Pancreatic elastase: preparation and implementation of the study

Elastase-1( pancreatic elastase-1) is a special enzyme produced by the pancreas. The study for the presence of this enzyme is carried out using biochemical analysis. This indicator has an independent diagnostic value, but it is studied most often together with the determination of the level of amylase, OAK and coprogram. The detection of the level of this indicator in the stool is used to assess the performance of the pancreas. This analysis is carried out by ELISA, use for it feces, which is collected in a sterile container. The normal figure for an adult varies from 201 mcg / g. Examination of samples can last from one to nine days.

What is elastase?

Elastase is an enzyme that is part of the hydrolase group. Its molecular weight reaches 28,000 carbon units. If compared with other proteases, this enzyme is capable of splitting the structural protein, which consists of elastic fibers of connective tissue, walls of blood vessels, skin. Elastase is of two forms - pancreatic and leukocytic.

Where is synthesized?

Pancreatic elastase-1 is synthesized in the pancreas, and then in the form of proelastase is released into the small intestine along with other enzymes. In the small intestine under the action of the serine protease, it is transformed into elastase. PE-1 in the intestine does not split, which is why its concentration in the stool is an indicator of the regulation of the amount and composition of pancreatic juice secreted by the pancreas.

Which group do you belong to?

Together with chymotrypsin and trypsin, elastase belongs to the serine protease group. This is due to the fact that the active center contains serine. All the enzymes previously listed make up about 40% of the total protein concentration of the exocrine area in the pancreas. All of them are one family. PE-1 has a higher specificity than trypsin. Therefore, its activation occurs when the peptide bonds formed by amino acids are separated. Also elastase is able to participate in the process of splitting the elastin protein, which does not decompose under the action of trypsin and chymotrypsin.

Definition of pancreatic elastase in feces is often used to diagnose cystic fibrosis. As a result of the disease cystic fibrosis, which is a genetic pathology, there is a disruption in the structure and functionality of cells that are located on the gland ducts. Cystic fibrosis provokes defeat of the lungs, stomach, kidneys, intestines. In this case, an analysis of pancreatic elastase will show a significant decrease in the stool mass. The test for this indicator is a highly sensitive and specific method of research, which is widely used in gastroenterology, hepatology and endocrinology.

Indications for analysis of

Pancreatic elastase-1 level assay can be used to determine pancreatic secretion deficiency, for diagnosis of cystic fibrosis, malignant neoplasms, and pancreatitis in chronic form. In addition, the study was shown to observe the process of therapy of a deficiency in the enzymatic activity of the pancreas.

A study for pancreatic elastase( the norm will be presented below) may be prescribed if the following symptoms are observed:

• Diarrhea or constipation.
• Inflammation of the intestine.
• Pain and heaviness in the stomach after eating.
• A sharp decrease in body weight.
• Change in consistency, color and smell of stool.
• The presence of remains in the stool is not up to the end of the digested food.

There are no contraindications to this assay.

Specificity of the study of stool for the content of elastase-1 in it can reach 95%, and sensitivity - almost 93%.Another advantage of this study is the low ability of pancreatic elastase-1 to cleave. This allows you to save material for a long time, if you meet all the conditions for its collection.

Preparation for research and collection of material for its implementation

For the study, it is necessary to take a specimen of feces. It is preferable to take the analysis in the morning, in the interval from 7 to 11 am. Before the study allowed to eat. This is due to the fact that elastase, which comes with food, in the intestine does not collapse and can not affect the result of the study. It is important not to take laxatives for several days before taking the test, do not use rectal suppositories and barium preparations. It is necessary to pass the analysis before other manipulations like an enema or a colonoscopy are performed.

The carrying out and the result of the study on the content of elastase-1 in the stool mass is also not affected by drug treatment, suggesting the intake of pancreatic enzymes.

Several rules should be observed when collecting biomaterial. It is necessary to observe the sterility of the container and to ensure that urine does not fall into the stool sample. Then you should transfer the sample of feces into a special container in a volume of 30-60 milliliters and close tightly with a lid. Prior to the dispatch of stool for research, it should be stored in the refrigerator. The temperature should be from five to eight degrees. Collect feces for this study can be during the day, and if necessary, allowed to freeze it at a temperature of -20 degrees.

Research method

The enzyme immunoassay is used in the assay. On the plastic plate for the ELISA, the lab technician applies a layer of antibodies that only elastase-1 can recognize. Then a sample of the biomaterial being studied is attached to the antibodies. A label with a dye is applied to the biotin portion. The intensity of the marker color is determined by the spectrophotometry method.

Normal enzyme parameters in biomaterial

The parameters of elastase-1 in a newborn child are slightly below normal, but by 2 weeks they reach the normal level. Analyze the data obtained should only a highly qualified specialist. The decoding of the results is as follows.

• Value of the EP & gt;200 mcg / g indicate a normal function of the pancreas. The larger the value, the better the function of this organ( when pancreatic elastase> 500 μg / g or simply 500 - well).
• The value of 100-200 mcg / g is mild pancreatic insufficiency.
• The value of EP & lt; 100 μg / g is a moderate or severe organ failure.

That is, if the indicator is more than normal, it will not have any clinical significance. But when an insufficient level of elastase is revealed during the study, it is necessary to start treatment.