切换至 "中华医学电子期刊资源库"

中华胃肠内镜电子杂志 ›› 2018, Vol. 05 ›› Issue (04) : 174 -179. doi: 10.3877/cma.j.issn.2095-7157.2018.04.007

所属专题: 文献

综述

不同种胰酶作用后形成的物质片段
王妍1, 令狐恩强1,()   
  1. 1. 100853 北京,解放军总医院消化科
  • 收稿日期:2018-10-10 出版日期:2018-11-15
  • 通信作者: 令狐恩强
  • 基金资助:
    北京市科委课题(D141100000414003)

Fragments produced by different kinds of pancreatic enzymes

Yan Wang1, Enqiang Linghu1,()   

  1. 1. Department of Gastroenterology & Hepatology, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2018-10-10 Published:2018-11-15
  • Corresponding author: Enqiang Linghu
  • About author:
    Corresponding author: Linghu Enqiang, Email:
引用本文:

王妍, 令狐恩强. 不同种胰酶作用后形成的物质片段[J]. 中华胃肠内镜电子杂志, 2018, 05(04): 174-179.

Yan Wang, Enqiang Linghu. Fragments produced by different kinds of pancreatic enzymes[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2018, 05(04): 174-179.

胰腺分泌的各种胰酶能够进入小肠分解复杂的营养物质,在食物的消化吸收过程中起着至关重要的作用。不同种胰酶的含量及其作用的专一性处于精确的调控中,使得人类能够适应多种不同的饮食。慢性胰腺炎等多种胰腺疾病均可引起胰腺外分泌功能不全,从而导致消化不良、脂肪痢等症状。本文将针对胰酶对蛋白质、脂肪、碳水化合物等营养物质的消化作用以及不同种胰酶作用后形成的物质片段展开介绍,为多种胰腺疾病的早期诊断及治疗提供理论基础。

Pancreatic enzymes can enter the small intestine to break down complex nutrients and play a vital role in the digestion and absorption of food. Furthermore, the content and specificity of the digestive enzymes remain under amazing control so that humans can adapt to a wide range of diets. Chronic pancreatitis and other pancreatic diseases can cause pancreatic exocrine dysfunction, leading to maldigestion, steatorrhea and other symptoms. This article will focus on the digestion of protein, fat, carbohydrates and other nutrients by pancreatic enzymes, and the substance fragments formed by different kinds of pancreatic enzymes, which provides a theoretical basis for the early diagnosis and treatment of various pancreatic diseases.

