Tests of pancreatic exocrine function - Clinical significance in pancreatic and non-pancreatic disorders

Best Practice and Research: Clinical Gastroenterology

Volumn 23, Issue 3, 2009, Pages 425-439

  Keller, Jutta ^a   Aghdassi, Ali Alexander ^b   Lerch, Markus M ^b   Mayerle, Julia V ^b   Layer, Peter ^a  

^a ISRAELITISCHES KRANKENHAUS   (Germany)

^b UNIVERSITY OF GREIFSWALD   (Germany)

Author keywords

13C breath test; elastase 1; pancreatic enzyme secretion; pancreatic function test; pancreatic insufficiency; secretin caerulein test; steatorrhoea

Indexed keywords

CHYMOTRYPSIN; PANCREAS ENZYME; TRANSMEMBRANE CONDUCTANCE REGULATOR;

ACUTE PANCREATITIS; ARTICLE; CELIAC DISEASE; CHRONIC PANCREATITIS; CYSTIC FIBROSIS; DIAGNOSTIC ACCURACY; DIGESTIVE SYSTEM FUNCTION DISORDER; ENTERITIS; ENZYME SYNTHESIS; ENZYME THERAPY; GASTRECTOMY; GASTROINTESTINAL DISEASE; HUMAN; NONHUMAN; PANCREAS CANCER; PANCREAS DISEASE; PANCREAS EXOCRINE INSUFFICIENCY; PANCREAS FUNCTION TEST; PATHOPHYSIOLOGY; SHWACHMAN SYNDROME; STEATORRHEA; ZOLLINGER ELLISON SYNDROME;

ABDOMINAL PAIN; CELIAC DISEASE; CYSTIC FIBROSIS; DIABETES MELLITUS, TYPE 1; DIABETES MELLITUS, TYPE 2; DIAGNOSTIC IMAGING; EXOCRINE PANCREATIC INSUFFICIENCY; FECES; GASTRECTOMY; HUMANS; INFLAMMATORY BOWEL DISEASES; PANCREATECTOMY; PANCREATIC DISEASES; PANCREATIC FUNCTION TESTS; PANCREATIC NEOPLASMS; PANCREATITIS, ALCOHOLIC; PANCREATITIS, CHRONIC;

EID: 66349109467     PISSN: 15216918     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.bpg.2009.02.013     Document Type: Article

References (96)

