The findings of low patient adherence and the impact of adherence on relapses and healthcare resource utilization strongly suggest opportunities to reduce healthcare resource utilization and healthcare costs among RRMS patients taking interferon-beta therapy. Efforts should be undertaken to understand and improve medication-taking behaviour in this population so as to minimize the negative impacts of RRMS on patients while reducing unnecessary direct and indirect costs to treat disease exacerbations.

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The Kunitz trypsin inhibitor (KTI) and the Bowman−Birk inhibitor (BBI) of trypsin and chymotrypsin contain disulfide bonds. Glycinin, the major storage protein in soybeans also contains disulfide bonds. Treatment of soy white flour with a NADP−thioredoxin system (NTS) effectively reduced disulfide bonds in soy flour and increased protein digestibility by trypsin and pancreatin as measured by the pH stat method. Treatment of soy flour with NTS increased the digestibility compared to soy white flour by 29.3 and 60.6% for trypsin and pancreatin, respectively. NTS-treated soy flour had similar digestibility by trypsin to autoclaved soy flour and casein, but digestibility by pancreatin was less than autoclaved soy flour and casein. The degree of reduction by NTS was highly correlated to the degree of hydrolysis (DH) by trypsin (R 2 = 0.93) and pancreatin (R 2 = 0.99). The DH of NTS-treated soy flour by trypsin is reflective of both inactivation of trypsin inhibitors and overall protein digestibility while pancreatin hydrolysis is reflective of only overall protein digestibility. The Kunitz trypsin inhibitor (KTI) and the Bowman-Birk inhibitor (BBI) of trypsin and chymotrypsin contain disulfide bonds. Glycinin, the major storage protein in soybeans also contains disulfide bonds. Treatment of soy white flour with a NADP-thioredoxin system (NTS) effectively reduced disulfide bonds in soy flour and increased protein digestibility by trypsin and pancreatin as measured by the pH stat method. Treatment of soy flour with NTS increased the digestibility compared to soy white flour by 29.3 and 60.6% for trypsin and pancreatin, respectively. NTS-treated soy flour had similar digestibility by trypsin to autoclaved soy flour and casein, but digestibility by pancreatin was less than autoclaved soy flour and casein. The degree of reduction by NTS was highly correlated to the degree of hydrolysis (DH) by trypsin (R 2 ) 0.93) and pancreatin (R 2 ) 0.99). The DH of NTS-treated soy flour by trypsin is reflective of both inactivation of trypsin inhibitors and overall protein digestibility while pancreatin hydrolysis is reflective of only overall protein digestibility.

To improve protein digestibility of aqueously extracted soy proteins, an effective chemical treatment under mild conditions is needed. Soy proteins, including storage protein glycinin and antinutritional factors such as trypsin inhibitors, are rich in disulfide bonds. Reduction of these disulfide bonds by incubating soy proteins with sodium sulfite and sodium metabisulfite at 55°C showed no net increase of free sulfhydryl groups after dialysis to remove the residual reducing agent. However, the in vitro digestibility measured by trypsin hydrolysis using the pH-Stat method was significantly increased. Sodium metabisulfite (SMBS) was more effective in increasing in vitro digestibility than sodium sulfite at the same molar concentration. The digestibility of soy protein treated by 0.5 mmol SMBS/g soy flour at 55°C was more than doubled compared to that of the control without reduction treatment. Large-scale testing of soy proteins treated with SMBS for an in vivo animal feeding study showed similar in vitro digestibility by trypsin, e.g., the degree of hydrolysis of the treated sample was 8.5% compared to 1.6% of the control. These soy proteins were further evaluated using a chick growth model. The protein efficiency ratio (PER) increased by 57% when the chicks fed SMBStreated soy were compared to the chicks fed raw soy flour. SMBS-fed chicks did not display any pancreatic hypertrophy compared to those fed with raw soy control. These results indicate that there is great potential to use safe chemicals and mild temperature to inactivate the antinutritional factors in soybeans and thus improve digestibility of soy proteins that are extracted with low-temperature aqueous process.

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