Lipase supplementation therapy: standards, alternatives, and perspectives.

摘要: Treatment of steatorrhea by lipase supplementation therapy has become more successful in the last decade due to better understanding physiology and pathophysiology digestive process. Porcine been therapeutic standard for several decades will continue be treatment choice pancreatic exocrine insufficiency. Modern concepts recommend administration 25,000-40,000 units porcine per meal using pH-sensitive pancreatin microspheres. In case failure, dose should increased, compliance checked, other reasons malabsorption excluded. Still, most patients, lipid digestion cannot completely normalized current therapy, future developments are needed optimizing treatment. this article, pathophysiologic characteristics insufficiency, prerequisites use alternative sources as well currently available lipases nonporcine origin, new discussed. Current literature suggests that bovine products present a theoretical but play no major role western world. Fungal inferior properties compared with conventional products. Bacterial show promising potential offer alternatives. Moreover, human gene transfer application bioengineered gastric appear on horizon.