1. Layer P., and Keller J. Pancreatic enzymes: secretion and luminal nutrient digestion in health and disease. J Clin Gastroenterol 28 (1999) 3-10
2. Etemad B., and Whitcomb D.C. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 120 (2001) 682-707
3. DiMagno E.P., Go V.L., and Summerskill H.J. Intraluminal and postabsorptive effects of amino acids on pancreatic enzyme secretion. J Lab Clin Med 82 (1973) 241-248
4. Andersen D.K. Mechanisms and emerging treatments of the metabolic complications of chronic pancreatitis. Pancreas 35 (2007) 1-15
5. DiMagno E.P., Malagelada J.R., and Go V.L. Relationship between alcoholism and pancreatic insufficiency. Ann N Y Acad Sci 252 (1975) 200-207
6. Keller J., and Layer P. Human pancreatic exocrine response to nutrients in health and disease. Gut 54 Suppl. 6 (2005) vi1-vi28
7. Carriere F., Laugier R., Barrowman J.A., et al. Gastric and pancreatic lipase levels during a test meal in dogs. Scand J Gastroenterol 28 (1993) 443-454
8. Layer P., Go V.L., and DiMagno E.P. Fate of pancreatic enzymes during small intestinal aboral transit in humans. Am J Physiol 251 (1986) G475-G480
9. DiMagno E.P., Go V.L., and Summerskill W.H. Relations between pancreatic enzyme ouputs and malabsorption in severe pancreatic insufficiency. N Engl J Med 288 (1973) 813-815
10. Layer P., von der Ohe M.R., Holst J.J., et al. Altered postprandial motility in chronic pancreatitis: role of malabsorption. Gastroenterology 112 (1997) 1624-1634
11. Moran C.E., Sosa E.G., Martinez S.M., et al. Bone mineral density in patients with pancreatic insufficiency and steatorrhea. Am J Gastroenterol 92 (1997) 867-871
12. Dujsikova H., Dite P., Tomandl J., et al. Occurrence of metabolic osteopathy in patients with chronic pancreatitis. Pancreatology 8 (2008) 583-586
13. Mann S.T., Mann V., Stracke H., et al. Fecal elastase 1 and vitamin D3 in patients with osteoporotic bone fractures. Eur J Med Res 13 (2008) 68-72
14. Chowdhury R.S., and Forsmark C.E. Review article: pancreatic function testing. Aliment Pharmacol Ther 17 (2003) 733-750
15. Niederau C., and Grendell J.H. Diagnosis of chronic pancreatitis. Gastroenterology 88 (1985) 1973-1995
16. Ochi K., Mizushima T., Harada H., et al. Chronic pancreatitis: functional testing. Pancreas 16 (1998) 343-348
17. Andersen B.N., Pedersen N.T., Scheel J., et al. Incidence of alcoholic chronic pancreatitis in Copenhagen. Scand J Gastroenterol 17 (1982) 247-252
18. Olsen T.S. Lipomatosis of the pancreas in autopsy material and its relation to age and overweight. Acta Pathol Microbiol Scand [A] 86A (1978) 367-373
19. Chari S.T., and Singer M.V. The problem of classification and staging of chronic pancreatitis. Proposals based on current knowledge of its natural history. Scand J Gastroenterol 29 (1994) 949-960
20. Lowenfels A.B., Maisonneuve P., Cavallini G., et al. Prognosis of chronic pancreatitis: an international multicenter study. International Pancreatitis Study Group. Am J Gastroenterol 89 (1994) 1467-1471
21. Ammann R.W., and Muellhaupt B. The natural history of pain in alcoholic chronic pancreatitis. Gastroenterology 116 (1999) 1132-1140
22. Ammann R.W., and Muellhaupt B. Progression of alcoholic acute to chronic pancreatitis. Gut 35 (1994) 552-556
23. Somogyi L., Martin S.P., and Ulrich C.D. Recurrent acute pancreatitis. Curr Treat Options Gastroenterol 4 (2001) 361-368
24. Layer P., Yamamoto H., Kalthoff L., et al. The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis. Gastroenterology 107 (1994) 1481-1487
25. Comfort M.G.E., and Baggenstoss A. Chronic relasping pancreatitis: a study of 29 cases without associated disease of the biliary or gastrointestinal tract. Gastroenterology 6 (1946) 239-285
26. Whitcomb D.C., Preston R.A., Aston C.E., et al. A gene for hereditary pancreatitis maps to chromosome 7q35. Gastroenterology 110 (1996) 1975-1980
27. Howes N., Lerch M.M., Greenhalf W., et al. Clinical and genetic characteristics of hereditary pancreatitis in Europe. Clin Gastroenterol Hepatol 2 (2004) 252-261
