A first approach for an evidence-based in vitro digestion method to adjust pancreatic enzyme replacement therapy in cystic fibrosis

摘要: Background Patients with cystic fibrosis have to take enzymatic supplements allow for food digestion. However, an evidence-based method adjust Pancreatic Enzyme Replacement Therapy (PERT) is inexistent, and lipid content of meals used as a rough criterion. Objective In this study, in vitro digestion model was set up determine the theoretical optimal dose (TOD) supplement selection foods, which that allows maximum lipolysis extent. Methods A static applied simulate eight foods covering wide range contents. First, fixed at 2000 lipase units per gram fat (LU/g fat) using intestinal pH bile salt concentration variables. Second, concentrations were variable supplement. Lipolysis extent determined by measuring free fatty acids released from initial triglycerides after Results terms percentage fitted into linear-mixed segmented deducted equations predict TOD reach 90% every food. In addition, effect investigated. Results The predictive obtained assessed showed not only dependent on enzyme or content. Moreover, had significant effects lipolysis. Therefore can be developed taking account these variables. Conclusions Depending characteristics, specific should assigned achieve extent. This work represents first step towards PERT dosing, will vivo setting validate its efficacy.