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1.
Biotechnol Appl Biochem ; 71(4): 712-720, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38409863

ABSTRACT

Organic waste valorization is one of the principal goals of the circular economy. Bioprocesses offer a promising approach to achieve this goal by employing microorganisms to convert organic feedstocks into high value products through their metabolic activities. In this study, a fermentation process for yeast cultivation and extracellular lipase production was developed by utilizing food waste. Lipases are versatile enzymes that can be applied in a wide range of industrial fields, from detergent, leather, and biodiesel production to food and beverage manufacturing. Among several oleaginous yeast species screened, Saitozyma flava was found to exhibit the highest secreted lipase activity on pNP-butyrate, pNP-caproate, and pNP-caprylate. The production medium was composed of molasses, a by-product of the sugar industry, which provided nutrients for yeast biomass formation. At the same time, waste cooking oil was employed to induce and enhance extracellular lipase production. After 48 h of process, 20 g/L of yeast biomass and 150 mU/mgdw of lipase activity were achieved, with a productivity of 3 mU/mgdw/h. The purified lipase from S. flava showed optimal performances at temperature 28°C and pH 8.0, exhibiting a specific activity of 62 U/mg when using p-NPC as substrate.


Subject(s)
Lipase , Molasses , Lipase/metabolism , Lipase/biosynthesis , Lipase/chemistry , Plant Oils/metabolism , Plant Oils/chemistry , Cooking , Fermentation , Basidiomycota/enzymology , Basidiomycota/metabolism
2.
Curr Pharm Des ; 30(17): 1307-1316, 2024.
Article in English | MEDLINE | ID: mdl-38629357

ABSTRACT

BACKGROUND: Surgical site infections are one of the major clinical problems in surgical departments that cost hundreds of millions of dollars to healthcare systems around the world. AIM: The study aimed to address the pressing issue of surgical site infections, which pose significant clinical and financial burdens on healthcare systems globally. Recognizing the substantial costs incurred due to these infections, the research has focused on understanding the role of lipase and protease production by multi-drug resistant bacteria isolated from surgical wounds in the development of post-surgical wound infections. METHODS: For these purposes, 153 pus specimens were collected from patients with severe post-surgical wound infections having prolonged hospital stays. The specimens were inoculated on appropriate culture media. Gram staining and biochemical tests were used for the identification of bacterial growth on suitable culture media after 24 hours of incubation. The isolated pathogens were then applied for lipase and protease, key enzymes that could contribute to wound development, on tributyrin and skimmed milk agar, respectively. Following the CSLI guidelines, the Kirby-Bauer disc diffusion method was used to assess antibiotic susceptibility patterns. The results revealed that a significant proportion of the samples (127 out of 153) showed bacterial growth of Gram-negative (n = 66) and Gram-positive (n = 61) bacteria. In total, isolated 37 subjects were declared MDR due to their resistance to three or more than three antimicrobial agents. The most prevalent bacteria were Staphylococcus aureus (29.13%), followed by S. epidermidis (18.89%), Klebsiella pneumoniae (18.89%), Escherichia coli (14.96%), Pseudomonas aeruginosa (10.23%), and Proteus mirabilis (7.87%). Moreover, a considerable number of these bacteria exhibited lipase and protease activity with 70 bacterial strains as lipase positive on tributyrin agar, whereas 74 bacteria showed protease activity on skimmed milk agar with P. aeruginosa as the highest lipase (69.23%) and protease (76.92%) producer, followed by S. aureus (lipase 62.16% and protease 70.27%). RESULTS: The antimicrobial resistance was evaluated among enzyme producers and non-producers and it was found that the lipase and protease-producing bacteria revealed higher resistance to selected antibiotics than non-producers. Notably, fosfomycin and carbapenem were identified as effective antibiotics against the isolated bacterial strains. However, gram-positive bacteria displayed high resistance to lincomycin and clindamycin, while gram-negative bacteria were more resistant to cefuroxime and gentamicin. CONCLUSION: In conclusion, the findings suggest that lipases and proteases produced by bacteria could contribute to drug resistance and act as virulence factors in the development of surgical site infections. Understanding the role of these enzymes may inform strategies for preventing and managing post-surgical wound infections more effectively.


