A layered single-side readout depth of interaction time-of-flight-PET detector

We are exploring a scintillator-based PET detector with potential of high sensitivity, depth of interaction (DOI) capability, and timing resolution, with single-side readout. Our design combines two previous concepts: (1) multiple scintillator arrays stacked with relative offset, yielding inherent DOI information, but good timing performance has not been demonstrated with conventional light sharing readout. (2) Single crystal array with one-to-one coupling to the photodetector, showing superior timing performance compared to its light sharing counterparts, but lacks DOI. The combination, where the first layer of a staggered design is coupled one-to-one to a photodetector array, may provide both DOI and timing resolution and this concept is here evaluated through light transport simulations. Results show that: (1) unpolished crystal pixels in the staggered configuration yield better performance across all metrics compared to polished pixels, regardless of readout scheme. (2) One-to-one readout of the first layer allows for accurate DOI extraction using a single threshold. The number of multi pixel photon counter (MPPC) pixels with signal amplitudes exceeding the threshold corresponds to the interaction layer. This approach was not possible with conventional light sharing readout. (3) With a threshold of 2 optical photons, the layered approach with one-to-one coupled first layer improves timing close to the MPPC compared to the conventional one-to-one coupling non-DOI detector, due to effectively reduced crystal thickness. Single detector timing resolution values of 91, 127, 151 and 164 ps were observed per layer in the 4-layer design, to be compared to 148 ps for the single array with one-to-one coupling. (4) For the layered design with light sharing readout, timing improves with increased MPPC pixel size due to higher signal per channel. In conclusion, the combination of straightforward DOI determination, good timing performance, and relatively simple design makes the proposed concept promising for DOI-Time-of-Flight PET detectors.

Exploring light confinement in laser-processed LYSO:Ce for photon counting CT application

With the goal of developing a low-cost scintillator-based photon counting detector (PCD) with high dose efficiency suitable for CT, the light transport characteristics in LYSO:Ce detectors containing laser induced optical barriers (LIOB) are simulated. Light confinement and light collection efficiencies (LCE) are studied for a variety of optical barrier patterns and properties (refractive index (RI) and barrier/crystal interface roughness). Up to 80% confinement is achievable with a simple pixel pattern with one barrier wall separating each pixel coupled one-to-one to a photodetector (PD) pixel. Confinement is heavily dependent on barrier properties, and rough interfaces and higher RI results in increased cross-talk. Three approaches to enhance performance beyond the basic pattern are explored: (1) Multiple barrier walls separating each crystal pixel. (2) Introduction of long and short range confinement by having multiple crystal pixels per PD pixel. (3) Combination of LIOB and laser ablation (LA). (1) Is effective for rough interfaces where confinement can be increased by up to 24% for double compared to single walls. (2) Results in high confinement in the pixel centered on the PD pixel, but lower confinement closer to the PD edge. This feature may be explored to achieve spatial resolution beyond the PD pixel size using light sharing based positioning algorithms. (3) Can increase confinement for smooth interfaces using a smooth ablation in the bottom part of the crystal. A general trend across all configurations is a trade-off between light confinement and LCE. The LCE attainable is found comparable to that for mechanically pixelated arrays. While the confinement achievable with LIOB is always lower compared to a mechanically pixelated array, the former may offer a high level of flexibility in terms of detector design. This, in combination with the possibility to fabricate sub-mm pixels in a cost-effective manner, makes LIOB a promising technology for scintillator-based PCDs.

Simulation study of light transport in laser-processed LYSO:Ce detectors with single-side readout

A tightly focused pulsed laser beam can locally modify the crystal structure inside the bulk of a scintillator. The result is incorporation of so-called optical barriers with a refractive index different from that of the crystal bulk, that can be used to redirect the scintillation light and control the light spread in the detector. We here systematically study the scintillation light transport in detectors fabricated using the laser induced optical barrier technique, and objectively compare their potential performance characteristics with those of the two mainstream detector types: monolithic and mechanically pixelated arrays. Among countless optical barrier patterns, we explore barriers arranged in a pixel-like pattern extending all-the-way or half-way through a 20 mm thick LYSO:Ce crystal. We analyze the performance of the detectors coupled to MPPC arrays, in terms of light response functions, flood maps, line profiles, and light collection efficiency. Our results show that laser-processed detectors with both barrier patterns constitute a new detector category with a behavior between that of the two standard detector types. Results show that when the barrier-crystal interface is smooth, no DOI information can be obtained regardless of barrier refractive index (RI). However, with a rough barrier-crystal interface we can extract multiple levels of DOI. Lower barrier RI results in larger light confinement, leading to better transverse resolution. Furthermore we see that the laser-processed crystals have the potential to increase the light collection efficiency, which could lead to improved energy resolution and potentially better timing resolution due to higher signals. For a laser-processed detector with smooth barrier-crystal interfaces the light collection efficiency is simulated to  >42%, and for rough interfaces  >73%. The corresponding numbers for a monolithic crystal is 39% with polished surfaces, and 71% with rough surfaces, and for a mechanically pixelated array 35% with polished pixel surfaces and 59% with rough surfaces.

Novel laser-processed CsI:Tl detector for SPECT

PURPOSE

The aim of this work is to demonstrate the feasibility of a novel technique for fabrication of high spatial resolution CsI:Tl scintillation detectors for single photon emission computed tomography systems.

