Intact proteins vs. amino acid mixtures on pancreatic enzyme secretion and intraluminal protease activity

Elemental diets, in which the nitrogenous component is present as synthetic amino acids or protein hydrolysate, have been found to be beneficial in the treatment of intestinal disease, in particular, acute ischemic enteropathy, radiation enteropathy, and Crohn’s disease. ¹ One mechanism offered in explanation of the beneficial effect of elemental diets in these diseases is the reduction in pancreatic protease activities in the intestinal lumen. This explanation was based on direct and indirect evidence that pancreatic proteases, particularly trypsin and chymotrypsin, aggravated the intestinal lesions associated with hemorrhagic and endotoxin shock and short-term mesenteric ischemia, ² combined with evidence that elemental diets resulted in less pancreatic secretion and lower levels of luminal pancreatic proteases.