28. Witt H., Luck W., Hennies H.C., et al. Mutations in the gene encoding the serine protease inhibitor, Kazal type 1 are associated with chronic pancreatitis. Nat Genet 25 (2000) 213-216
29. Weiss F.U., Simon P., Witt H., et al. SPINK1 mutations and phenotypic expression in patients with pancreatitis associated with trypsinogen mutations. J Med Genet 40 (2003) e40
30. Rosendahl J., Witt H., Szmola R., et al. Chymotrypsin C (CTRC) variants that diminish activity or secretion are associated with chronic pancreatitis. Nat Genet 40 (2008) 78-82
31. Weiss F.U., Simon P., Bogdanova N., et al. Complete cystic fibrosis transmembrane conductance regulator gene sequencing in patients with idiopathic chronic pancreatitis and controls. Gut 54 (2005) 1456-1460
32. Kloppel G., Luttges J., Lohr M., et al. Autoimmune pancreatitis: pathological, clinical, and immunological features. Pancreas 27 (2003) 14-19
33. Toskes P.P. Hyperlipidemic pancreatitis. Gastroenterol Clin North Am 19 (1990) 783-791
34. Sarles H., Augustine P., Laugier R., et al. Pancreatic lesions and modifications of pancreatic juice in tropical chronic pancreatitis (tropical calcific diabetes). Dig Dis Sci 39 (1994) 1337-1344
35. Keller J., Holst J.J., and Layer P. Inhibition of human pancreatic and biliary output but not intestinal motility by physiological intraileal lipid loads. Am J Physiol Gastrointest Liver Physiol 290 (2006) G704-G709
36. Conwell D.L., Zuccaro G., Purich E., et al. Comparison of endoscopic ultrasound chronic pancreatitis criteria to the endoscopic secretin-stimulated pancreatic function test. Dig Dis Sci 52 (2007) 1206-1210
37. Regan P.T., Malagelada J.R., DiMagno E.P., et al. Comparative effects of antacids, cimetidine and enteric coating on the therapeutic response to oral enzymes in severe pancreatic insufficiency. N Engl J Med 297 (1977) 854-858
38. Jensen A.R., Matzen P., Malchow-Moller A., et al. Pattern of pain, duct morphology, and pancreatic function in chronic pancreatitis. A comparative study. Scand J Gastroenterol 19 (1984) 334-338
39. Stein J., Jung M., Sziegoleit A., et al. Immunoreactive elastase I: clinical evaluation of a new noninvasive test of pancreatic function. Clin Chem 42 (1996) 222-226
40. Balci N.C., Alkaade S., Magas L., et al. Suspected chronic pancreatitis with normal MRCP: findings on MRI in correlation with secretin MRCP. J Magn Reson Imaging 27 (2008) 125-131
41. Bali M.A., Sontou R., Arvanitakis M., et al. Evaluation of the stimulating effect of a low dose of secretin compared to the standard dose on the exocrine pancreas with MRCP: preliminary results in normal subjects (MRCP quantification of secretin stimulation). Abdom Imaging (2007)
42. Dominguez-Munoz J.E., Iglesias-Garcia J., Iglesias-Rey M., et al. Optimising the therapy of exocrine pancreatic insufficiency by the association of a proton pump inhibitor to enteric coated pancreatic extracts. Gut 55 (2006) 1056-1057
43. 13C-mixed triglyceride breath test to assess oral enzyme substitution therapy in patients with chronic pancreatitis. Clin Gastroenterol Hepatol 5 (2007) 484-488
44. Adler G., Hupp T., and Kern H.F. Course and spontaneous regression of acute pancreatitis in the rat. Virchows Arch A Pathol Anat Histol 382 (1979) 31-47
45. Niederau C., Niederau M., Luthen R., et al. Pancreatic exocrine secretion in acute experimental pancreatitis. Gastroenterology 99 (1990) 1120-1127
46. Saluja A., Saito I., Saluja M., et al. In vivo rat pancreatic acinar cell function during supramaximal stimulation with caerulein. Am J Physiol 249 (1985) G702-G710
47. Czako L., Yamamoto M., and Otsuki M. Exocrine pancreatic function in rats after acute pancreatitis. Pancreas 15 (1997) 83-90
48. Evander A., Hederstrom E., Hultberg B., et al. Exocrine pancreatic secretion in acute experimental pancreatitis. Digestion 24 (1982) 159-167