METHODS

The scintillators are fabricated using laser-induced optical barriers technique to create optical microstructures (or optical barriers) inside the CsI:Tl crystal bulk. The laser-processed CsI:Tl crystals are 3, 5, and 10 mm in thickness. In this work, the authors focus on the simplest pattern of optical barriers in that the barriers are created in the crystal bulk to form pixel-like patterns resembling mechanically pixelated scintillators. The monolithic CsI:Tl scintillator samples are fabricated with optical barrier patterns with 1.0 × 1.0 mm(2) and 0.625 × 0.625 mm(2) pixels. Experiments were conducted to characterize the fabricated arrays in terms of pixel separation and energy resolution. A 4 × 4 array of multipixel photon counter was used to collect the scintillation light in all the experiments.

RESULTS

The process yield for fabricating the CsI:Tl arrays is 100% with processing time under 50 min. From the flood maps of the fabricated detectors exposed to 122 keV gammas, peak-to-valley (P/V) ratios of greater than 2.3 are calculated. The P/V values suggest that regardless of the crystal thickness, the pixels can be resolved.

CONCLUSIONS

The results suggest that optical barriers can be considered as a robust alternative to mechanically pixelated arrays and can provide high spatial resolution while maintaining the sensitivity in a high-throughput and cost-effective manner.

Pasteurization of mother's own milk reduces fat absorption and growth in preterm infants

AIM

A randomized study was conducted to evaluate whether pasteurized milk (Holder pasteurization 62.5 degrees C, 30 min) reduces fat absorption and growth in preterm infants.

METHODS

Preterm infants (825-1325 g) born with gestational age < or =30 weeks were randomized into two groups, of which one started with pasteurized own mother's milk for 1 week and continued with raw milk the following week, and a second group was fed in reverse order. By using this design the infants served as their own controls. At the end of each week, a 72-h fat balance was performed and growth was monitored.

RESULTS

We found, on an average, 17% higher fat absorption with raw as compared to pasteurized milk. Infants gained more weight and linear growth assessed as knee-heel length was also greater during the week they were fed raw milk as compared to the week they were fed pasteurized milk.

CONCLUSION

Feeding preterm infants pasteurized as compared to raw own mother's milk reduced fat absorption. When the infants were fed raw milk, they gained more in knee-heel length compared to when they were fed pasteurized milk.

The structure of truncated recombinant human bile salt-stimulated lipase reveals bile salt-independent conformational flexibility at the active-site loop and provides insights into heparin binding

Human bile salt-stimulated lipase (BSSL), which is secreted from the pancreas into the digestive tract and from the lactating mammary gland into human milk, is important for the effective absorption of dietary lipids. The dependence of BSSL on bile acids for activity with water-insoluble substrates differentiates it from other lipases. We have determined the crystal structure of a truncated variant of human BSSL (residues 1-5.8) and refined it at 2.60 A resolution, to an R-factor of 0.238 and R(free) of 0.275. This variant lacks the C-terminal alpha-helix and tandem C-terminal repeat region of native BSSL, but retains full catalytic activity. A short loop (residues 115-126) capable of occluding the active-site (the active site loop) is highly mobile and exists in two conformations, the most predominant of which leaves the active-site open for interactions with substrate. The bile salt analogue 3-[(3-cholamidopropyl)dimethylammonio]-1-propane sulfonic acid (CHAPS) was present in the crystallisation medium, but was not observed bound to the enzyme. However, the structure reveals a sulfonate group from the buffer piperizine ethane sulfonic acid (PIPES), making interactions with Arg63 and His115. His115 is part of the active-site loop, indicating that the loop could participate in the binding of a sulphate group from either the glycosaminoglycan heparin (known to bind BSSL) or a bile acid such as deoxycholate. Opening of the 115-126 active-site loop may be cooperatively linked to a sulphate anion binding at this site. The helix bundle domain of BSSL (residues 319-398) exhibits weak electron density and high temperature factors, indicating considerable structural mobility. This domain contains an unusual Asp:Glu pair buried in a hydrophobic pocket between helices alpha(H) and alpha(K) that may be functionally important. We have also solved the structure of full-length glycosylated human BSSL at 4.1 A resolution, using the refined coordinates of the truncated molecule as a search model. This structure reveals the position of the C-terminal helix, missing in the truncated variant, and also shows the active-site loop to be in a closed conformation.

Do human bile salt stimulated lipase and colipase-dependent pancreatic lipase share a common heparin-containing receptor?

Bile salt stimulated lipase (BSSL), a lipolytic enzyme secreted with pancreatic juice and with human milk, is in concert with colipase-dependent pancreatic lipase, important for the intestinal digestion of dietary lipids. BSSL may also facilitate uptake of free cholesterol from the intestinal lumen, while colipase-dependent lipase has a similar role for fatty acids. According to this theory, the two lipases bind to the intestinal mucosa via a common heparin-involving receptor. In the present study, binding of the two lipases to heparin was explored in vitro using purified human lipases and heparin molecules varying in both chain length and charge density. Native, but not denatured, BSSL bound avidly to heparin and several of the heparin variants. In contrast, at physiologic salt concentration, colipase-dependent lipase did not bind to heparin. Thus, our data do not support the view that the two lipases share a common intestinal heparin-like receptor. Hence, it seems unlikely that such binding could be of physiologic relevance for colipase-dependent lipase, although for BSSL the data are supportive.

