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Circulating trypsin-like immunoreactivity in chronic pancreatitis

A Andriulli, G Masoero, M Felder

    Digestive Diseases and Sciences
    |June 1, 1981
    PubMed
    Summary

    Fasting serum trypsin-like immunoreactivity declines with worsening exocrine pancreatic function in chronic pancreatitis. Levels may also be affected by factors beyond pancreatic atrophy, impacting disease assessment.

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    Area of Science:

    • Gastroenterology
    • Endocrinology
    • Biochemistry

    Background:

    • Chronic pancreatitis (CP) is a progressive inflammatory disease leading to irreversible damage of the pancreas.
    • Fasting serum trypsin-like immunoreactivity (sTLI) is a potential biomarker for pancreatic function, but its regulatory factors in CP require clarification.

    Purpose of the Study:

    • To investigate the factors influencing fasting serum levels of trypsin-like immunoreactivity in patients with chronic pancreatitis.
    • To assess the relationship between sTLI and exocrine pancreatic function, disease manifestations, and imaging findings.

    Main Methods:

    • Study included 100 patients with chronic pancreatitis during a painless disease phase.
    • Evaluated fasting serum trypsin-like immunoreactivity (sTLI).
    • Assessed pancreatic calcifications, duodenal aspirate outputs (bicarbonate, trypsin, chymotrypsin) via pancreatic secretory studies, and clinical manifestations (diabetes, steatorrhea).

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    Main Results:

    • No correlation was found between sTLI and pancreatic calcifications.
    • sTLI levels progressively declined with impaired bicarbonate and enzyme outputs in duodenal aspirates.
    • Reduced sTLI was observed in nearly all patients with diabetes and steatorrhea.

    Conclusions:

    • Fasting serum trypsin-like immunoreactivity levels reflect the functional capacity of the exocrine pancreas in chronic pancreatitis.
    • While reduced sTLI is associated with diabetes and steatorrhea, other un identified factors may influence sTLI levels, even with normal pancreatic imaging or secretory tests.