表1 胰腺蛋白水解酶的作用位点及产物
图1 甘油三酯的消化过程及产物
图2 淀粉与糖原的结构及作用产物
[1]
Zhou Q, Melton DA.Pancreas regeneration[J]. Nature, 2018, 557(7705):351-358.
[2]
Roxas M. The role of enzyme supplementation in digestive disorders[J]. Altern Med Rev, 2008, 13(4):307-314.
[3]
Mossner J, Keim V. Pancreatic enzyme therapy[J]. Dtsch Arztebl Int, 2010, 108(34-35):578-582.
[4]
Altshuler AE, Kistler EB, Schmidschönbein GW.Autodigestion: Proteolytic Degradation and Multiple Organ Failure in Shock[J]. Shock, 2016, 45(5):483-489.
[5]
Wood EJ.Textbook of biochemistry with clinical correlations (6th edition)[J]. Biochem Mol Biol Edu, 2006, 34(3):236-237.
[6]
Whitcomb DC, Lowe ME.Human pancreatic digestive enzymes [J]. Dig Dis Sci, 2007, 52(1):1-17.
[7]
Lieberman M.Mark′s basic medical biochemistry:a clinical approach, 5th ed[M].Lippincott Williams & Wilkins,2009.
[8]
Whitcomb DC.Acute pancreatitis[J]. N Eng J Med, 2006, 354(20):2142-2150.
[9]
Gorry MC, Gabbaizedeh D, Furey W, et al.Mutations in the cationic trypsinogen gene are associated with recurrent acute and chronic pancreatitis[J]. Gastroenterology, 1997, 113(4):1063-1068.
[10]
Witt H. A signal peptide cleavage site mutations in the cationic trypsinogen gene is strongly associated with chronic pancreatitis[J]. Gastroenterology, 1999, 117(1):7-10.
[11]
Whitcomb DC, Gorry MC, Preston RA, et al.Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene[J]. Nat Genet, 1996, 14(2):141-145.
[12]
Pfützer R , Myers E, Applebaumshapiro S, et al.Novel cationic trypsinogen (PRSS1) N29T and R122C mutations cause autosomal dominant hereditary pancreatitis[J]. Gastroenterology, 2001, 120(5):271-272.
[13]
Whitcomb DC.Value of genetic testing in the management of pancreatitis[J]. Gut, 2004, 53(11):1710-1717.
[14]
Frick TW, Fernández-del Castillo C, Bimmler D, et al.Elevated calcium and activation of trypsinogen in rat pancreatic acini[J]. Gut, 1997, 41(3):339-343.
[15]
Sutton R, Criddle D, Raraty MG, et al.Signal Transduction, Calcium and Acute Pancreatitis[J]. Pancreatology, 2003, 3(6):497-505.
[16]
Bishop MD, Freedman SD, Zielenski J, et al.The cystic fibrosis transmembrane conductance regulator gene and ion channel function in patients with idiopathic pancreatitis[J]. Hum Genet, 2005, 118(3-4):372-381.
[17]
Alazmi WM, Fogel EL, Schmidt S, et al.ERCP findings in idiopathic pancreatitis:patients who are cystic fibrosis gene positive and negative[J]. Gastrointest Endosc, 2006, 63(2):234-239.
[18]
Jahan-Mihan A, Luhovyy BL, El Khoury D, et al.Dietary proteins as determinants of metabolic and physiologic functions of the gastrointestinal tract[J]. Nutrients, 2011, 3(5):574-603.
[19]
Carrere J, Figarella C, Guy O, et al.Human pancreatic chymotrypsinogen A:a non-competitive enzyme immunoassay, and molecular forms in serum and amniotic fluid[J]. Biochim Biophys Acta, 1986, 883(1):46-53.
[20]
Mohapatra S, Majmunder S, Smyrk TC, et al.Diabetes mellitus is associated with an exocrine pancreatopathy:conclusions from a review of the literature[J]. Pancreas, 2016, 45(8):1104-1110.
[21]
Zsori G, Illes D, Terzin V, et al.Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus:do we need to treat it A systematic review[J]. Pancreatology, 2018, 18(5):559-565.
[22]
Binder HJ, Reuben A. Nutrient digestion and absorption[M]//Boron WF, Boulpaep EL.Medical Physiology:a Cellular and Molecular Approach.Philadelphia,PA:Saunders,2009:949-979.
