Gut, 1970, 11, 720-725 Progress report Gut: first published as 10.1136/gut.11.8.720 on 1 August 1970. Downloaded from

Intestinal peptidases Current interest in the intestinal peptidases is centred round two main topics: (1) their role in the of dietary protein and (2) investigation of Fraser's hypothesis that coeliac disease is due to a congenital deficiency of the peptidase(s) which normally digest gluten. This report will consider these topics and also briefly review recent studies on a lysosomal peptidase concerned with the digestion of dietary folate.

Role of Peptidases in Protein Digestion Although it has been accepted for many years that proteins are completely hydrolysed to their constituent amino acidsl-5 it is only relatively recently that the intestinal epithelial cells (enterocytes) have been acknowledged as playing a direct role in this process. Previously it had been considered that the peptidases were secreted by these cells into the lumen as 'erepsin'6-8 although Ugolev and his colleagues have claimed that the entire process of http://gut.bmj.com/ protein digestion occurs at the brush border9. Their hypothesis has recently received support by the demonstration of binding of pancreatic proteases to the brush border.10'11 Following the isolation, by Crane and his colleagues, of intact brush borders'2, and the localization of disaccharidase activity to this organelle,

it has become generally accepted that the final stages of polysaccharide on September 26, 2021 by guest. Protected copyright. digestion occurs at the brush border. Studies on the subcellular localization of peptidases were soon undertaken and indicated that these enzymes, too, were localized to the brush border. It thus appeared that the final stages of protein digestion, like that of polysaccharide digestion, occurred at the brush border. These early studies on the subcellular localization of peptidases within the enterocyte used the artificial substrate L leucyl-,B naphthylamide. However, the enzymes responsible for the hydrolysis of leucine-containing dipeptides have now been clearly separated from the enzymes which hydrolyse leucyl- ,P naphthylamide in several tissues, including intestinal mucosa.18-21 This criticism may apply to certain other studies using artificial chromogenic sub- strates.22-25 This observation helps to resolve the apparent conflict between the histo- chemical localization of leucine amino-peptidase (leucyl-,B naphthylami- dase) to the brush border and the biochemical studies which indicated that only 5 to 10% of activity was localized to isolated brush borders. The major proportion of the true peptidase activity was found in the cytosol.26-30 Joseffson and his colleagues have, however, sounded a note of caution in the interpretation of these subcellular fractionation experiments.3' They have noted that dipeptidase activity is rapidly released from isolated intestinal mucosa and commented that this invalidates subcellular fractiona- 721 Intestinal peptidases

tion data using this tissue. However, their data in fact support a localization Gut: first published as 10.1136/gut.11.8.720 on 1 August 1970. Downloaded from to the cytosol rather than to the brush border, since this organelle retains its enzymes remarkably well during subcellular fractionation. This apparent disparity between histochemical and biochemical studies has prompted several groups of workers to study the localization of intestinal peptidases by indirect methods. The results of these experiments are also con- flicting. Experiments in vitro using gut slices and everted sacs suggested that at least some peptidases are located external to the site of transport in the brush border membrane.32-34 Other experiments in vitro35-37 and recent experiments in vivo3840 are compatible with intracellular hydro- lysis of dipeptides and suggest that transport is located external to the site of hydrolysis. The presence of a peptide transport system in several bacterial species has been recognized for several years.4"-45 From a biochemical point of view there are three groups of peptidases. (1) Several -glycyl-glycine peptidase, leucyl-glycine peptidase, glycyl-leucine peptidase, and imino- and imido-peptidases-which hydrolyse proline containing .48 These peptides generally require the presence of metal ions for full activity and are inhibited by EDTA 9. (2) An amino- tripeptidase, which hydrolyses the N-terminal residue from tripeptides. Although this enzyme has not been purified from intestinal mucosa, in other tissues the tripeptidase has negligible activity against di- or tetra-peptides.50-53 It is not inhibited by EDTA and at least a proportion of this peptidase is localized to the brush border region of the enterocyte.27'28 (3) An amino- oligopeptidase which hydrolyses longer peptides.54 55 This enzyme is at least partially localized to the brush border, and although it has not been purified from intestinal mucosa, it is known that brush borders can hydrolyse peptides of at least six amino acid residues.56 The enzyme cleaves the amino- acid residues sequentially from the N terminal end of the peptide.57 The amino-oligopeptidase of the brush border is apparently not inhibited by EDTA and has not yet been shown to be distinct, in intestinal mucosa, http://gut.bmj.com/ from amino-tripeptidase or leucyl B naphthylamidase (the 'leucine amino- peptidase' of the histochemists). Important contributions to our understanding of the specificity of intes- tinal peptidases have been made recently by Fottrell and his colleagues.58-61 They demonstrated that the peptidases of the enterocyte, like those of the erythrocyte, exist in multiple forms. Most peptides are hydrolysed by several

electrophoretically distinct enzymes and conversely each enzyme hydrolyses on September 26, 2021 by guest. Protected copyright. several different peptides. Much work remains to be done before we have a clear understanding of the specificity and localization of the many intestinal peptidases. It is also very apparent that the role ofpeptidases in protein diges- tion is more complex than the role of the brush border disaccharidases in carbohydrate digestion. Unlike the disaccharidases, as far as I am aware there have been no con- firmed reports of a congenital deficiency of a digestive peptidase. A recent report, however, of the congenital absence of enterokinase in certain children with apparent pancreatic insufficiency is of interest.62 Enterokinase is a peptidase secreted by the intestinal mucosa (it is said to be a brush border peptidase63) which converts the various pancreatic proteases from their inactive precursor zymogens to the fully active form of the enzyme. Examples of this process are trypsinogen-->trypsin, procarboxypeptidase->.carboxy- peptidase. To summarize the present position, it appears that the peptides released by peptic and pancreatic digestion (estimated to be three to six amino acid residues in length64) are hydrolysed to free amino acids and dipeptides by the brush border amino-peptidases. It is probable that the amino acids and dipep- tides are transported into the enterocyte where the final stages of dipqptide hydrolysis occurs. It must be pointed out, however, in ascribing a digestive 722 T. J. Peters