Subject(s)
Anti-Bacterial Agents , Drug Resistance, Multiple, Bacterial , Lipase , Microbial Sensitivity Tests , Peptide Hydrolases , Humans , Drug Resistance, Multiple, Bacterial/drug effects , Lipase/metabolism , Lipase/biosynthesis , Anti-Bacterial Agents/pharmacology , Peptide Hydrolases/metabolism , Peptide Hydrolases/biosynthesis , Surgical Wound Infection/microbiology , Surgical Wound Infection/drug therapy , Wound Infection/microbiology , Wound Infection/drug therapy , Male , Female , Adult , Middle Aged , Gram-Positive Bacteria/drug effects , Gram-Positive Bacteria/isolation & purification , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/isolation & purification
3.
Braz. arch. biol. technol ; 63: e20180444, 2020. graf
Article in English | LILACS | ID: biblio-1132252

ABSTRACT

Abstract Fungi have always attracted a lot of attention as they are able to produce a vast repertoire of enzymes that find a broad spectrum of uses in biotechnological and industrial fields. Undoubtedly, one of the most promising biocatalysts is the lipase, which has been widely used for the biotransformation of a number of commercial products due to its high stability, high catalytic efficiency, versatility and selectivity, making it one of the most attractive and best-studied enzymes. In this study we report the isolation and molecular identification of new lipase-producing fungi from different environmental samples from Morocco. The production and activity of extracellular lipases, at different parameters, was evaluated using the Rhodamine B agar, submerged fermentation and biochemical methods. Two fungal strains Arthrographis curvata and Rhodosporidium babjevae, were isolated and found to produce large amounts of lipases. The optimal activity of the extracellular lipase was detected at 40°C and pH 9.0 for A. curvata and at 40 °C and pH 8.0 for R. babjevae. This study add new information at the growing list of fungal species producing lipases with improved physicochemical proprieties which could constitute a new line of research for further studies and to be exploited for industrial or bioremediation purposes.


Subject(s)
Biotechnology , Fungi/enzymology , Lipase/biosynthesis
4.
Electron. j. biotechnol ; 30: 33-38, nov. 2017. tab, graf
Article in English | LILACS | ID: biblio-1021336

ABSTRACT

Background: Lipases are used in detergent industries to minimise the use of phosphate-based chemicals in detergent formulations. The use of lipase in household laundry reduces environmental pollution and enhances the ability of detergent to remove tough oil or grease stains. Results: A lipase-producing indigenous Bacillus subtilis strain [accession no. KT985358] was isolated from the foothills of Trikuta mountain in Jammu and Kashmir, India. The lipase (BSK-L) produced by this strain expressed alkali and thermotolerance. Lipase has an optimal activity at pH 8.0 and temperature 37°C, whereas it is stable at pH 6.0­9.0 and showed active lipolytic activity at temperatures 30 to 60°C. Furthermore, lipase activity was found to be stimulated in the presence of the metal ions Mn2+, K+, Zn2+, Fe2+ and Ca2+. This lipase was resistant to surfactants, oxidising agents and commercial detergents, suggesting it as a potential candidate for detergent formulation. BSK-L displayed noticeable capability to remove oil stains when used in different washing solutions containing buffer, lipase and commercial detergent. The maximum olive oil removal percentage obtained was 68% when the optimum detergent concentration (Fena) was 0.3%. The oil removal percentage from olive oil-soiled cotton fabric increased with 40 U/mL of lipase. Conclusions: This BSK-L enzyme has the potential for removing oil stains by developing a pre-soaked solution for detergent formulation and was compatible with surfactants, oxidising agents and commercial detergents.


Subject(s)
Bacillus subtilis/metabolism , Lipase/metabolism , Temperature , Bacillus subtilis/isolation & purification , Bacillus subtilis/enzymology , Detergents , Alkalinization , Thermotolerance , Hydrogen-Ion Concentration , Lipase/biosynthesis
5.
Electron. j. biotechnol ; 19(4): 62-67, July 2016. ilus
Article in English | LILACS | ID: lil-793954