Crystallization and preliminary X-ray analysis of native and recombinant human bile-salt dependent lipase: strategies for improvement of diffraction quality

Human bile-salt dependent lipase (BSDL), secreted into both the digestive tract and human milk, is integral to the effective absorption of dietary lipids. In attempts to obtain crystals suitable for high-resolution X-ray crystallographic studies, various forms of the enzyme have been crystallized, including native and desialidated human milk BSDL and both intact recombinant BSDL and a truncated form lacking the heavily glycosylated C-terminal repeat region. Trigonal crystals of native BSDL, with unit-cell parameters a = b = 90.0, c = 156.1 A, were obtained using 15-20%(w/v) PEG 8000 as precipitant. These crystals diffract to 3.5 A along the unique axis, but to only 5-7 A in orthogonal directions. Crystals of recombinant truncated BSDL grown from 15-20%(w/v) PEG 6000 are orthorhombic, space group P2(1)2(1)2(1), with unit-cell parameters a = 59.2, b = 90.0, c = 107.7 A, and diffract to 2.6 A resolution. These are suitable for structural analysis by X-ray crystallography.

Digestion of ceramide by human milk bile salt-stimulated lipase

BACKGROUND

There is a renewed interest in metabolism of sphingolipids because of their role in signal transduction. Sphingomyelin is the dominating phospholipid in human milk but its metabolism and possible function in the gastrointestinal tract of breast fed infants is unknown. We explored whether bile salt-stimulated milk lipase has a role in sphingolipid metabolism.

METHODS

In vitro assays of sphingomyelinase and ceramidase activities, using radiolabeled substrates, human milk samples and purified native and recombinant variants of bile salt-stimulated milk lipase with or without known activators or inhibitors.

RESULTS

Human whey and purified lipase catalysed hydrolysis of palmitoyl-labeled ceramide with the highest rate around pH 8.5-9.0. 1 mg of lipase hydrolysed 0.7 micromol ceramide in one hour at pH 8.5 in presence of 4 mM bile salt. The activity of whey was inhibited by antibodies towards human bile salt-stimulated milk lipase, indicating that this lipase accounted for virtually all ceramidase activity in the milk. In contrast, bile salt-stimulated milk lipase showed no activity against sphingomyelin. However we give evidence of a separate, hitherto unknown, acid sphingomyelinase in human milk. Under the used in vitro conditions this sphingomyelinase could account for hydrolysis of half of milk sphingomyelin in one hour.

CONCLUSIONS

Human milk bile salt-stimulated milk lipase hydrolyses ceramide and may thus have a role in sphingomyelin digestion, but only after initial hydrolysis to ceramide and phosphorylcholine. Part of the latter could be carried out in the stomach by the acid milk sphingomyelinase now described. We speculate that these two milk enzymes may be of importance for optimal use of human milk sphingolipids.

Naturally occurring variants of human milk bile salt-stimulated lipase

Analysis of milk samples from a number of lactating women revealed molecular variants of bile salt-stimulated lipase (BSSL) of both lower and higher molecular mass than that commonly occurring. In contrast to previous observations, we report on individuals having only a variant of lower mass, both one of lower and one of common mass, or both one of lower and one of higher mass of the lipase. From two individuals we purified the lower molecular mass BSSL variant and characterized it. The amount of lipase in the milk of these two individuals was considerably less than average (mean of 10 women with BSSL of the most common molecular mass). The BSSL variant of lower mass showed the same bile salt activation, pH dependency, temperature stability as those most commonly occurring. We could localize the difference in mass to the large O-glycosylated repeat sequence close to the C-terminus of the protein. With respect to all characteristics studied, the BSSL variant of higher mass was also similar to that most commonly ocurring. Again, the difference in mass could be localized to the repeat region of the protein. Hence, it appears as if the repeat region, normally carrying 16 repeats of 11 amino acids each, varies in size between individuals.

Carboxylic ester hydrolase and amylase in ischemic pancreatitis in the guinea pig

The observation that an elevated level of pancreatic carboxylic ester hydrolase (CEH) in serum is a more sensitive and specific marker of acute pancreatitis than is elevated serum amylase activity prompted us to explore whether these findings could be confirmed in an experimental model and, if so, to find the explanation behind this difference. We therefore developed a model for ischemic pancreatitis in the guinea pig and a sandwich enzyme-linked immunosorbent assay for determination of CEH in this species. There was a strong correlation between duration of ischemia and severity of pancreatic inflammation and between severity of inflammation and serum CEH level. In contrast, serum amylase was elevated only in animals with the most severe grade of inflammation. Amylase was, however, increased in urine in animals with mild inflammation, but the level did not increase with severity of inflammation. Only one of 31 animals had detectable CEH in urine. In animals with intermediate serum CEH levels the serum and biliary concentrations correlated, indicating that CEH may be cleared by the liver. Amylase was detectable in bile only in animals with high serum levels. The results confirm our observations made in previous clinical studies. A likely explanation for differences in serum levels of CEH and amylase is clearance from the circulation at different rates and, at least partly, via different routes, e.g., the liver and kidney, respectively.

