Fecal proteolytic enzymes

Fecal proteolytic enzymes are a collective group of serine proteases, including trypsin, chymotrypsin, and elastase, that are secreted by the pancreas or produced by gut microbiota to facilitate the breakdown of dietary proteins in the gastrointestinal tract [PMID: 26303129]. Under physiological conditions, these enzymes are essential for nutrient absorption; however, elevated levels in the stool are implicated in the pathophysiology of Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) [PMID: 24613397]. Excess luminal protease activity triggers Protease-Activated Receptor 2 (PAR-2) on epithelial cells, which compromises the intestinal barrier and induces visceral hypersensitivity [PMID: 21903712]. Conversely, a significant reduction in fecal elastase-1 is a gold-standard biomarker for diagnosing Pancreatic Exocrine Insufficiency (PEI) [PMID: 28210626]. Therapeutic interventions target these enzymes through protease inhibitors like camostat mesylate to reduce inflammation or through pancreatic enzyme replacement therapy (PERT) to restore digestive capacity in deficient states [PMID: 32125455].

Other names

Fecal proteasesStool proteasesLuminal serine proteasesIntestinal proteases

Inhibition of serine protease activity to prevent activation of protease-activated receptors (PARs) and reduce mucosal inflammation; or replacement of deficient enzymes to restore digestive function.