ABSTRACT

Background: A thermostable lipase MAS1 from marine Streptomyces sp. strain was considered as a potential biocatalyst for industrial application, but its production level was relatively low. Here, the effect of chaperones co-expression on the secretory expression of lipase MAS1 in Pichia pastoris was investigated. Result: Co-expression of protein disulfide isomerase (PDI), HAC1 and immunoglobulin binding protein could increase the expression level of lipase MAS1, whereas co-expression of Vitreoscilla hemoglobin showed a negative effect to the lipase MAS1 production. Among them, PDI co-expression increased lipase MAS1 expression level by 1.7-fold compared to the control strain harboring only the MAS1 gene. Furthermore, optimizing production of lipase MAS1 with Pichia pastoris strain X-33/MAS1-PDI in a 30-L bioreactor were conducted. Lower induction temperature was found to have a benefit effect for lipase MAS1 production. Lipase activity at 24 and 22°C showed 1.7 and 2.1-fold to that at 30°C, respectively. Among the induction pH tested, the highest lipase activity was obtained at pH 6.0 with activity of 440 U/mL after 144 h fermentation. Conclusion: Our work showed a good example for improving the production of recombinant enzymes in Pichia pastoris via chaperon co-expression and fermentation condition optimization.


Subject(s)
Streptomyces/metabolism , Lipase/biosynthesis , Pichia , Temperature , Cell Survival , Molecular Chaperones , Bioreactors , Protein Disulfide-Isomerases , Vitreoscilla , Fermentation , Batch Cell Culture Techniques , Hydrogen-Ion Concentration
6.
Braz. j. microbiol ; 47(2): 461-467, Apr.-June 2016. tab, graf
Article in English | LILACS | ID: lil-780837

ABSTRACT

Abstract A Plackett–Burman Factorial Design of 16 experiments was conducted to assess the influence of nine factors on the production of lipases by filamentous fungi. The factors investigated were bran type (used as the main carbon source), nitrogen source, nitrogen source concentration, inducer, inducer concentration, fungal strain (Aspergillus niger or Aspergillus flavus were selected as good lipase producers via submerged fermentation), pH and agitation. The concentration of the yeast extract and soybean oil and the pH had a significant effect (p < 0.05) on lipase production and were consecutively studied through a Full Factorial Design 23, with the concentration of yeast extract and pH being significant (p < 0.05). These variables were optimized using a central composite design, obtaining maximum lipolytic activities with the use of 45 g/L of yeast extract and pH 7.15. The statistical model showed a 94.12% correlation with the experimental data.


Subject(s)
Aspergillus flavus/metabolism , Aspergillus niger/metabolism , Industrial Microbiology/methods , Fungal Proteins/biosynthesis , Lipase/biosynthesis , Carbon/metabolism , Culture Media/metabolism , Culture Media/chemistry , Fermentation , Nitrogen/metabolism
7.
Braz. j. microbiol ; 47(3): 647-657, July-Sept. 2016. tab, graf
Article in English | LILACS | ID: lil-788974

ABSTRACT

ABSTRACT The purpose of this study was to isolate, purify and optimize the production conditions of an organic solvent tolerant and thermostable lipase from Acinetobacter sp. AU07 isolated from distillery waste. The lipase production was optimized by response surface methodology, and a maximum production of 14.5 U/mL was observed at 30 ºC and pH 7, using a 0.5% (v/v) inoculum, 2% (v/v) castor oil (inducer), and agitation 150 rpm. The optimized conditions from the shake flask experiments were validated in a 3 L lab scale bioreactor, and the lipase production increased to 48 U/mL. The enzyme was purified by ammonium sulfate precipitation and ion exchange chromatography and the overall yield was 36%. SDS-PAGE indicated a molecular weight of 45 kDa for the purified protein, and Matrix assisted laser desorption/ionization time of flight analysis of the purified lipase showed sequence similarity with GDSL family of lipases. The optimum temperature and pH for activity of the enzyme was found to be 50 ºC and 8.0, respectively. The lipase was completely inhibited by phenylmethylsulfonyl fluoride but minimal inhibition was observed when incubated with ethylenediaminetetraacetic acid and dithiothreitol. The enzyme was stable in the presence of non-polar hydrophobic solvents. Detergents like SDS inhibited enzyme activity; however, there was minimal loss of enzyme activity when incubated with hydrogen peroxide, Tween 80 and Triton X-100. The kinetic constants (Km and Vmax) revealed that the hydrolytic activity of the lipase was specific to moderate chain fatty acid esters. The Vmax, Km and Vmax/Km ratio of the enzyme were 16.98 U/mg, 0.51 mM, and 33.29, respectively when 4-nitrophenyl palmitate was used as a substrate.


