CELA2A

• OMIM: 609 443
• UniProt: P08217

The pancreatic elastase ( elastase -1, but Gene Name: CELA2A ) is a digestive enzyme that is produced in the pancreas of all vertebrates. The enzyme cleaves proteins ( so-called endopeptidase ) and belongs generally to the elastases. It is discharged with other digestive enzymes, such as setting of the alpha -amylase, lipase, trypsin and phospholipases of the pancreas in the small intestine.

Function

Pancreatic elastase is produced as an inactive zymogen ( proelastase ) in the pancreas and activated in the small intestine by cleavage with trypsin at the enzyme elastase. The active digestive enzyme cleaves particular elastin. The pancreatic elastase is excreted unchanged in the faeces.

Laboratory Diagnostic significance

The elastase remains stable during passage through the intestine and accumulates in the chair. The amount of found in the stool pancreatic elastase -1 provides information on the exocrine function of the pancreas. During acute inflammations of the pancreas pancreatic elastase enters into the blood and thus can be measured in serum. A reduced pancreatic elastase concentration is an indication of an exocrine pancreatic insufficiency or cystic fibrosis. The ELISA test for fecal elastase -1 was developed in 1989 at the University of Giessen.

The elastase out of the chair is determined in unclear diarrhea or constipation, fatty stools, bloating, and weight loss; also with upper abdominal pain and food intolerances. In cases of suspected acute pancreatitis or an acute episode of chronic pancreatitis, the determination may be made from the serum. It it is a sensitive and specific detection of the inflammatory process.

The reference value in the stool is for adults and children after the first month of life 200 to > 500 ug E1 / g 100-200 micrograms E1 / g stool are expressed as mean to slight insufficiency, values ​​<100 ug E1 / g stool judged as severe insufficiency. In serum of the normal value is <3.5 mg / ml.

An elevated elastase levels in the blood serum speaks for acute pancreatitis or an acute episode of chronic pancreatitis, an increased value in the stool has no clinical significance.

Decreased elastase levels in the blood serum have no meaning. Decreased values ​​in the stool indicate a decreased production of digestive enzymes. This can for example be the result of chronic inflammation of the pancreas, a pancreatic cancer (pancreatic cancer ) or a cyst pancreas. In addition, the decreased values ​​may indicate a chronic alcohol abuse. In children, decreased values ​​found in a genetic metabolic disorder of cystic fibrosis. The decreased elastase values ​​are then detected in the first few weeks of life.