Elastase

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Elastase is a digestive enzyme produced by the pancreas that helps break down fats, carbohydrates, and proteins. It is a serine protease that catalyzes the cleavage of carboxyl groups on small hydrophobic amino acids, such as glycine, alanine, and valine. Its primary role is the breakdown of elastin, a protein that imparts elasticity to connective tissue.

Elastase is measured in feces to help evaluate whether a person's pancreas is functioning properly. The cut-off level for pancreatic insufficiency is elastase-1 concentration below 200 μg/g stool.

Conditions that have been shown to lead to a reduced elastase include:

• Coeliac disease
• Inflammatory bowel disease
• Diabetes mellitus
• Bile acid diarrhea
• HIV infection

Other conditions that can be associated with pancreatic insufficiency include:

• Chronic pancreatitis
• Pancreatic cancer
• Pancreatic surgery
• Necrotizing acute pancreatitis
• Cystic fibrosis
• Gastric surgery
• Short bowel syndrome