Subject(s)
Organic Chemicals , Solvents , Bacterial Proteins/isolation & purification , Bacterial Proteins/biosynthesis , Acinetobacter/enzymology , Lipase/isolation & purification , Lipase/biosynthesis , Organic Chemicals/chemistry , Solvents/chemistry , Substrate Specificity , Temperature , Bacterial Proteins/chemistry , Enzyme Stability , Kinetics , Chromatography, Ion Exchange , Enzyme Activation , Extracellular Space/enzymology , Hydrogen-Ion Concentration , Ions , Lipase/chemistry , Lipolysis , Metals , Molecular Weight
8.
Electron. j. biotechnol ; 18(1): 20-28, Jan. 2015. ilus, graf, tab
Article in English | LILACS | ID: lil-736981

ABSTRACT

Background Oil and grease laden wastewaters pose hindrance to the treatment units and further threaten the receiving water bodies. Lipase-producing microbial strains are increasingly being exploited for the remediation of such effluents. Results When bacterial strains isolated from oil mill effluent were screened for their lipolytic activity, two isolates, COM-4A and COM-6B showed significant extracellular lipase activity. They were identified to be Staphylococcus pasteuri and Bacillus subtilis, respectively. S. pasteuri COM-4A was cultivated in nutrient media based on coconut oil mill waste (CMW), in which it showed good growth at concentrations up to 20 g/L. While growing in such media, it was capable of producing lipase and other important extracellular hydrolytic enzymes. Furthermore, the isolate was able to effectively biodegrade the CMW supplemented in the medium. Applying the Box Behnken Design of Response Surface Methodology, lead to a 1.4-fold increase in both lipase production and oil removal by the isolate. The lipase was purified 9.02-fold and the molecular weight of the monomeric enzyme was deduced to be around 56 kDa. Characterization of the enzyme revealed it to be alkaliphilic and moderately thermophilic in nature, with pH and temperature optima of 9.0 and 50°C, respectively. The enzyme was also quite stable in the presence of water-miscible organic solvents. Conclusion Hence, the COM-4A lipase could be considered to be suitable for a variety of industrial applications such as in detergent formulations and in biodiesel production as well, apart from the possibility of applying it for bioremediation of fat and oil contaminants.


Subject(s)
Staphylococcus/enzymology , Palm Oil/metabolism , Lipase/isolation & purification , Lipase/biosynthesis , Temperature , Bacillus subtilis/enzymology , Biodegradation, Environmental , Chromatography, Ion Exchange , Biomass , Detergents , Biofuels , Wastewater , Hydrogen-Ion Concentration
9.
Electron. j. biotechnol ; 14(4): 6-6, July 2011. ilus, tab
Article in English | LILACS | ID: lil-640501

ABSTRACT

Aneurinibacillus thermoaerophilus strain AFNA as a novel isolated extracellular thermostable organic solvent tolerant lipase producing bacterium was employed in the present study. The lipase production of strain AFNA and its correlation with bacterial growth was studied via a modeling assessment by response surface methodology (RSM) and artificial neural network (ANN) techniques. The best achieved models were multilayer full feed forward incremental back propagation network and modified cubic response surface model (mRSM) using backward elimination. The highest lipase specific activity (13.1 Umg-1) and bacterial growth (OD600 = 3.0) were obtained at technically similar: growth temperature (53 and 53ºC), inoculum size (2.6 and 3.0 percent), agitation rate (118 and 115 rpm) and initial pH (7.0 and 7.2) but different medium volume (139 and 87 ml) and incubation period (48 and 38 hrs), respectively. In addition, the importance of effective parameters on the bacterial growth and lipase production was studied where pH and inoculum size were the most and the least effective factors, respectively. Significant correlation between lipase production and bacterial growth was observed when Bivariate correlation was employed to analyse the data. As a conclusion, lipase production was the result of a synergistic combination of effective parameters interactions and these parameters were in equilibrium.


