Potato tuber proteins efficiently inhibit human faecal proteolytic activity: implications for treatment of peri-anal dermatitis.
BACKGROUND
Frequent diarrhoea after intestinal resections and faecal incontinence in healthy infants may lead to perianal injury. A causative agent may be a high concentration of pancreatic proteases in faeces. The aim of the present study was to assess whether protease inhibitors are applicable for treating and preventing peri-anal dermatitis by inhibiting the initial cause of the inflammation, the faecal proteases.


METHODS
Proteolytic activity was estimated in faeces of subjects frequently suffering from peri-anal dermatitis: patients with intestinal resections and healthy infants. The development of perianal dermatitis was studied after the construction of a reservoir with ileoanal anastomosis. The inhibitory effect of crude and partly purified potato juice on proteolytic activity of faecal output from patients with intestinal resections and healthy infants was investigated in vitro and in vivo (skin tests).


RESULTS
Faecal protease activity in faeces from patients with intestinal resections and healthy infants was found to be significantly higher than in healthy adults. After the construction of an ileum reservoir, 46 of 48 patients developed a protease-related peri-anal dermatitis. The partly purified protein fraction from potatoes inhibited the larger part of faecal proteases in vitro and completely prevented skin irritation by pancreatic proteases dissolved in sterilized faecal fluid, in a 24-h skin test, on the back of healthy human volunteers.


CONCLUSIONS
Potato proteins contain protease inhibitors, which suppress almost the complete proteolytic activity in faeces. Topical application of potato protease inhibitors might be a novel approach in preventing protease-induced peri-anal dermatitis, and therapeutic studies are needed to confirm our results.
Ruseler-van Embden
J G H
JG
University Medical Center Rotterdam, Rotterdam, the Netherlands. j.vanembden@erasmusmc.nl
van Lieshout
L M C
LM
Smits
S A
SA
van Kessel
I
I
Laman
J D
JD
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D003872:Dermatitis / Q000188:drug therapy*; D005243:Feces / Q000201:enzymology*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D007082:Ileum / Q000601:surgery; D007223:Infant; D008875:Middle Aged; D010940:Plant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D035281:Plant Tubers / Q000378:metabolism*; D011480:Protease Inhibitors / Q000627:therapeutic use*; D012882:Skin Tests; D011198:Solanum tuberosum / Q000378:metabolism*
D010940:Plant Proteins; D011480:Protease Inhibitors