Recombinant human-milk bile-salt-stimulated lipase. Functional properties are retained in the absence of glycosylation and the unique proline-rich repeats

Human milk bile-salt-stimulated lipase ensures efficient utilization of milk lipid in breast-fed infants. The N-terminal two-thirds of the peptide chain is highly conserved and shows striking similarities to typical esterases. In contrast, the remaining C-terminal part consists of a unique sequence of 16 proline-rich O-glycosylated repeats of 11 residues each. Recently we could show, using recombinant lipase variants, that neither these repeats nor the single N-linked sugar chain are essential for catalytic efficiency. In the present study, we report on the lack of importance of glycosylation and the unique repeats for other important functional properties, i.e. bile-salt activation, heparin binding, heat stability, stability at low pH and resistance to proteolytic inactivation. Compared to native enzyme, recombinant full-length lipase produced in two mammalian cell lines differed slightly in glycosylation pattern with no effects on the functional properties. Moreover, a variant lacking all repeats and the C-terminal tail following the last repeat exhibited the same functional characteristics as purified native milk enzyme. Thus, the structural basis for all the typical and functionally important properties reside in the N-terminal conserved part, in spite of the fact that none of these properties are shared by typical esterases. We could however, demonstrate that the C-terminal repeats are responsible for the unusual behaviour of the enzyme in size-exclusion chromatography, resulting in a considerably higher than expected apparent molecular mass.

Human milk bile salt-stimulated lipase: functional and molecular aspects

In breast-fed infants, digestion of milk triglycerides, the major source of energy and long-chain polyunsaturated fatty acids, is catalyzed by a concerted action of gastric lipase, colipase-dependent pancreatic lipase, and bile salt-stimulated lipase (BSSL). The major part of BSSL is present in the milk and the lesser part originates in the infant's exocrine pancreas. Gastric lipase is important in initiating digestion of milk fat globule triglycerides in the stomach. BSSL shifts the final products of triglyceride digestion from monoglyceride and free fatty acid (the products of colipase-dependent pancreatic lipase) to glycerol and free fatty acid, which may promote efficient absorption. Moreover, BSSL is likely to promote efficient use of milk cholesteryl- and fat-soluble vitaminesters and long-chain polyunsaturated fatty acids (> C18). The cDNA sequence has shown that BSSL has a unique primary structure. The N-terminal half is highly conserved between species and shows striking homology to typical esterases, for example, acetylcholine esterase. In contrast, the C-terminal half, containing 16 proline-rich repeats of 11 amino acid residues, is unique to BSSL. Using several recombinant variants of BSSL, we have found that these unique repeats and the glycosylation are completely dispensable for activity. Thus all typical properties of BSSL reside in the N-terminal half of the molecule.

Digestion of triacylglycerols containing long-chain polyenoic fatty acids in vitro by colipase-dependent pancreatic lipase and human milk bile salt-stimulated lipase

To assess the role of human milk bile salt-stimulated lipase (BSSL) in the digestion of polyunsaturated ester bonds of triacylglycerols, hydrolysis of docosahexaenoic acid (22:6(n-3)) ester bonds was compared to that of oleic acid (18:1(n-9)) or arachidonic acid (20:4(n-6)) esters. As model substrates, we used rat chylomicrons obtained after feeding human milk fat globules and radiolabeled fatty acids. Radiolabeled chylomicrons were incubated with colipase-dependent pancreatic lipase, with BSSL, or with both enzymes in combination. Both enzymes hydrolyzed 18:1 more efficiently than 22:6 esters. With colipase-dependent lipase there was a large accumulation of 22:6 in diacylglycerol whereas with BSSL it accumulated mainly in monoacylglycerol. Esters containing 20:4 were hydrolyzed by BSSL as efficiently as 18:1 but this fatty acid also accumulated as diacylglycerol with colipase-dependent lipase. At low bile salt concentrations, as found in duodenal contents of newborns, colipase-dependent lipase was virtually unable to hydrolyze esters of 20:4 and 22:6 whereas BSSL hydrolyzed these esters at appreciable rates. Combining the two enzymes gave the most efficient hydrolysis of all fatty acids tested regardless of bile salt concentrations. BSSL may thus have a physiological role in completing duodenal hydrolysis of milk triacylglycerols containing 22:6- or 20:4-esters to free fatty acids and monoacylglycerol.

Recombinant human milk bile salt-stimulated lipase. Catalytic activity is retained in the absence of glycosylation and the unique proline-rich repeats

Human milk bile salt-stimulated lipase ensures efficient utilization of triacylglycerol by breast-fed infants. Cloning and sequencing of cDNA have revealed that the peptide chain consists of 722 amino acid residues showing only little homology to typical lipases. The sequence is identical to that of pancreatic carboxylic-ester hydrolase. The COOH-terminal part contains 16 proline-rich repeats of 11 residues with O-linked carbohydrate. The only N-linked sugar chain is situated close to the active-site serine. Using C127 cells and a bovine papilloma virus vector, high and stable expression of full-length lipase and of several variants, obtained by site-directed mutagenesis, was achieved. The produced proteins were purified and further characterized. Variants lacking all, or all but two, repeats were active with similar specific activity and the same bile salt dependence as the native milk enzyme. Changing the asparagine necessary for N-glycosylation gave the same principal results. Active recombinant full-length lipase was also produced in a bacterial system. We conclude that neither glycosylation (N- or O-linked) nor the proline-rich repeats are essential for catalytic activity or bile salt activation of human milk bile salt-stimulated lipase.

