Pancreatic elastase is a protein that is produced almost solely by the pancreas. It is secreted into the duodenum to help degrade food remains. A lack of this protein can cause a number of physiological problems. An assay for pancreatic elastase-1 is used clinically with stool samples to diagnose problems with the ability of the pancreas to secrete digestive enzymes.
Elastases are members of a family of proteases and degrade other proteins, enhancing the digestive process. They can break down elastin, a type of connective tissue that holds organs together. In addition, they break down a number of other proteins. An elastase is an endoprotease, meaning that it cleaves within the protein being degraded. These enzymes are also serine proteases, a specific type of protease that has the amino acid serine at its active site.
An enzyme that was originally called pancreatic elastase turned out to be a different type of elastase that was not specific to the pancreas. The term is still retained clinically, but pancreatic elastase-1 technically refers to member 3B of the chymotrypsin-like elastase family. This enzyme is often referred to as fecal elastase-1 in the clinical literature.
The pancreas has dual functions in mammalian physiology. It is important for digestion and secretes enzymes into the digestive milieu of the lower intestine. Hormones responsible for glucose uptake are also secreted. Malfunction of the pancreas can result in malnutrition, because food is not properly broken down and the nutrients are lost. This is a particular problem with fat-soluble vitamins, such as Vitamin D.
A pancreas that is not performing properly can cause a number of symptoms, including reflux symptoms in the esophagus, loose and watery stools, a low level of hydrochloric acid, and bloating. People who are older, have diabetes, or have had their gall bladders removed are at some risk of experiencing pancreatic digestion enzyme secretion issues. There are complex gastroenterology tests that can be performed to test for pancreatic enzyme secretion. The pancreatic elastase test is a simpler alternative that can be performed by testing stool that has stood at room temperature for up to five days.
The concentration of this enzyme in the stool is much greater than that in the duodenal juice, indicating that the enzyme is surviving the harsh conditions of digestion and elimination from the body. Levels of this form of elastase correlate extremely well with the more sophisticated gold standard measurements. The test is also not affected by elastase supplements that may have been taken by the patient, since these supplements utilize pork pancreatic elastase, which does not react with the test designed for the human enzyme.