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A first approach for an evidence-based in vitro digestion method to adjust pancreatic enzyme replacement therapy in cystic fibrosis

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A first approach for an evidence-based in vitro digestion method to adjust pancreatic enzyme replacement therapy in cystic fibrosis

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dc.contributor.author Calvo-Lerma, Joaquim es_ES
dc.contributor.author Fornes-Ferrer, Victor es_ES
dc.contributor.author Peinado Pardo, Irene es_ES
dc.contributor.author Heredia Gutiérrez, Ana Belén es_ES
dc.contributor.author Ribes-Koninckx C. es_ES
dc.contributor.author Andrés Grau, Ana María es_ES
dc.date.accessioned 2020-04-06T08:55:49Z
dc.date.available 2020-04-06T08:55:49Z
dc.date.issued 2019-02-22 es_ES
dc.identifier.issn 1932-6203 es_ES
dc.identifier.uri http://hdl.handle.net/10251/140190
dc.description.abstract [EN] Background Patients with cystic fibrosis have to take enzymatic supplements to allow for food digestion. However, an evidence-based method to adjust Pancreatic Enzyme Replacement Therapy (PERT) is inexistent, and lipid content of meals is used as a rough criterion. Objective In this study, an in vitro digestion model was set up to determine the theoretical optimal dose (TOD) of enzymatic supplement for a selection of foods, which is the dose that allows for maximum lipolysis extent. Methods A static in vitro digestion model was applied to simulate digestion of eight foods covering a wide range of lipid contents. First, the dose of the enzymatic supplement was fixed at 2000 lipase units per gram of fat (LU/g fat) using intestinal pH and bile salt concentration as variables. Second, intestinal pH and bile salt concentrations were fixed and the variable was the dose of the enzymatic supplement. Lipolysis extent was determined by measuring the free fatty acids released from initial triglycerides content of foods after digestion. Results in terms of percentage of lipolysis extent were fitted into a linear-mixed segmented model and the deducted equations were used to predict the TOD to reach 90% of lipolysis in every food. In addition, the effect of intestinal pH and bile salt concentration were investigated. Results The predictive equations obtained for the assessed foods showed that lipolysis was not only dependent on the dose of the enzyme supplement or the lipid content. Moreover, intestinal pH and bile salt concentration had significant effects on lipolysis. Therefore an evidence-based model can be developed taking into account these variables. Conclusions Depending on food characteristics, a specific TOD should be assigned to achieve an optimal digestion extent. This work represents a first step towards an evidence-based method for PERT dosing, which will be applied in an in vivo setting to validate its efficacy. es_ES
dc.description.sponsorship This work was fully funded by the European Union and the Horizon 2020 Research and Innovation Framework Programme (PHC-26-2014 call Self management of health and disease: citizen engagement and mHealth) under grant number 643806. es_ES
dc.language Inglés es_ES
dc.publisher Public Library of Science es_ES
dc.relation.ispartof PLoS ONE es_ES
dc.rights Reconocimiento (by) es_ES
dc.subject.classification TECNOLOGIA DE ALIMENTOS es_ES
dc.title A first approach for an evidence-based in vitro digestion method to adjust pancreatic enzyme replacement therapy in cystic fibrosis es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1371/journal.pone.0212459 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/643806/EU/Innovative approach for self-management and social welfare of Cystic Fibrosis patients in Europe: development, validation and implementation of a telematics tool./ es_ES
dc.rights.accessRights Abierto es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Tecnología de Alimentos - Departament de Tecnologia d'Aliments es_ES
dc.contributor.affiliation Universitat Politècnica de València. Instituto Universitario de Ingeniería de Alimentos para el Desarrollo - Institut Universitari d'Enginyeria d'Aliments per al Desenvolupament es_ES
dc.description.bibliographicCitation Calvo-Lerma, J.; Fornes-Ferrer, V.; Peinado Pardo, I.; Heredia Gutiérrez, AB.; Ribes-Koninckx C.; Andrés Grau, AM. (2019). A first approach for an evidence-based in vitro digestion method to adjust pancreatic enzyme replacement therapy in cystic fibrosis. PLoS ONE. 14(2):1-14. https://doi.org/10.1371/journal.pone.0212459 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1371/journal.pone.0212459 es_ES
dc.description.upvformatpinicio 1 es_ES
dc.description.upvformatpfin 14 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 14 es_ES
dc.description.issue 2 es_ES
dc.relation.pasarela S\379077 es_ES
dc.description.references Lesmes, U., & McClements, D. J. (2012). Controlling lipid digestibility: Response of lipid droplets coated by β-lactoglobulin-dextran Maillard conjugates to simulated gastrointestinal conditions. Food Hydrocolloids, 26(1), 221-230. doi:10.1016/j.foodhyd.2011.05.011 es_ES
dc.description.references Humbert, L., Rainteau, D., Tuvignon, N., Wolf, C., Seksik, P., Laugier, R., & Carrière, F. (2018). Postprandial bile acid levels in intestine and plasma reveal altered biliary circulation in chronic pancreatitis patients. Journal of Lipid Research, 59(11), 2202-2213. doi:10.1194/jlr.m084830 es_ES
dc.description.references Lamothe, S., Azimy, N., Bazinet, L., Couillard, C., & Britten, M. (2014). Interaction of green tea polyphenols with dairy matrices in a simulated gastrointestinal environment. Food Funct., 5(10), 2621-2631. doi:10.1039/c4fo00203b es_ES
dc.description.references Muggeo, V. & Muggeo, V. M. R. Segmented mixed models with random changepoints in R Working paper (2016). es_ES


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