Bile salt-stimulated lipase in human milk. Evidence that bile salt induces lipid binding and activation via binding to different sites

Human milk bile salt-stimulated lipase ensures efficient triacylglycerol utilization in breast-fed newborns. For activity against long-chain triacylglycerol, primary bile salts are a prerequisite. Bile salts also protect the enzyme from inactivation by intestinal proteases. We have studied the effect of different bile salts on activation, protease protection, lipid binding, and enzyme inactivation, caused by an arginine modifying agent. Based on the results we propose a model involving two bile salt binding sites; one activation-site specific for primary bile salt, and another, less specific, lipid binding promoting site at which also secondary bile salt binds. Binding to this latter site induces binding of enzyme to emulsified substrates but binding promoting site at which also secondary bile salt binds. Binding to this latter site induces binding of enzyme to emulsified substrates but without subsequent lipolysis.

Does the bile salt-stimulated lipase of human milk have a role in the use of the milk long-chain polyunsaturated fatty acids?

Long-chain polyunsaturated (LCP) fatty acids derived from linoleic (18:2 n-6) and alpha-linolenic (18:3 n-3) acids are considered essential nutrients in preterm infants. The efficiency by which such fatty acids are released as absorbable products from triacylglycerol was explored in vitro using rat chylomicron triacylglycerol as substrate. When incubated with purified human pancreatic colipase-dependent lipase and colipase, arachidonic acid (20:4 n-6) was released less efficiently than linoleic acid from such triacylglycerol. This difference was not seen when purified human milk bile salt-stimulated lipase (BSSL) was incubated with the triacylglycerol substrate, and it was almost abolished when colipase-dependent lipase (with colipase) and BSSL acted simultaneously, as they do in breast-fed infants. There was no difference in arachidonic acid and eicosapentaenoic acid (20:5 n-3) release rates with either colipase-dependent lipase or BSSL, albeit the release was more rapid with the milk enzyme than with colipase-dependent lipase. Again, the most efficient release as absorbable free fatty acids was achieved when the two lipases operated together. The relative resistance to hydrolysis of arachidonic acid and eicosapentaenoic acid by colipase-dependent lipase was best explained by the localization of the first double bond to the delta-5 position of the respective fatty acid. The results obtained suggest that BSSL is of importance for the efficient use of human milk LCP fatty acids.

Carboxylic ester hydrolase. A sensitive serum marker and indicator of severity of acute pancreatitis

When using clinical criteria, both falsely positive and falsely negative diagnoses of acute pancreatitis (AP) are often made. Based on a clinical study, elevated serum levels of the pancreatic lipolytic enzyme carboxylic ester hydrolase (CEH) was recently suggested to be a highly specific marker of acute pancreatitis. To determine the sensitivity of the test for AP, a study on patients with the diagnosis set objectively was necessary. In the present study, AP was diagnosed by contrast-enhanced computed tomography in 64 patients, and histopathological examination of tissue removed at laparotomy in 18 of them. By these criteria, 42 patients suffered from acute interstitial pancreatitis (AIP), and 22 patients from necrotizing pancreatitis (NP). Based on the CEH concentrations in the first serum sample obtained in each patient, the sensitivity of CEH for pancreatitis was 98%. From the second day after admission, CEH levels in patients with NP were significantly higher than in patients with AIP. Furthermore, in patients with NP, CEH values remained at a raised level for the following 10 d, whereas a significant decrease of CEH values was noted in patients with AIP. In contrast, total serum amylase activities were higher in patients suffering of AIP than in patients suffering of NP during the observation period. We conclude, that the sensitivity of the CEH test is very high for AP. CEH concentrations remaining at a high level are suggestive of NP, whereas diminishing CEH levels are suggestive of AIP.

cDNA cloning of human-milk bile-salt-stimulated lipase and evidence for its identity to pancreatic carboxylic ester hydrolase

We have isolated and sequenced cDNA clones covering the entire coding sequence of human-milk bile-salt-stimulated lipase, as well as 996 nucleotides of the 3' end of the pancreatic enzyme carboxylic ester hydrolase. The deduced amino acid sequence of the lipase starts with a 23-residue leader peptide. The open reading frame continues with 722 amino acid residues. The sequence contains in the C-terminal part a proline-rich repeat, 16 repeats of 11 amino acid residues each. The mRNA was estimated to be approximately 2500 nucleotides from Northern blot and of similar size in mammary and pancreatic tissues. Data obtained indicate that the lipase and the carboxylesterase are identical and coded for by the same gene. The cDNA is 2428 bases long, which indicates that a near full-length copy of the transcript has been isolated. Comparisons with other enzymes show that the lipase is a new member of the supergene family of serine hydrolases. It is not only closely related (and in its N-terminal half virtually identical) to lysophospholipase from rat pancreas and cholesterol esterase from bovine pancreas, but also shows a high degree of similarity to several esterases, e.g. acetylcholine esterase. In contrast, no such similarity could be found to typical lipases.

