Diagnostic and Research Aspects of Small Intestinal Disaccharidases in Coeliac Disease

Abstract

Disaccharidases (DS) are brush border enzymes embedded in the microvillous membrane of small intestinal enterocytes. In untreated coeliac disease (CD), a general decrease of DS activities is seen. This manuscript reviews different aspects of DS activities in CD: their utility in the diagnosis and their application to in vitro toxicity testing. The latter has never been established in CD research. However, with the recent advances in small intestinal organoid techniques, DS might be employed as a biomarker for in vitro studies. This includes establishment of self-renewing epithelial cells raised from tissue, which express differentiation markers, including the brush border enzymes. Determining duodenal DS activities may provide additional information during the diagnostic workup of CD: (i) quantify the severity of the observed histological lesions, (ii) provide predictive values for the grade of mucosal villous atrophy, and (iii) aid diagnosing CD where minor histological changes are seen. DS can also provide additional information to assess the response to a gluten-free diet as marked increase of their activities occurs four weeks after commencing it. Various endogenous and exogenous factors affecting DS might also be relevant when considering investigating the role of DS in other conditions including noncoeliac gluten sensitivity and DS deficiencies.

Carbohydrate Intolerance and Disaccharidase Measurement – a Mini-Review

“…However given all these deficiencies, the general consensus is that disaccharidase testing of biopsy samples with combined biochemical and histological investigation remain the test of choice. 29…”

Sources, Processing-Related Transformation, and Gut Axis Regulation of Conventional and Potential Prebiotics

“…In addition, in the intestinal environment, a group of brush-border enzymes embedded in the microvilli of small intestinal cells, disaccharidases, are also critical for the degradation of dietary ingested carbohydrates into monosaccharides. 69 Measuring the levels of disaccharides is commonly used to assess disaccharidase deficiency in children, particularly as lactase, sucrase, maltase, and palatinase; 70 meanwhile, approximately half of the adults with gastrointestinal symptoms are detected to have disaccharidase enzyme deficiency, which can aid diagnosis and management of gastrointestinal symptoms. 71 Therefore, the amount and activity of disaccharidase can also be taken into account in the in vitro simulated gastrointestinal digestion stage.…”

“…The digestion parameters for each stage in vitro were proposed, including, for the oral stage, the duration of chewing, saliva secretion, amylase activity, and pH; for the gastric stage, its duration, gastric secretion, pH, pepsin activity, stomach lipase activity, and presence of bile salts; and for the intestinal phase, the duration, pH, pancreatic enzyme activity, and presence of bile. In addition, in the intestinal environment, a group of brush-border enzymes embedded in the microvilli of small intestinal cells, disaccharidases, are also critical for the degradation of dietary ingested carbohydrates into monosaccharides . Measuring the levels of disaccharides is commonly used to assess disaccharidase deficiency in children, particularly as lactase, sucrase, maltase, and palatinase; meanwhile, approximately half of the adults with gastrointestinal symptoms are detected to have disaccharidase enzyme deficiency, which can aid diagnosis and management of gastrointestinal symptoms .…”

Normal Disaccharidase Activity and Disaccharidase Activity in Patients with Functional Enteropathies

“…Активность сахаразы постоянна на протяжении всех отделов ТК. В дистальном отделе подвздошной кишки мальтаза в 2 раза активнее, чем в проксимальном отделе тощей кишки [22].…”