49. Evander A., Lundquist I., and Ihse I. Influence of gastrointestinal hormones on the course of acute experimental pancreatitis. Hepatogastroenterology 29 (1982) 161-166
50. Dominguez-Munoz J.E., Hieronymus C., Sauerbruch T., et al. Fecal elastase test: evaluation of a new noninvasive pancreatic function test. Am J Gastroenterol 90 (1995) 1834-1837
51. Dominguez-Munoz J.E., Pieramico O., Buchler M., et al. Exocrine pancreatic function in the early phase of human acute pancreatitis. Scand J Gastroenterol 30 (1995) 186-191
52. Regan P.T., Malagelada J.R., Go V.L., et al. A prospective study of the antisecretory and therapeutic effects of cimetidine and glucagon in human acute pancreatitis. Mayo Clin Proc 56 (1981) 499-503
53. Seidensticker F., Otto J., and Lankisch P.G. Recovery of the pancreas after acute pancreatitis is not necessarily complete. Int J Pancreatol 17 (1995) 225-229
54. Boreham B., and Ammori B.J. A prospective evaluation of pancreatic exocrine function in patients with acute pancreatitis: correlation with extent of necrosis and pancreatic endocrine insufficiency. Pancreatology 3 (2003) 303-308
55. Bozkurt T., Maroske D., and Adler G. Exocrine pancreatic function after recovery from necrotizing pancreatitis. Hepatogastroenterology 42 (1995) 55-58
56. McMahon M.J. Acute pancreatitis: when is enzyme treatment indicated?. Digestion 54 Suppl. 2 (1993) 40-42
57. Migliori M., Pezzilli R., Tomassetti P., et al. Exocrine pancreatic function after alcoholic or biliary acute pancreatitis. Pancreas 28 (2004) 359-363
58. Patankar R.V., Chand R., and Johnson C.D. Pancreatic enzyme supplementation in acute pancreatitis. HPB Surg 8 (1995) 159-162
59. Mitchell C.J., Playforth M.J., Kelleher J., et al. Functional recovery of the exocrine pancreas after acute pancreatitis. Scand J Gastroenterol 18 (1983) 5-8
60. Ghaneh P., and Neoptolemos J.P. Exocrine pancreatic function following pancreatectomy. Ann N Y Acad Sci 880 (1999) 308-318
61. DiMagno E.P. Medical treatment of pancreatic insufficiency. Mayo Clin Proc 54 (1979) 435-442
62. Perez M.M., Newcomer A.D., Moertel C.G., et al. Assessment of weight loss, food intake, fat metabolism, malabsorption, and treatment of pancreatic insufficiency in pancreatic cancer. Cancer 52 (1983) 346-352
63. Yamaguchi K., Yokohata K., Nakano K., et al. Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR?. Dig Dis Sci 46 (2001) 282-288
64. Warshaw A.L., Rattner D.W., Fernandez-del Castillo C., et al. Middle segment pancreatectomy: a novel technique for conserving pancreatic tissue. Arch Surg 133 (1998) 327-331
65. Keller J., and Layer P. Intestinal function tests. Praxis (Bern 1994) 94 (2005) 1433-1438
66. Correlation between genotype and phenotype in patients with cystic fibrosis. The cystic fibrosis genotype-phenotype consortium. N Engl J Med 329 (1993) 1308-1313
67. Kopelman H., Durie P., Gaskin K., et al. Pancreatic fluid secretion and protein hyperconcentration in cystic fibrosis. N Engl J Med 312 (1985) 329-334
68. Durno C., Corey M., Zielenski J., et al. Genotype and phenotype correlations in patients with cystic fibrosis and pancreatitis. Gastroenterology 123 (2002) 1857-1864
69. Kristidis P., Bozon D., Corey M., et al. Genetic determination of exocrine pancreatic function in cystic fibrosis. Am J Hum Genet 50 (1992) 1178-1184
70. Walkowiak J., Cichy W.K., and Herzig K.H. Comparison of fecal elastase-1 determination with the secretin-cholecystokinin test in patients with cystic fibrosis. Scand J Gastroenterol 34 (1999) 202-207
71. Walkowiak J., Herzig K.H., Strzykala K., et al. Fecal elastase-1 is superior to fecal chymotrypsin in the assessment of pancreatic involvement in cystic fibrosis. Pediatrics 110 (2002) e7
72. Walkowiak J., Lisowska A., Przyslawski J., et al. Faecal elastase-1 test is superior to faecal lipase test in the assessment of exocrine pancreatic function in cystic fibrosis. Acta Paediatr 93 (2004) 1042-1045
73. Talley N.J., Young L., Bytzer P., et al. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol 96 (2001) 71-76