The complete digestion of human milk triacylglycerol in vitro requires gastric lipase, pancreatic colipase-dependent lipase, and bile salt-stimulated lipase

Gastric lipase, pancreatic colipase-dependent lipase, and bile salt-stimulated lipase all have potential roles in digestion of human milk triacylglycerol. To reveal the function of each lipase, an in vitro study was carried out with purified lipases and cofactors, and with human milk as substrate. Conditions were chosen to resemble those of the physiologic environment in the gastrointestinal tract of breast-fed infants. Gastric lipase was unique in its ability to initiate hydrolysis of milk triacylglycerol. Activated bile salt-stimulated lipase could not on its own hydrolyze native milk fat globule triacylglycerol, whereas a limited hydrolysis by gastric lipase triggered hydrolysis by bile salt-stimulated lipase. Gastric lipase and colipase-dependent lipase, in combination, hydrolyzed about two thirds of total ester bonds, with monoacylglycerol and fatty acids being the end products. Addition of bile salt-stimulated lipase resulted in hydrolysis also of monoacylglycerol. When acting together with colipase-dependent lipase, bile salt-stimulated lipase contributed also to digestion of tri- and diacylglycerol. We conclude that digestion of human milk triacylglycerol depends on three lipases with unique, only partly overlapping, functions. Their concerted action results in complete digestion with free glycerol and fatty acids as final products.

Human gastric lipase. The N-terminal tetrapeptide is essential for lipid binding and lipase activity

Human gastric lipase subjected to limited tryptic proteolysis lost its ability to hydrolyze emulsified long-chain triacylglycerol. Activity against a water-soluble substrate was however retained, indicating that proteolysis did not affect the active site. Sequence analysis revealed that trypsin specifically cleaved the linkage between lysine-4 and leucine-5. This cleavage rendered the enzyme unable to bind to emulsified triacylglycerol particles, e.g. human milk fat globules. We suggest that the N-terminal tetrapeptide, in particular lysine-4, is essential for the binding of human gastric lipase to lipid/water interfaces, and hence, for its physiological function.

Fatty acids generated by gastric lipase promote human milk triacylglycerol digestion by pancreatic colipase-dependent lipase

The concerted action of purified bovine gastric lipase and human pancreatic colipase-dependent lipase and colipase, or crude human pancreatic juice, in the digestion of human milk triacylglycerols was explored in vitro. Gastric lipase hydrolyzed milk triacylglycerol with an initially high rate but became severely inhibited already at low concentration of released fatty acid. In contrast, colipase-dependent lipase could not, by itself, hydrolyze milk triacylglycerol. However, a short preincubation of milk with gastric lipase, resulting in a limited lipolysis, made the milk fat triacylglycerol available for an immediate and rapid hydrolysis by pancreatic juice, and also for purified colipase-dependent lipase, provided colipase and bile salts were present. The same effect was obtained when incubation with gastric lipase was replaced by addition of long-chain fatty acid. Long-chain fatty acid increased the binding of colipase-dependent lipase to the milk fat globule. Binding was efficient only in the presence of both fatty acid and colipase. We conclude that a limited gastric lipolysis of human milk triacylglycerol, resulting in a release of a low concentration of long-chain fatty acids, is of major importance for the subsequent hydrolysis by colipase-dependent lipase in the duodenum.

Bovine pregastric lipase: a model for the human enzyme with respect to properties relevant to its site of action

Preduodenal lipolysis is considered to promote efficient lipid digestion in the neonatal period. The lipase(s) responsible may be of pregastric or gastric origin depending upon the species. We have previously reported on purification and molecular characterization of a pregastric lipase from calf. Antibodies to this bovine enzyme crossreact with a protein of similar size in human gastric contents and also inhibit its lipolytic activity. Since the bovine and human enzymes also have similar kinetic properties, the view is favoured that the bovine enzyme can be used as a model for physiological studies relevant to human neonates. In contrast to the lipases operating in the small intestine pregastric lipase has the unique property of initiating the hydrolysis of human milk fat globule triacylglycerol. In order to do this no cofactor is required. Pregastric lipase was stable at low pH and had an acid-pH optimum. Furthermore, it was extremely resistant to pepsin. In contrast, pancreatic proteinases, i.e. trypsin and chymotrypsin, inactivated the enzyme. The rate of inactivation was increased in the presence of bile salts which by themselves could inhibit enzyme activity. Thus, pregastric lipase is ideally suited for activity in the stomach but will not, under healthy conditions, contribute to lipid digestion in the duodenum.

Bile-salt-stimulated lipase in human milk: evidence for its synthesis in the lactating mammary gland

Human milk contains many enzymes and other biologically active proteins. One of the enzymes, the bile salt-stimulated lipase, constitutes as much as 1% of the milk proteins. Its importance for efficient utilization of milk lipids by the breast-fed infant is now well established. However, whether the lipase protein is a product of protein synthesis within the mammary gland has up till now been an unanswered question. Using biopsy material from lactating human mammary gland we have now demonstrated that the enzyme is synthesized within the gland. This was done by immunoprecipitation of [35S]methionine-labelled protein from tissue pieces. By activity determination we could also determine the amount of enzyme stored in the gland. It was concluded that bile salt-stimulated lipase accounted for 1.3 micrograms/mg tissue protein. Finally, from this figure it could be calculated that about 10-15% of the total protein present in the tissue was milk protein.

Killing of Giardia lamblia by human milk lipases: an effect mediated by lipolysis of milk lipids

Killing of Giardia lamblia by fresh human milk requires the presence of bile salt, a known activator of bile salt-stimulated lipase, the major lipase in human milk. Purified enzyme did not kill the parasite even in the presence of activator unless milk lipids were also present in the reaction mixture. Free fatty acids had a marked giardiacidal effect, a phenomenon supporting the view that fatty acids, released during hydrolysis of milk triglycerides, are responsible for the killing of G. lamblia by human milk. Bile salt-independent lipolysis took place in milk during storage at 4 C. This lipolysis correlated strongly with activity of lipoprotein lipase, also present in human milk. During such storage, raw human as well as bovine milk developed giardiacidal activity that could be prevented by inactivation or inhibition of the milk lipases by pasteurization or addition of eserine to the milk, respectively, before storage.