function to the intracellular dipeptidases that the cells from many tissues Gut: first published as 10.1136/gut.11.8.720 on 1 August 1970. Downloaded from contain dipeptidases which play an important role in the turnover of the cell's own constituent proteins ;65 there is no reason to suppose that the enterocyte is exempt from this process.

Coeliac Disease: an Inborn Error of Peptide Metabolism? In 1956 Frazer and his colleagues suggested that coeliac disease might be due to a congenital intestinal peptidase deficiency.66-68 They showed that peptic-tryptic digests of gluten induced a relapse in patients with coeliac disease. If this digest was incubated with normal intestinal mucosa it was rendered harmless. Similarily complete hydrolysis of the gluten to its con- stituent amino acids rendered it non-toxic. They postulated that coeliac mucosa might lack an enzyme which normally hydrolyses the toxic pep- tide(s). Fraser and his colleagues also found that deamidated gluten was not toxic, which suggested that patients with coeliac disease might lack gluta- minase. However, although untreated patients have reduced levels of this enzyme in the intestinal mucosa, patients in remission have normal amounts of the glutaminase.69 This emphasizes the importance of studying coeliac patients in remission. In relapse, many intestinal enzymes, including the disaccharidases,70 alkaline phosphatase,71 and dipeptidases,72-74 have been shown to be reduced but in remission the activity returns to normal indicating that these enzymes are secondarily depressed, If an enzyme deficiency is primary, one would expect that its absence would persist even if the intestinal mucosa was morphologically normal. Douglas and Booth have recently investigated Fraser's hypothesis in detail.75 They showed that intestinal mucosa from patients with coeliac

disease in relapse, had a reduced ability to liberate amino acids from a peptic- http://gut.bmj.com/ tryptic digest of gluten. However, treatment with either a gluten-free diet or corticosteroids restored this 'polypeptidase' activity to normal levels. In addition they showed that the 'fingerprint' peptide maps of the intestinal digests were identical in normal subjects and in both treated and untreated patients. This is strong evidence against coeliac disease being due to congenital deficiency of the peptidase which hydrolyses gluten. on September 26, 2021 by guest. Protected copyright.

Pteroyl Polyglutamate Hydrolase and Folate Absorption It is well known that the principal dietary forms of folate are the pteroyl polyglutamates. In these compounds the pteroyl moiety is linked to a series of glutamic acid residues, which are joined by the unusual,79,79a peptic bond. During absorption these glutamic acid residues are split off and only the monoglutamate is found circulating in the plasma76'77. The polygluta- mates are hydrolysed to the monoglutamate by an intestinal peptidase, pteroyl polyglutamate hydrolase (PPH)-formerly known as folate conjugase. In avian species this peptidase is secreted in large amounts by the pancreas and has a pH optimum of 7.4.78,79 Thus hydrolysis of the polyglutamates can readily occur in the intestinal lumen of birds. In mammals, including man, the situation is different. Very little enzyme is present in pancreatic juice80 or indeed in the other intestinal secretions.81,82 High concentrations of the enzyme are, however, present in the intestinal mucosa. Subcellular fractionation studies have indicated that the enzyme is concentrated in the lysosomal fraction.83 ThepH optimum of4.6 and the demonstration oflatency of this enzyme are consistent with the lysosomal location.84.85 A preliminary abstract suggested that PPH, like many other hydrolases, was localized to 723 Intestinal peptidases

the brush border region of the enterocyte, but this has proved incorrect, Gut: first published as 10.1136/gut.11.8.720 on 1 August 1970. Downloaded from and the lysosomal site has now been confirmed.87'88 The question immediately arises as to how the substrate in the lumen and the enzyme in the lysosome can interact. It is possible that the enzyme released from sloughed enterocytes may hydrolyse the polyglutamates within the intestinal lumen. The pH of the small intestinal lumen is generally con- sidered to be 5-5-6-5, and the activity of PPH in this range would be expected to be low.89 It has been shown recently that physiological concentrations of bile acids inhibit PPH, which suggests that intraluminal hydrolysis of the polyglutamates is unlikely.88 90 However, since only about 500 ,g of poly- glutamates is digested each day,91 92 sufficient intraluminal hydrolysis could occur, even under these adverse conditions. Alternatively it has been sug- gested that the polyglutamates enter the enterocyte either by a specific transport process or perhaps by pinocytosis.82,83 Fusion of the pinocytotic residues with lysosomes, a well documented phenomenon,93-95 would allow the enzyme and substrate to interact, releasing the pteroyl monoglutamate. Until recently studies on the mechanism of dietary folate absorption have used a crude pteroyl polyglutamate extracted from yeast and have relied on the microbiological detection of the liberated monoglutamates. The recent reports of the synthesis of radioactively labelled pteroyl polyglutamates by two groups of workers represent an important ad- vance96'98 and should facilitate an early solution of many of these problems. T. J. PETERS

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