Non-pancreatic lipase in children with pancreatic fibrosis.

It has been shown that children with pancreatic fibrosis who have no pancreatic lipase at all may absorb a considerable proportion of dietary fat (Shohl, 1948; Andersen, 1945a and b; Ross, 1955). In addition it has been demonstrated by Andersen (1945a) that there may be a considerable amount of hydrolyzed fat in the stools of children with pancreatic fibrosis. These findings would indicate the presence of non-pancreatic lipase in the gastrointestinal tract derived either from dietary or nondietary sources. Possible sources of dietary lipase have not been adequately investigated. Although Green (1890) demonstrated lipase in the germinating seeds of the castor bean, we could find no reports on the lipase content of various fresh fruit and vegetables which are commonly used in human diets. Freudenberg (1929) showed that there was lipase in human and cow's milk and claimed that the enzyme in milk was activated by a lipokinase in human gastric juice. Several possible sources of non-dietary lipase in the gastro-intestinal tract have been studied. Sch0nheyder and Volqvartz (1944) demonstrated lipase in both gastric juice and gastric mucosa from infants and adults: they showed that only the lower triglycerides were hydrolyzed to an appreciable degree by this lipase and that the optimum pH was 5 5 to 5 8. It has been questioned, however, if gastric lipase is secreted by the stomach or if it enters the stomach by regurgitation from the duodenum (Wolman, 1943). That intestinal bacteria might be a source of lipase in children with pancreatic fibrosis was suggested by Andersen (1945a) who found that a considerable degree of hydrolysis of faecal fat occurred in stools which were left standing for 48 hours at room temperature. The object of the present study was to investigate the activity of several possible sources of dietary and non-dietary lipase in the gastro-intestinal tracts of children with pancreatic fibrosis. Materials and Methods