On the source of bile salt-stimulated lipase in human milk: a study based on serum concentrations as determined by sandwich enzyme-linked immunosorbent assay technique

Human milk contains a bile salt-stimulated lipase (BSSL) which is considered to contribute significantly to lipid digestion in newborns. Human pancreatic juice contains an enzyme, carboxyl ester hydrolase (CEH), that is immunochemically and functionally identical to the milk enzyme. It has not been clear, however, whether the milk enzyme is synthesized within the mammary gland or whether the pancreatic enzyme is transported to the mammary gland for secretion. In this study we describe an enzyme-linked immunosorbent assay (ELISA) for determinations of BSSL and CEH in serum. Serum samples from healthy adults of both sexes contain significant amounts of enzyme (3.2 +/- 1.7 micrograms/L). Lactating women did not have higher serum levels, which would be expected if the milk enzyme were a product of the pancreas, and it was calculated that the concentrations found could not sufficiently account for the amounts secreted in the milk. We therefore conclude that BSSL is synthesized within the mammary gland. This conclusion is further strengthened by our findings that serum of breast-fed newborns contains very little if any enzyme. Since macromolecular absorption is high early in life, and witch's milk contains high enzyme levels, again one would expect high serum levels if BSSL were a pancreatic product.

Purification and molecular characterization of bovine pregastric lipase

A pregastric lipase was purified from calf pharyngeal tissues. The purification procedure was based on chromatographies on octyl-Sepharose and lentil-lectin-Sepharose followed by gel filtration. The final preparation, with an overall recovery of 26% of activity, gave a single protein band on dodecyl sulfate/polyacrylamide gel electrophoresis with a Mr of 55000. The Mr on gel filtration was 44-48000. The discrepancy may be due to the fact that pregastric lipase is a glycoprotein containing approximately 10% (w/w) of carbohydrate. The pI was around 7.0 and the enzyme protein is characterized by a high content of branched, aliphatic amino acid residues. The NH2-terminal amino acid sequence is: H2N-Phe-Leu/(Ile)-Gly-. Rabbit antibodies to the purified preparation detected only one component in the crude starting material in immuno-blotting experiments. Preincubation with antiserum resulted in loss of enzyme activity, showing that the antibodies were directed against the lipase.

Further characterization of the bile salt-stimulated lipase in human milk

Bile salt-stimulated lipase is a milk enzyme unique to the higher primates. Its molecular and kinetic characteristics differ greatly from other lipolytic enzymes; e.g., pancreatic lipase and lipoprotein lipase. It has a much higher app. Mr, 310000 on gel filtration and 100000 after denaturation. It requires primary bile salts for optimal activity and bile salts also protect the enzyme from proteolytic and heat inactivation. It may, due to its low substrate specificity, contribute to the utilization of a variety of milk lipids. Since it lacks positional specificity, digestion of milk triglycerides should be complete, which may explain why fat absorption is more efficient in breast-fed than in formula-fed infants.

Digestion of human milk lipids: physiologic significance of sn-2 monoacylglycerol hydrolysis by bile salt-stimulated lipase

The bile salt-stimulated lipase secreted with human milk was found to be devoid of positional specificity, i.e., it hydrolyzed emulsified triacylglycerols to glycerol and fatty acids. It also hydrolyzed micellar sn-2 monoacylglycerols. This is in contrast to pancreatic lipase which has a pronounced preference for hydrolysis of sn-1 and sn-3 ester bonds. When the two enzymes were operating together, as in the intestine of the infant fed raw human milk, the sn-2 monoacylglycerols formed by pancreatic lipase served as an excellent substrate for bile salt-stimulated lipase. Thus, the end products of triacylglycerol hydrolysis became glycerol and fatty acids and not sn-2 monoacylglycerol and fatty acids. The bile salt-stimulated lipase also catalyzed incorporation of fatty acids into acylglycerols to a much lesser extent than did pancreatic lipase. Together these two effects of bile salt-stimulated lipase have a promoting effect on the overall process of intraluminal lipolysis. In newborn infants, with low intraduodenal bile salt concentrations, glycerol and fatty acids also should be more readily absorbed than monoacylglycerol and fatty acids. Thus, by serving as a complement to pancreatic lipase, bile salt-stimulated lipase can ensure efficient utilization of milk lipids also in infants with immature endogenous mechanisms for fat digestion and absorption.

Lingual lipase. Its role in lipid digestion in infants with low birthweight and/or pancreatic insufficiency

At birth both pancreatic lipase and carboxylic ester hydrolase, two important lipolytic enzymes secreted by the pancreas, are present in duodenal contents but the activities of these enzymes are low. Another enzyme of possible importance in lipolysis is the lingual lipase which is secreted from serous glands present at the posterior part of the tongue. The enzyme is present already at birth and has been found in gastric contents from preterm infants in the 34th gestational week. The secretion of lingual lipase is stimulated by feeding and it is resistent against acid inactivation. The activity in gastric contents increases after feeding. This lipase hydrolyzes dietary triglycerides to mainly diglycerides and free fatty acids and may serve as a complement to the poorly developed pancreatic lipase activity. Furthermore, by the formation of polar lipolytic products the digestibility of dietary lipids in the duodenum may increase. Human milk lipase contributes to the lipolysis. It is inactive in the milk but becomes activated by the bile acids in the duodenum. Balance studies in preterm infants have shown that by pasteurization of human milk fat absorption decreases by one third.

