Therapeutic potential and clinical efficacy of acid-resistant fungal lipase in the treatment of pancreatic steatorrhoea due to cystic fibrosis.

Abstract

We investigated the therapeutic potential of an acid-resistant fungal lipase prepared from Aspergillus niger. We first demonstrated in vitro that it had a wide pH optimum of 2.5-5.5 and was resistant to pepsin and trypsin. We gave the enzyme or matching placebo in random order by mouth with a fatty meal to 10 adult patients with pancreatic steatorrhoea due to cystic fibrosis (CF) and sampled gastric contents for the following 2 h. Mean acid-resistant lipase activity was 330 nmol/ml/min free fatty acid released on placebo, compared with 896 nmol/ml/min on fungal lipase (p = 0.006 for area under the curve). We compared this lipase's clinical efficacy with that of two conventional pancreatin microsphere formulations in an open randomised crossover fat-balance study in 10 similar patients. Each preparation was given for 2 weeks, and a fat-balance study, using a faecal recovery marker, was performed on the final 3 days; a period without treatment was also included. The fungal lipase had no effect on faecal wet weight or on the coefficient of fat absorption (59.0% vs. 52.3%; NS) in comparison with placebo. The established enteric-coated microsphere preparation (Creon) produced a significant reduction in faecal wet weight and improvement in coefficient of fat absorption (81.4% vs. 52.3%; p less than 0.01) in comparison with placebo. The newer microsphere preparation (Pancrex M) was also effective, but perhaps less so than Creon; there were no significant differences between the two preparations.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: P L Zentler-Munro, B A Assoufi, K Balasubramanian, S Cornell, D Benoliel, T C Northfield, M E Hodson
• Journal: Pancreas (Pancreas) Vol. 7 Issue 3 Pg. 311-9 ( 1992) ISSN: 0885-3177 [Print] United States
• PMID: 1594552 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Acids
• Dietary Fats
• Fungal Proteins
• Lipase

Topics

• Acids
• Adult
• Aspergillus niger (enzymology)
• Celiac Disease (drug therapy, etiology, metabolism)
• Cystic Fibrosis (complications)
• Dietary Fats (metabolism)
• Fungal Proteins (therapeutic use)
• Humans
• Lipase (therapeutic use)
• Pancreatic Diseases (drug therapy, etiology, metabolism)