[23]
Adibi SA, Gray SJ, Menden E. The kinetics of amino acid absorption and alteration of plasma composition of free amino acids after intestinal perfusion of amino acid mixtures[J]. Am J Clin Nutr, 1967, 20(1):24-33.
[24]
Capriotti AL, Caruso G, Cavaliere C, et al.Identification of potential bioactive peptides generated by simulated gastrointestinal digestion of soybean seeds and soy milk proteins[J]. J Food Compos Anal, 2015, 44:205-213.
[25]
Admassu H, Gasmalla M, Yang R, et al.Bioactive Peptides Derived from Seaweed Protein and Their Health Benefits:Antihypertensive, Antioxidant, and Antidiabetic Properties[J]. J Food Sci, 2017, 83(1):6-16.
[26]
Beaulieu L, Sirois M, Tamigneaux.Evaluation of the in vitro biological activity of protein hydrolysates of the edible red alga, Palmaria palmata (dulse) harvested from the Gaspe coast and cultivated in tanks[J]. J Appl Phycol, 2016, 28(5):1-15.
[27]
Carey MC.Digestion and absorption of fat[C].Semin Gastrointest Dis,1992,3:189-208.
[28]
Van Tilbeurgh H, Gargouri Y, Dezan C, et al.Crystallization of pancreatic procolipase and of its complex with pancreatic lipase[J]. J Mol Biol, 1993, 229(2):552-554.
[29]
Borgstroem B. Influence of bile salt, PH, and time on the action of pancreatic lipase; physiological implications[J]. J Lipid Res, 1964, 5:522-531.
[30]
Pongprasobchai S. Maldigestion from pancreatic exocrine insufficiency[J]. J Gastroenterol Hepatol, 2013, 28(S4):99-102.
[31]
Dimagno EP, Go VL, Summerskill WH.Relations between pancreatic enzyme ouputs and malabsorption in severe pancreatic insufficiency[J]. N Engl J Med, 1973, 288(16):813-815.
[32]
Toouli J, Brooke-Smith M, Bassi C, et al.Guidelines for the management of acute pancreatitis[J]. J Gastroenterol Hepatol, 2002, 17(s1):515-539.
[33]
Borgstrom B, Dahlqvist A, Lundh G, et al.Studies of intestinal digestion and absorption in the human[J]. J Clin Invest, 1957, 36(10):1521-1536.
[34]
Van Den Bosch H, Postema NM, De Haas GH, et al.On the positional specificity of phospholipase A from pancreas[J]. Biochim Biophys Acta, 1965, 98(3):657-659.
[35]
Bach AC, Babayan VK.Medium-chain triglycerides:an update[J]. Am J Clin Nutr, 1982, 36(5):950-962.
[36]
Maldonadovalderrama J, Wilde P, Macierzanka A, et al.The role of bile salts in digestion[J]. Adv Colloid Interfac Advances in Colloid & Interface Science, 2011, 165(1):36-46.
[37]
Huggins KW, Boileau AC, Hui DY.Protection against diet-induced obesity and obesity-related insulin resistance in Group 1B PLA2-deficient mice[J]. Am J Physiol Endocrinol Metab, 2002, 283(5):E994-E1001.
[38]
Iqbal J, Hussain MM.Intestinal lipid absorption[J]. Am J Physiol Endocrinol Metab, 2009, 296(6):E1183-E1194.
[39]
McIntyre N.Cholesterol Absorption[M]//Rommel K, Goebell H., Bohmer R.. Lipid absorption:biochemical and clinical aspects. London:MTP Press Ltd.,1976:73-84.
[40]
Feinle-Bisset C, Azpiroz F. Dietary lipids and functional gastrointestinal disorders[J]. Am J Gastroenterol, 2013, 108(5):737-747.
[41]
Ebert EC.Maldigestion and malabsorption[J]. Dis Mon, 2001, 47(2): 49-68.
[42]
Devlin TM.Textbook of Biochemistry with Clinical Correlations[M]. Hoboken,NJ:Wiley-Liss,2006:529-571.
[43]
Lieberman M, Marks AD.Basic Medical Biochemistry:a Clinical Approach[M].Baltimore,MD:Lippincott,Williams and Wilkins,2009:395-396.