Hydrolysis of human milk fat globules by pancreatic lipase: role of colipase, phospholipase A2, and bile salts

Human milk fat globules were used to explore how dietary triglycerides are hydrolyzed by pancreatic lipase. These triglycerides were hydrolyzed very slowly by lipase alone as if the surface layer of proteins and phospholipids impeded the action of the enzyme. The inhibition of lipase activity could be overcome by addition either of colipase or of pancreatic phospholipase A2. Colipase enhanced triglyceride hydrolysis in a dose-dependent manner whether bile salts were present or not. Bile salts had no effect on the activity of pancreatic lipase alone but further enhanced the activity at all concentrations of colipase tested. Bile salts were a prerequisite to relieve inhibition of lipase activity by phospholipase A2. Human milk fat globules exposed to phospholipase A2 should be representative of a physiological substrate for pancreatic lipase. A major new observation was that bile salts, even at high concentrations, stimulated triglyceride hydrolysis of such phospholipase-treated globules by pancreatic lipase also in the absence of colipase.

The bile-salt-stimulated lipase in human milk. Purification and characterization

The bile-salt-stimulated lipase was purified from human whey by chromatography on heparin-Sepharose and Affi-Gel blue. The purified enzyme gave a single band with a molecular weight of 90 000 on dodecylsulphate/polyacrylamide gels and this band accounted for at least 98% of the protein on the gel. An antiserum to the purified lipase completely inhibited the enzyme activity and gave a single precipitate against human whey and purified lipase. The bile-salt-stimulated lipase was inhibited by diisopropylfluorophosphate, which bound to the purified enzyme in a molar ratio of 0.85 mol/mol. The lipase is a glycoprotein with a high content of acidic amino acid residues and an isoelectric point of around 4. Proline constitutes more than 10% of the total amino acid residues. The purified lipase has a turnover number of around 150 S-1.

Lingual lipase: an important lipase in the digestion of dietary lipids in cystic fibrosis?

A convenient lipase assay that discriminates between pancreatic and lingual lipase activities was developed to describe some properties of the triglyceride-hydrolyzing activities of lingual lipase (from von Ebners glands) and pancreatic lipase. Secretion of lingual lipase is stimulated by feeding. Gastric contents collected postyprandially from patients with cystic fibrosis (CF) contained lipase activity which is probably secreted from pharyngeal tissues. Also, duodenal contents from CF patients contained lipase activity with properties very close to those found in gastric contents from CF patients and controls. Apparently, the serous glands responsible for the secretion of lingual lipase is less affected than the exocrine pancrease in this disease. During fat balance experiments, CF patients utilized around 40% of the dietary lipids and more than 50% of milk lipids given as a test meal were hydrolyzed in the duodenum within 2 hr. In these patients with severe pancreatic insufficiency, we suggest that the lingual lipase is responsible for a considerable proportion of triglyceride hydrolysis. This hydrolysis starts in the stomach and continues in duodenum.

Colipase enhances hydrolysis of dietary triglycerides in the absence of bile salts

This study explores how dietary lipids are digested when intraduodenal bile salts are low or absent. Long-chain triglycerides emulsified with phosphatidylcholine were found to be hydrolyzed very slowly by pancreatic lipase alone, as if the surface layer of phospholipids enveloping the triglycerides impeded the action of the enzyme. Colipase enhanced triglyceride hydrolysis severalfold, both when added before or after the lipase. Hydrolysis became even more rapid when the emulsion was first incubated with pancreatic phospholipase. Hydrolysis of long-chain triglycerides was also severely impeded when other proteins were added to the system, probably because they adsorbed to the oil-water interface of the emulsion droplets. It was previously known that bile salts can relieve such inhibition, presumably by desorbing the adsorbed proteins. Colipase was found to enhance hydrolysis severalfold in a dose-dependent manner even in the absence of bile salts, i.e., it could partially or completely relieve the inhibition depending upon the amount and the type of inhibitory protein added to the system. Prior exposure of a protein-coated triglyceride emulsion to another lipase also enhanced the rate at which pancreatic lipase could then hydrolyze the lipids. Most dietary triglycerides are probably presented for intestinal digestion in emulsions covered by proteins and/or phospholipids. These emulsions would be hydrolyzed slowly by pancreatic lipase alone. However, through the action of the lipase in stomach contents and of pancreatic phospholipase and through the lipolysis-promoting effects of collipase, these triglycerices can be rather efficiently hydrolyzed, even in the absence of bile salts.

On the source of lipase activity in gastric contents

--A convenient assay procedure for determination of the activity of pharyngeal lipase (gastric content lipase), using a long chain triglyceride as substrate, is described. Lipase activity in extracts of rat tongue, salivas collected from the upper esophageal pouch from two human newborns with congenital esophageal atresia and in gastric content obtained from an infant with pyloric stenosis were studied. Optimal lipase activities of the three enzyme sources were found in the same pH-range. During hydrolysis the composition of the products formed were also similar. The data presented indicate that at least some of the lipase activity which is responsible for lipolysis in the stomach of the newborn, originates in pregastric tissues.