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Vital-Zymes™ Complete: Enzyme Support for Children on the Autism Spectrum

August 2008

Children with Autism Spectrum Disorders (ASD) may be deficient in a number of gastrointestinal enzymes which may contribute to the malabsorption, intestinal inflammation, and other GI issues they commonly exhibit. These children may benefit from replenishment of enzymes using a supplemental digestive enzyme formula.

Vital-Zymes™ Complete is a potent, multi-enzyme formula that is frequently recommended by practitioners for children with ASD as it provides a broad range of enzymes to help support normal digestion and assist intestinal repair mechanisms. Vital-Zymes Complete provides several enzymes that may more specifically address the needs of these children than standard digestive enzyme formulas.

Supplies DPP-IV activity: One key enzyme that may be deficient in ASD patients is dipeptidyl peptidase IV (DPP-IV). This proteolytic enzyme, normally expressed on intestinal brush border membranes, is responsible for cleaving digestion-resistant, proline-rich peptides found in gluten and casein.1,2 Prolyl peptides, often referred to as gluteomorphins and casomorphins, are suspected of exerting opioid-like (exorphin) activity in the central nervous system.3 Studies show that children with ASD actually produce antibodies against DPP-IV4 and may thus have diminished capacity to break down dietary exorphins. Vital-Zymes™ Complete provides a unique Protease/Peptidase Complex with DPP-IV activity that may be helpful in reducing levels of bioactive prolyl peptides. Preliminary research suggests that supplementing with a DPP-IV-containing enzyme blend can be of supportive benefit to children with ASD.5

Supports against carbohydrate intolerance and dysbiosis: Decreased activity of one or more of the carbohydrate-digesting enzymes, including glucoamylase, palatinase/isomaltase and disaccharidases such as lactase, maltase, and sucrase, has been reported in ASD children with gastrointestinal concerns.6 Deficiencies of carbohydrases and disaccharidases result in incomplete carbohydrate and sugar digestion. Thus, increased amounts of partially digested carbohydrates reach the distal intestine and colon which feed pathogenic microorganisms such as Candida albicans and Clostridium difficile. The complex, highly branched starch amylopectin is especially problematic. Impaired carbohydrate digestion sets up a vicious cycle of dysbiosis in which the proliferation of pathogens damages the intestinal mucosa leading to greater deficiencies of digestive enzymes that in turn leads to further growth of pathogens.

Promotes breakdown of amylopectin starch: Diminished carbohydrase activity can also contribute to uncomfortable gastrointestinal symptoms such as bloating, gaseousness, and foul smelling, loose stools. Parents frequently report these types of symptoms in their autistic children and enzymatic support may help resolve these troublesome gastrointestinal problems. Studies in children with congenital disaccharidase deficiencies demonstrate that supplementing with disaccharide-digesting enzymes leads to clinical improvements in symptoms such as diarrhea, gas, cramping and bloating.7,8 Vital-Zymes™ Complete provides a broad spectrum of carbohydrase enzymes including glucoamylase, lactase, sucrase, maltase, alpha-galactosidase, and the unique enzyme pullulanase. Pullulanase is known to support complete cleaving of the highly branched and difficult to digest amylopectin polysaccharide starch. Utilization of this pullulanase enzyme, in conjunction with the full range of carbohydrase and disaccharidase enzymes, offers maximal digestive capabilities for breaking down the full spectrum of carbohydrates/sugars, inclusive of the amylopectin starch. Vital-Zymes™ Complete is distinguished from other enzyme formulas in part because of its expanded capabilities for digesting amylopectin.

Supplies significant lipase activity for fat digestion: Insufficient levels of lipase enzymes have been described as part of the intestinal pathology noted in children with regressive autism. Specific deficiencies in adequate levels of lipase have been reported based on the stool analysis results obtained from a group of ASD children. One report found that 50% of autistic children demonstrated fat malabsorption leading to inadequate digestion of dietary fats, fat-soluble nutrients, and compromised essential fatty acids.9 Many practitioners have found that utilizing optimal levels of the lipase has safely and effectively addressed steatorrhea characterized as extremely foul smelling, floating, loose stools. Vital-Zymes™ Complete is distinguished from other enzyme formulations in that it provides significantly higher activity levels of lipase, 15,000 LU, to optimize the broadest range fat digesting capabilities.

