ernst-Albert Meyer: Digestive complaints: Plant enzymes as a therapy option. In: PTA-Forum , issue 04/2008.
  6. ^ Markus Köller: ciliates instead of slaughterhouse waste. December 11, 2013, archived from the original on November 12, 2014 ; Retrieved December 12, 2013 .
  7. ↑ Revolutionary advances in the treatment of pancreatic disease . Münstersche Zeitung, October 11, 2018, accessed on March 22, 2020 .