[44]
Goodman BE.Insights into digestion and absorption of major nutrients in humans[J]. Adv Physiol Educ, 2010, 34(2):44-53.
[45]
Campbell I. Digestion and absorption[J]. Anaesth Intens Car, 2009, 10(7):342-343.
[46]
Abrams Ck Fau-Hamosh M, Hamosh M Fau-Dutta SK, Dutta Sk Fau-Hubbard VS, et al.Role of nonpancreatic lipolytic activity in exocrine pancreatic insufficiency[J]. Gastroenterology, 1987, 92(1):125-129.
[47]
Beck IT.The role of pancreatic enzymes in digestion[J]. Am J Clin Nutr, 1973, 26(3):311-325.
[48]
Gray GM.Carbohydrate digestion and absorption. Role of the small intestine[J]. N Engl J Med, 1975, 292(23):1225-1230.
[49]
Alpers DH.Digestion and absorption of carbohydrates and proteins[M].1987:1469-1487.
[50]
Omer A, Quigley E. Carbohydrate Maldigestion and Malabsorption [J]. Clin Gastroenterol & H, 2018, 16(8):1197-1199.
[51]
Lebenthal E, Lee PC.Development of functional response in human exocrine pancreas[J]. Pediatrics, 1980, 66(4):556-560.
[52]
Lankisch PG, Otto J. Salivary isoamylase in duodenal aspirates[J]. Dig Dis Sci, 1986, 31(12):1299-1302.
[53]
Sjolund K, Haggmark A, Ihse I, et al.Selective deficiency of pancreatic amylase[J]. Gut, 1991, 32(5):546-548.
[54]
Lowe CU, May CD.Selective pancreatic deficiency, absent amylase, diminished trypsin, and normal lipase[J]. AMA Am J Dis Child, 1951, 82(4):459-464.
[55]
Mehta DI, Wang HH, Akins RE, et al.Isolated pancreatic amylase deficiency: probable error in maturation[J]. J Pediatr, 2000, 136(6):844-846.
[56]
Singh VK, Haupt ME, Geller DE, et al.Less common etiologies of exocrine pancreatic insufficiency[J]. World J Gastroenterol, 2017, 23(39): 7059-7076.
[1] 尚培中, 张润萍, 张伟, 贾国洪, 李晓武, 苗建军, 刘冰. 梗阻性黄疸临床防治新技术单中心应用研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 104-107.
[2] 周岩冰, 刘晓东. 腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 9-13.
[3] 吴方园, 孙霞, 林昌锋, 张震生. HBV相关肝硬化合并急性上消化道出血的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 45-47.
[4] 逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[5] 张海涛, 康婵娟, 翟静洁. 胰管支架置入治疗急性胆源性胰腺炎效果观察[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 654-657.
[6] 何吉鑫, 杨燕妮, 王继伟, 李建国, 谢铭. 肠道菌群及肠道代谢产物参与慢性便秘发生机制的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 495-499.
[7] 姜里蛟, 张峰, 周玉萍. 多学科诊疗模式救治老年急性非静脉曲张性上消化道大出血患者的临床观察[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 520-524.
[8] 孙欣欣, 刘军, 陈超伍, 孙超. 超声内镜引导细针穿刺抽吸术在胰腺占位性病变中的应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 418-421.
[9] 王小红, 钱晶, 翁文俊, 周国雄, 朱顺星, 祁小鸣, 刘春, 王萍, 沈伟, 程睿智, 秦璟灏. 巯基丙酮酸硫基转移酶调控核因子κB信号介导自噬对重症急性胰腺炎大鼠的影响及机制[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 422-426.
[10] 陆萍, 邹健. 凝血和纤维蛋白溶解标志物的动态变化对急性胰腺炎患者预后的评估价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 427-432.
[11] 吉茜茜, 田尧, 马林, 钱进. 红细胞分布宽度-白蛋白比值联合BISAP评分对急性胰腺炎严重程度及死亡率的预测价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 433-438.
[12] 黄岩, 刘晓巍, 杨春玲, 兰烨. 急性胰腺炎合并糖尿病患者的临床特征及血糖代谢与病情严重度的相关性[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 439-442.
[13] 王家圆, 王晓东. 消化系统恶性肿瘤相关肌少症的研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(07): 823-827.
[14] 许瑛杰, 朱佳, 康闽, 侯俊, 苏改秀, 李胜男, 张丹, 赖建铭. 风湿病合并消化道穿孔患儿的临床特点分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 648-654.
[15] 魏红涛, 普布仓决, 格桑央宗, 黎燕, 益西旺扎, 李鹏. 拉萨地区上消化道溃疡患者幽门螺杆菌感染及治疗分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 662-665.
阅读次数
全文


摘要