Subject(s)
Bacillaceae , Lipase/biosynthesis , Neural Networks, Computer , Models, Theoretical , Surface Properties , Temperature
10.
Rev. argent. microbiol ; 43(3): 218-225, jun.-set. 2011. graf, tab
Article in English | LILACS | ID: lil-634695

ABSTRACT

The yeast Yarrowia lipolytica accumulates oils and is able to produce extracellular lipases when growing in different carbon sources including glycerol, the principal by-product of the biodiesel industry. In this study, biomass production of a novel mutant strain of Y. lipolytica was statistically optimized by Response Surface Methodology in media containing biodiesel-derived glycerol as main carbon source. This strain exhibited distinctive morphological and fatty acid profile characteristics, and showed an increased extracellular lipase activity. An organic source of nitrogen and the addition of 1.0 g/l olive oil were necessary for significant lipase production. Plackett-Burman and Central Composite Statistical Designs were employed for screening and optimization of fermentation in shaken flasks cultures, and the maximum values obtained were 16.1 g/l for biomass and 12.2 Units/ml for lipase, respectively. Optimized batch bioprocess was thereafter scaled in aerated bioreactors and the values reached for lipase specific activity after 95 % of the glycerol had been consumed, were three-fold higher than those obtained in shaken flasks cultures. A sustainable bioprocess to obtain biomass and extracellular lipase activity was attained by maximizing the use of the by-products of biodiesel industry.


Optimización de la producción de biomasa usando glicerol crudo, de una cepa mutante de Yarrowia lipolytica con actividad incrementada de lipasa. La levadura Yarrowia lipolytica acumula aceites y produce una lipasa extracelular al crecer en diferentes fuentes de carbono, entre ellas el glicerol, principal subproducto de la creciente industria del biodiésel. En el presente trabajo, se optimizó mediante la metodología de superficies de respuesta la producción de biomasa de una nueva cepa mutante de Y. lipolytica, empleando medios con glicerol derivado de la industria del biodiésel como principal fuente de carbono. Esta cepa presentó características morfológicas y perfil de ácidos grasos distintivos, y una mayor actividad de lipasa extracelular. Para obtener una producción significativa de lipasa extracelular, fue necesario el agregado de una fuente orgánica de nitrógeno y de 1 g/l de aceite de oliva. Se utilizaron los diseños estadísticos de Plackett-Burman y central compuesto para la selección y la optimización de las fermentaciones en frascos agitados; los máximos valores de biomasa y de lipasa obtenidos fueron de 16,1 g/l y 12,2 unidades/ml, respectivamente. Luego, el bioproceso en lote optimizado se escaló a biorreactores aireados, y los valores de actividad específica de lipasa alcanzados después de haberse consumido el 95 % del glicerol fueron tres veces más altos que los obtenidos en los cultivos en frascos agitados. En suma, se desarrolló un bioproceso sostenible para la obtención de biomasa y de una actividad de lipasa extracelular, que a la vez maximiza el uso de subproductos de la industria del biodiésel.


Subject(s)
Biomass , Culture Media/pharmacology , Fungal Proteins/genetics , Glycerol/pharmacology , Industrial Microbiology/methods , Lipase/genetics , Mycology/methods , Yarrowia/growth & development , Bioreactors , Biofuels/analysis , Culture Media, Conditioned/chemistry , DNA, Fungal/genetics , DNA, Intergenic/genetics , Fermentation , Fungal Proteins/biosynthesis , Genes, Fungal , Glycerol/isolation & purification , Hyphae/ultrastructure , Lipase/biosynthesis , Yarrowia/enzymology , Yarrowia/genetics , Yarrowia/ultrastructure
11.
Electron. j. biotechnol ; 12(3): 5-6, July 2009. ilus, tab
Article in English | LILACS | ID: lil-551883

ABSTRACT

We cloned 2-keto-3-deoxy-gluconate kinase (KDGK), which catalyzes the phosphorylation of 2-keto-3-deoxygluconate (KDG) to 2-keto-3-deoxy-6-phophogluconate (KDPG) from Serratia marcescens KCTC 2172. The nucleotide sequence revealed a single open reading frame containing 1,208 bp and encoding for 309 amino acids, with a molecular weight of 33,993 Da. The enzyme was purified via GST affinity chromatography. The putative KdgT binding site was detected upstream of the initial codon. The KDG kinase utilized 2-ketogluconate (KG) and KDG as substrates. The optimal temperature and pH for KDGK activity were 50ºC and 8.0, respectively.


