This document discusses pancreatic enzymes and their assays from duodenal contents. It begins by describing the pancreas and its endocrine and exocrine functions. It then discusses the main pancreatic enzymes - lipase, protease, and amylase - and their roles in digestion. Normal levels of the enzymes are provided. Several methods for assaying pancreatic enzymes are described, including measuring levels in plasma, feces, and through stimulation and tubeless tests. Pancreatic disorders like acute pancreatitis, chronic pancreatitis, and pancreatic cancer are overviewed. The document concludes by emphasizing the importance of pancreatic enzyme assays for monitoring pancreatic function.

1. KUVEMPU UNIVERSITY
Pancreatic Enzymes and their Assays,
Duodenal Contents
Under the Guidance
Dr. Rajeshwari,
Lecturer,
Dept. of Biochemistry.
Submitted By
Ms. Ankitha Hirematha
3rd Sem.

2. CONTENTS
1.
2.
3.
4.
5.
6.
7.
8.
9.
Pancreas
Pancreatic Enzymes
Level of Pancreatic Enzymes
Pancreatic Enzyme Assay
Pancreatic Disorders
Malabsorption Syndrome
Duodenal Contents
Conclusion
References

3. Pancreas
• Pancreas is a glandular organ in
the digestive system and endocrine
system of vertebrates.
• Hormones like insulin, glucagon
and somatostatin
• Pancreatic juice containing
digestive enzymes.
• Endocrine portion contains islets
of langerhans which has 4 types of
cells.
 α cells - glucagon
 β cells - insulin
 δ cells - somatostatin
 γ cells – pancreatic polypeptide
• Exocrine portion contains 2 types
of cells: duct cells and acinar cells
• Acinar cells secrete digestive
enzymes.

4. Pancreatic enzymes
Pancreatic enzymes are natural chemicals that help break down fats, proteins and carbohydrates.
A normally functioning pancreas secretes about 8 cups of fluid, called pancreatic juice, daily
into the duodenum, the portion of the small intestine that connects with the stomach. This fluid
contains pancreatic enzymes and helps neutralize stomach acid as it enters the small intestine.
Enzyme Type
Effects
Lipase
Lipase works with bile from the liver to
Lack of needed fats and fat-soluble
break down fat molecules so they can be
vitamins.
absorbed and
A shortage may cause:
Diarrhea and/or fatty stools.
used by the body.
Protease
Proteases break down proteins. They
Allergies or the formation of toxic
help keep the intestine free of parasites
substances
such as bacteria, yeast and protozoa.
digestion of proteins.
Increased
due
risk
to
for
incomplete
intestinal
infections.
Amylase
Amylase breaks down carbohydrates
Diarrhea due to the effects of
(starch) into sugars which are more
undigested starch in the colon.
easily absorbed by the body. This
enzyme is also found in saliva.

5. Normal level of Pancreatic Enzymes
Pancreatic lipase : 10-140 units per liter(U/L)
Pancreatic amylase : 23-85 units per liter(U/L)
Trypsin : 115-350ng/ml
Chymotrypsin : 2.3-51.4 U/g of stool
• The enzymes also include steapsin, carboxypeptidase, elastases & nucleases.

6. Pancreatic enzyme assay:
1. Plasma Enzymes
We can measure the plasma trypsin by immunoassay. In pancreatic
insufficiency, low level of plasma trypsin in adults is diagnosed. The children with
fibrocystic disease have normal pancreatic function initially, the level of plasma
trypsin may be high.
In acute pancreatitis, total plasma amylase activity is usually significantly
increased by release of this plasma amylase enzyme from damaged cells.
2. Faecal Enzymes
Faecal elastase level and faecal trypsin level is tested.
Because of the bacterial degradation in the intestinal lumen, faecal trypsin level is
extremely variable.
In infants with diarrhoea, the absence of enzymes indicates the fibrocystic disease of
the pancreas.

7. 3. Secretin Stimulation Test
Secretin is a hormone made by
the small intestine. Secretin stimulates the
pancreas to release a fluid that neutralizes
stomach acid and aids in digestion. The
secretin stimulation test measures the ability
of the pancreas to respond to secretin.
This test may be performed to determine the
activity of the pancreas in people with
diseases that affect the pancreas (for
example, cystic fibrosis or pancreatic
cancer).
During the test, a health care professional
places a tube down the throat, into the
stomach, then into the upper part of the
small intestine. Secretin is administered by
vein and the contents of the duodenal
secretions are aspirated (removed with
suction) and analyzed over a period of
about two hours.

8. Tubeless Tests
4. PABA Test
A synthetic peptide labelled with PABA is taken orally and the product of its
digestion by chymotrypsin, PABA, is absorbed and excreted in the urine.
Urinary excretion of PABA is significantly reduced in chronic pancreatitis.
5. PLT - Pancreato Lauryl Test
A standard meal is taken following an overnight fast along with a test food (with
PLT). One or more blood tests or a urine test is then made to see if the test food
has been digested (by the pancreatic enzymes) and then absorbed. Here
fluorescein dilaurate is used.

9. Disorders of the Pancreas
•Pancreatic disorders are rarely associated with
malabsorption
•3 types of pancreatic disorders:
1. Acute Pancreatitis
2. Chronic Pancreatitis
3. Carcinoma of Pancreas

10. Acute Pancreatitis

11. Chronic Pancreatitis

12. Pancreatic cancer
Malabsorption Syndromes
1.
2.
3.
4.
5.
Intestinal malabsorption
Pancreatic malabsorption
Megaloblastic anaemia
Steatorrhoea
Malabsorption of disaccharides

13. Duodenal contents
• Duodenum is the first section of the small intestine in most higher vertebrates.
• Site for iron absorption, chemical digestion.
• In Latin, „digitorum‟ means “twelve fingers‟ breadth”.
• It is a hollow jointed tube about 25 - 38 cm long, roughly horse-shoe shaped.
•It receives partially digested food from the stomach.and begins the absorption
for nutrients.

14. CONCLUSION
Since healthy human body depends on the normal functioning
of the pancreas, the pancreatic enzyme assay is needed to check
the normal level of the enzymes in duodenum and blood
stream.

15. REFERENCES
•http://pathology.jhu.edu/pc/BasicOverview1.php
•http://www.pancan.org/section_facing_pancreatic_cancer/learn_about_pan
_cancer/diet_and_nutrition/Pancreatic_enzymes.php
•http://www.webmd.com/digestive-disorders/picture-of-the-pancreas
•http://www.webmd.com/digestive-disorders/pancreas-function-tests
•http://pancreatitis.org.uk/what_is_pancreatitis.html
•Lawrence A. Kalpan, Amadeo J.Pesce (2009),Clinical Chemistry,5th
Ed.,Mosby Inc., Elsevier Inc. New York, 253-265.