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Cathodal elastase in duodenal juice from children with gastrointestinal disorders
Insights
This study measured cathodal elastase in children with malabsorption. Levels varied by age and condition, with pancreatic insufficiency showing significantly reduced enzyme activity.
Area of Science:
- Biochemistry
- Pediatric Gastroenterology
- Enzymology
Background:
- Cathodal elastase is a key enzyme in protein digestion.
- Assessing elastase activity aids in diagnosing malabsorption disorders in children.
- Age-related development of pancreatic enzymes is crucial for nutrient absorption.
Purpose of the Study:
- To quantify immunoreactive cathodal elastase, elastinolytic activity, and elastase substrate activity in duodenal juice of children with malabsorption.
- To investigate the influence of age and specific malabsorption conditions on these enzymatic activities.
- To evaluate the diagnostic utility of these markers in differentiating pancreatic insufficiency from other gastrointestinal disorders.
Main Methods:
- Analysis of duodenal juice from 89 fasting children with various malabsorption issues.
- Assays included immunoreactive cathodal elastase, elastinolytic activity, and activity on succinyl-trialanine substrate.
- Comparison of enzyme levels across different age groups and diagnostic categories (celiac disease, unclassified GI disorders, cow's milk protein intolerance, pancreatic insufficiency).
Main Results:
- Cathodal elastase immunoactivity averaged 1% of total duodenal juice protein.
- Enzyme levels showed significant age-dependent development in the first 24 months.
- Children with celiac disease exhibited lower levels of all measured parameters compared to other groups with normal pancreatic function.
- Children with pancreatic insufficiency demonstrated markedly reduced or undetectable levels of cathodal elastase and related activities.
Conclusions:
- Cathodal elastase levels are influenced by age, reflecting ongoing development in early childhood.
- Reduced elastase activity is a significant indicator in children with malabsorption, particularly in cases of pancreatic insufficiency.
- These enzymatic assays provide valuable insights into pediatric malabsorption and pancreatic exocrine function.
Abstract:
Immunoreactive cathodal elastase, elastinolytic activity, and activity on the low-molecular elastase substrate succinyl-trialanine were assayed in duodenal juice from 89 fasting children with different malabsorption problems. Cathodal elastase immunoactivity (mean value, 0.06 g/liter) averaged 1% of the total protein content in duodenal juice and 1/16 of the succinyl-trialanine-splitting activity. A strong influence of age was found for immunoactivity and elastinolytic activity, indicating continuing development of the cathodal elastase during the first 24 months of life. In 81 children with normal pancreatic function, significantly lower levels for all parameters including total protein were found for 14 with coeliac disease than for 34 children with unclassified gastrointestinal disorders and 33 with cow's milk protein intolerance. In eight children with pancreatic insufficiency, seven lacked detectable immunoactive cathodal elastase; low levels of succinyl-trialanine-splitting activity were found in six, and remnants of elastinolytic activity in three.