Pancreatic elastase
| Pancreatic elastase | ||
|---|---|---|
| Properties of human protein | ||
| Mass / length primary structure | 250 amino acids (after activation 240) | |
| Precursor | (258 aa) | |
| Identifier | ||
| Gene name | CELA1 | |
| External IDs | ||
| Enzyme classification | ||
| EC, category | 3.4.21.36 , serine protease | |
| MEROPS | S01.155 | |
| Response type | Cleavage of peptide bonds | |
| Substrate | Elastin | |
| Products | Elastin fragments | |
| Occurrence | ||
| Parent taxon | Vertebrates | |
The pancreatic elastase ( elastase 1 , elastase chymotrypsin-like 1 gene -Name: CELA1 ) is a digestive enzyme which in the pancreas of all vertebrates is formed. The enzyme breaks down proteins (so-called endopeptidase ) and generally belongs to the group of elastases . It is released from the pancreas into the small intestine along with other digestive enzymes such as alpha-amylase , lipase , trypsin and phospholipases .
history
Pancreatic elastase was discovered in 1949 by the Hungarians Józef Baló (born 1898) and Ilona Banga (born 1906). The latter also isolated it in 1952. The thesis of the two was that elastase in atherosclerosis destroys the elastic fibers of the cell walls . This assumption could, however, be refuted by a series of tests with chickens by DM Tennent in 1956.
function
Pancreatic elastase is produced in the pancreas as an inactive zymogen (proelastase) and activated in the small intestine by cleavage with trypsin to form the enzyme elastase. The active digestive enzyme breaks down elastin in particular . The pancreatic elastase is excreted unchanged in the stool.
Laboratory diagnostic significance
The elastase remains stable during the intestinal passage and accumulates in the stool. The amount of pancreatic elastase-1 found in the stool provides information about the exocrine function of the pancreas. During acute inflammation of the pancreas, pancreatic elastase passes into the blood and can therefore be measured in the serum. A decreased pancreatic elastase concentration is an indication of exocrine pancreatic insufficiency or cystic fibrosis . The ELISA test for fecal elastase-1 was developed in 1989 at the University of Giessen.
The elastase from the stool is determined in the case of unclear diarrhea or constipation , fatty stools , flatulence and weight loss; also for epigastric pain and food intolerance . If acute pancreatitis or an acute flare-up of chronic pancreatitis is suspected , the determination can be made from the serum . It is a sensitive and specific detection of the inflammatory process .
The reference value in the stool for adults and children after the first month of life is 200 to> 500 μg E1 / g. 100–200 μg E1 / g stool are assessed as moderate to mild insufficiency , values <100 μg E1 / g stool as severe insufficiency. The normal value in the serum is <3.5 ng / ml.
An increased elastase level in the blood serum suggests an acute pancreatitis or an acute flare-up of a chronic pancreatitis, an increased level in the stool has no clinical significance.
Decreased elastase values in the blood serum are of no significance. Decreased values in the stool indicate a decreased production of digestive enzymes. This can be the result of chronic pancreatitis, pancreatic cancer (pancreatic cancer) or a cyst pancreas, for example . In addition, the lowered values can indicate chronic alcohol abuse . In children, there are lowered values in a genetic metabolic disorder, cystic fibrosis. The lowered elastase values can then already be determined in the first few weeks of life.
literature
- C. Löser, A. Möllgaard, UR Fölsch: Faecal elastase 1: a novel, highly sensitive, and specific tubeless pancreatic function test. In: Good. Volume 39, Number 4, October 1996, pp. 580-586, ISSN 0017-5749 . PMID 8944569 . PMC 1383273 (free full text).
- HC Hieronymus: The elastase 1 stool test: a new, non-invasive pancreatic function test for the diagnosis and staging of chronic pancreatitis . Magdeburg 1998, Diss. Med., 65 S. http://d-nb.info/954100034 .
- PD Hardt, A. Krauss, L. Bretz, M. Porsch-Ozcürümz, H. Schnell-Kretschmer, E. Mäser, RG Bretzel, T. Zekhorn, HU Klör: Pancreatic exocrine function in patients with type 1 and type 2 diabetes mellitus . In: Acta diabetologica. Volume 37, Number 3, 2000, pp. 105-110, ISSN 0940-5429 . PMID 11277309 .
- JS Leeds, K. Oppong, DS Sanders: The role of fecal elastase-1 in detecting exocrine pancreatic disease. In: Nature reviews. Gastroenterology & Hepatology. Volume 8, Number 7, July 2011, pp. 405-415, ISSN 1759-5053 . doi : 10.1038 / nrgastro.2011.91 . PMID 21629239 .
Individual evidence
- ^ A b 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. 115 .
- ↑ A. Sziegoleit, E. Krause, HU Klör, L. Kanacher, D. Linder: Elastase 1 and chymotrypsin B in pancreatic juice and feces. In: Clinical biochemistry. Volume 22, Number 2, April 1989, pp. 85-89, ISSN 0009-9120 . PMID 2720968 .