74. DiMagno E.P., Go W.L., and Summerskill W.H. Impaired cholecystokinin-pancreozymin secretion, intraluminal dilution, and maldigestion of fat in sprue. Gastroenterology 63 (1972) 25-32
75. Carroccio A., Iacono G., Montalto G., et al. Exocrine pancreatic function in children with coeliac disease before and after a gluten free diet. Gut 32 (1991) 796-799
76. Freeman H.J. Pancreatic endocrine and exocrine changes in celiac disease. World J Gastroenterol 13 (2007) 6344-6346
77. Nousia-Arvanitakis S. Cystic fibrosis and the pancreas: recent scientific advances. J Clin Gastroenterol 29 (1999) 138-142
78. Fine K.D., Meyer R.L., and Lee E.L. The prevalence and causes of chronic diarrhea in patients with celiac sprue treated with a gluten-free diet. Gastroenterology 112 (1997) 1830-1838
79. Carroccio A., Iacono G., Lerro P., et al. Role of pancreatic impairment in growth recovery during gluten-free diet in childhood celiac disease. Gastroenterology 112 (1997) 1839-1844
80. Maconi G., Dominici R., Molteni M., et al. Prevalence of pancreatic insufficiency in inflammatory bowel diseases. Assessment by fecal elastase-1. Dig Dis Sci 53 (2008) 262-270
81. Barthet M., Lesavre N., Desplats S., et al. Frequency and characteristics of pancreatitis in patients with inflammatory bowel disease. Pancreatology 6 (2006) 464-471
82. Masoero G., Zaffino C., Laudi C., et al. Fecal pancreatic elastase 1 in the work up of patients with chronic diarrhea. Int J Pancreatol 28 (2000) 175-179
83. Heikius B., Niemela S., Lehtola J., et al. Pancreatic duct abnormalities and pancreatic function in patients with chronic inflammatory bowel disease. Scand J Gastroenterol 31 (1996) 517-523
84. Chapin L.E., Scudamore H.H., Baggenstoss A.H., et al. Regional enteritis: associated visceral changes. Gastroenterology 30 (1956) 404-415
85. Kingham J.G., Levison D.A., and Fairclough P.D. Diarrhoea and reversible enteropathy in Zollinger-Ellison syndrome. Lancet 2 (1981) 610-612
86. Buchler M., Malfertheiner P., Glasbrenner B., et al. Secondary pancreatic insufficiency following distal stomach resection. Langenbecks Arch Chir 367 (1985) 41-50
87. Friess H., Bohm J., Muller M.W., et al. Maldigestion after total gastrectomy is associated with pancreatic insufficiency. Am J Gastroenterol 91 (1996) 341-347
88. Iglesias-Garcia J. Management of exocrine pancreatic insufficiency associated with other clinical conditions: gastrointestinal surgery, diabetes mellitus, AIDS. Clinical Pancreatology for practising gastroenterologists and surgeons. In: Dominguez-Munoz JE, editor; 2005. p. 7.
89. Shwachman H., Diamond L.K., Oski F.A., et al. The syndrome of pancreatic insufficiency and bone marrow dysfunction. J Pediatr 65 (1964) 645-663
90. Boocock G.R., Morrison J.A., Popovic M., et al. Mutations in SBDS are associated with Shwachman-Diamond syndrome. Nat Genet 33 (2003) 97-101
91. Dror Y., and Freedman M.H. Shwachman-Diamond syndrome. Br J Haematol 118 (2002) 701-713
92. Johanson A., and Blizzard R. A syndrome of congenital aplasia of the alae nasi, deafness, hypothyroidism, dwarfism, absent permanent teeth, and malabsorption. J Pediatr 79 (1971) 982-987
93. Zenker M., Mayerle J., Lerch M.M., et al. Deficiency of UBR1, a ubiquitin ligase of the N-end rule pathway, causes pancreatic dysfunction, malformations and mental retardation (Johanson-Blizzard syndrome). Nat Genet 37 (2005) 1345-1350
94. Sellick G.S., Barker K.T., Stolte-Dijkstra I., et al. Mutations in PTF1A cause pancreatic and cerebellar agenesis. Nat Genet 36 (2004) 1301-1305
95. Stoffers D.A., Zinkin N.T., Stanojevic V., et al. Pancreatic agenesis attributable to a single nucleotide deletion in the human IPF1 gene coding sequence. Nat Genet 15 (1997) 106-110
96. Kahl M., Keller J., and Layer P. Functional testing, radiological work-up of chronic pancreatitis. In: Beger H.G., Matsuno S., and Cameron J.L. (Eds). Diseases of the pancreas: current surgical therapy (2008), Springer Verlag 319-330