Includes two uniquely protective enzymes: Vital-Zymes™ Complete also incorporates Serratia peptidase and lysozyme, two enzymes that may be of additional benefit to children with ASD. Serratia peptidase is a unique proteolytic enzyme that helps modulate inflammatory processes10,11 and reduces the ability of pathogenic organisms to generate the protective secretions that allow them to adhere to tissues.12,13 Lysozyme is a lytic polypeptide that disrupts glycosidic bonds in bacterial and yeast cell walls and has demonstrated anti-Candida activity.14 Serratia peptidase and lysozyme may thus protect against inflammation and dysbiosis within the intestinal tract and promote gastrointestinal healing in ASD patients.

Vital-Zymes™ Complete is a favorite of healthcare practitioners for children with ASD because it provides potent, broad-spectrum enzymatic support in easy-to-swallow capsules that are free from most common allergens. For especially sensitive patients who may have difficulty swallowing, Klaire Laboratories also offers Vital-Zymes™ Chewable, a moderate-potency formulation that contains the same enzymes as Vital-Zymes™ Complete, with the exception of lysozyme, in a convenient chewable form.

1) Koch S, Anthonsen D, Skovbjerg H, Sjöström H. On the role of dipeptidyl peptidase IV in the digestion of an immunodominant epitope in celiac disease. Adv Exp Med Biol 2003;524:181-7.

2) Stepniak D, Spaenij-Dekking L, Mitea C, et al. Highly efficient gluten degradation with a newly identified prolyl endoprotease: implications for celiac disease. Am J Physiol Gastrointest Liver Physiol 2006;291:G621-9.

3) Shattock P, Whiteley P. Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention. Expert Opin Ther Targets 2002;6:175-83.

4) Vojdani A, Bazargan M, Vojdani E, et al. Heat shock protein and gliadin peptide promote development of peptidase antibodies in children with autism and patients with autoimmune disease. Clin Diagn Lab Immunol 2004;11:515-24.

5) Houston D. Compositions and methods relating to reduction of symptoms of autism. U.S. Patent 6,821,514, filed December 6, 2002, and issued November 23, 2004.

6) Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. Gastrointestinal abnormalities in children with autistic disorder. J Pediatr 1999;135:559-63.

7) Treem WR, Ahsan N, Sullivan B, et al. Evaluation of liquid yeast-derived sucrase enzyme replacement in patients with sucrase-isomaltase deficiency. Gastroenterology 1993;105:1061-8.

8) Treem WR, McAdams L, Stanford L, et al. Sacrosidase therapy for congenital sucrase-isomaltase deficiency. J Pediatr Gastroenterol Nutr 1999;28:137-42.

9) Bradstreet J. Practitioners Scientific Session, Defeat Autism Now! Conference. May 2001, Atlanta, GA.

10) Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res 1990;18:379-88.

11) Panagariya A, Sharma AK. A preliminary trial of serratiopeptidase in patients with carpal tunnel syndrome. J Assoc Physicians India 1999;47:1170-2.

12) Rodeheaver GT, Rye DG, Rust R, et al. Mechanisms by which proteolytic enzymes prolong the golden period of antibiotic action. Am J Surg 1978;136:379-82.

13) Selan L, Berlutti F, Passariello C, Comodi-Ballanti MR, Thaller MC. Proteolytic enzymes: a new treatment strategy for prosthetic infections? Antimicrob Agents Chemother 1993;37:2618-21.

14) Samaranayake YH, Samaranayake LP, Pow EH, Beena VT, Yeung KW. Antifungal effects of lysozyme and lactoferrin against genetically similar, sequential Candida albicans isolates from a human immunodeficiency virus-infected southern Chinese cohort. J Clin Microbiol 2001;39:3296-302.

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