Exocrine pancreatic secretion; effects of pancreatic disease

A simple assay technique for pancreatic lipase

A simple and inexpensive procedure is described to include pancreatic lipase in the protocol for evaluation of pancreatic function by duodenal aspiration. The method involves dilution with an albumin solution, a 2-hr incubation with a commercially available substrate mixture, and manual titration with a burette. Results comparable to assay with a pH-stat were obtained. Assay for pancreatic lipase is recommended as a part of the diagnostic procedure of duodenal aspiration.

Elevated serum alkaline phosphatase level may aid in the diagnosis of pancreatitis

Ten cases of pancreatitis with elevated serum alkaline phosphatase (SAP) levels are reported. Patients with chronic or relapsing pancreatitis may at times develop increased SAP levels, either with or without definitive biochemical evidence of pancreatic disease. SAP estimation may assist in establishing a clinical diagnosis in cases of abdominal pain in which pancreatitis is suspected.

The assay of exocrinous peptidases in clinical chemistry

The various peptidases secreted by such exocrine tissues as gastric mucosa, pancreas and prostate are usually determined by catalytic methods. Another approach utilizes immunoassay. Endopeptidases were formerly assayed with protein substrates such as hemoglobin and albumin. These techniques are increasingly replaced by more specific ones using artificial peptide derivatives as substrates, some of which allow an increase in absorbance or fluorescence to be continuously recorded. The presently available methods of assaying pepsin, pancreatic trypsin, trypsinogen and carboxypeptidase A, enterokinase and several peptidases of human sperm are reviewed.