Subject(s)
Gluconates/metabolism , Serratia marcescens/genetics , Serratia marcescens/metabolism , Gelatinases/biosynthesis , Glutathione Transferase/biosynthesis , Glutathione Transferase/metabolism , Lipase/biosynthesis , Maltose/metabolism
12.
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo ; 44(5): 267-70, set.-out. 1989. ilus
Article in Portuguese | LILACS | ID: lil-89062

ABSTRACT

O fígado exerce um importante papel no metabolismo dos quilomicros. É responsável pela síntese de apolipoproteínas (ex., apo AI, apo CII, apo E), lecitina-colesterol-acil-tranferase e lipase de remover os remanescentes de quilomicros da circulaçäo sangüínea. Näo é surpresa portanto que o metabolismo de quilomicros esteja comprometido nas doenças hepáticas tais como hepatite aguda, cirrose e colestase. Assim, sendo, os autores revisaram os aspectos normais do metabolismo dos quilomicros os quais säo essencias para uma melhor compreensäo das alteraçöes lipoprotéicas observadas nas doenças hepáticas


Subject(s)
Rats , Animals , Apolipoproteins E/biosynthesis , Liver/metabolism , Lipase/biosynthesis , Phosphatidylcholine-Sterol O-Acyltransferase/biosynthesis , Chylomicrons/metabolism , Liver/enzymology
13.
Acta physiol. pharmacol. latinoam ; 38(2): 145-50, 1988. ilus
Article in English | LILACS | ID: lil-80438

ABSTRACT

Ratas Sprague-Dawley fueron estimuladas intraduadernalmente con ácido oleico y sacrificadas 20, 40, 60 y 80 m luego de la instilación. En todos los grupos se administró, 10m antes del sacrifício, 50 uCi de 3H-fenilalanina (3H-F) intraperitoneal. Se cuantificaron los niveles intrapancreáticos de Am, Chtg, Tg y Li y la incorporación de 3H-F en las proteínas secretoras. A los 40 m de la administración de ácido oleico se registró la máxima estimulación de ácido oleico se registró la máxima estimulación para Chtg (45%), Tg (38%) y Li (23%) por sobre los valores controles, no modificándose la Am. Todos los valores enzimáticos cayeron por debajo de los controles a los 60 y 80 minutos. La incorporación 3H-F fue máxima a los 40 m decayendo a tiempos más prolongados. En el presente trabajo demostramos que la administración intraduodenal de ácido oleico genera un aumento no paralelo en el nivel intrapancreático de algunas enzimas exportables, y que dichos valores caen a partir de los 40 m post-instilación, siendo la síntesis proteica afectada de manera similar


Subject(s)
Rats , Animals , Male , Oleic Acids/pharmacology , Amylases/biosynthesis , Chymotrypsin/biosynthesis , Lipase/biosynthesis , Pancreas/enzymology , Trypsinogen/biosynthesis , Oleic Acids/administration & dosage , Duodenum , Enzyme Induction , Rats, Inbred Strains , Stimulation, Chemical
14.
Rev. gastroenterol. Méx ; 58(1): 21-4, ene.-mar. 1993. ilus, tab
Article in Spanish | LILACS | ID: lil-196086

ABSTRACT

Evaluamos el tiempo de desintegración y la actividad digestiva in vitro de ocho suplementos comerciales pancreáticos bajo condiciones de acidez similares a las gastroduodenales. Las muestras se sometieron a un proceso activo de desintegración durante 45 min a pH de 1, 3 o 6, continuándose el proceso a pH en 6, durante 135 min., la actividad de lipasa y tripsina se determinó cada 15 min por titulometría. A pH constante de 6, los productos sin capa entérica y el Creón tuvieron los tiempos de desintegración más cortos; a pH más ácidos, estos tiempos se alargaron, siendo mayores a 90 min en los productos con capa entérica. La actividad de lipasa fue mayor a pH constante de 6 en Creón, Pankreón y Cotazym-C, Onotón y Cotazym-B. Posterior a la exposición a Ph ácido, la biodisponibilidad enzimática disminuyó en todos los productos. El tiempo de desintegración y la activación de las enzimas por ácido deben tomarse en cuenta al prescribir suplementos pancreáticos.


Subject(s)
Infant Nutritional Physiological Phenomena/supply & distribution , In Vitro Techniques , Exocrine Pancreatic Insufficiency/metabolism , Lipase/biosynthesis , Pancreas/enzymology , Trypsin/biosynthesis
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