Where is it produced?
Alpha-amylase is mainly produced in the salivary glands of the mouth and in the pancreas. Depending on where it is produced, it is called salivary or pancreatic amylase. In addition, alpha-amylases, which are formed in the ovaries and lungs, can also play a role in cancer diagnostics. Nevertheless, the enzyme is formed almost exclusively by the aforementioned glands and is secreted directly into the lumen of the digestive tract via their excretory ducts. Only a very small proportion naturally enters the bloodstream where it can be measured.
What happens if you have too little alpha-amylase in your bowel?
A reduced production of alpha-amylase typically occurs in the context of an underfunction of the pancreas, i.e. pancreatic insufficiency. This occurs, for example, in the course of a severe acute pancreatitis, but typically rather in the course of a chronic pancreatitis, which leads to the massive destruction of healthy pancreatic tissue. In theory, a deficiency of alpha-amylase could then lead to an inadequate utilization of carbohydrates ingested with food, which in turn would result in an insufficient energy supply for the body. In reality, however, reduced amylase formation in the pancreas can be compensated for by the formation of enzymes in the stomach and salivary glands of the oral cavity and is therefore unproblematic. In the case of functional disorders of the pancreas, the deficiency of enzymes involved in the digestion of fats and a possibly disturbed insulin production is much more serious.
What increases alpha-amylase in the blood?
Although an inflammation of the pancreas in the final stage can lead to an insufficiency, i.e. underfunction, of the pancreas and thus limit the production of amylase, a florid pancreatitis (pancreatitis) nevertheless initially leads to an increased transfer of the enzyme into the bloodstream via damage to the amylase-producing cells. Accordingly, the alpha-amylase value measured in the blood laboratory is an important marker for active chronic or acute pancreatitis. However, alpha-amylase measurement is increasingly being replaced by the determination of the pancreas-specific enzyme lipase.
This is particularly important if diseases of the parotid glands, such as the parotid gland (Glandula parotidea), are responsible for an increase in alpha-amylase in the blood. This can be the case, for example, in mumps, colloquially known as mumps, in which infection with the mumps virus can lead to damage to the amylase-producing cells of the parotid glands, but also to pancreatic involvement. An increased level of alpha-amylase in the blood can also indicate other clinical pictures.
For example, a bile stasis, which is usually caused by gallstones, can lead to an increase in amylase activity in the blood because the bile ducts and the pancreatic duct share a common end section, resulting in a build-up of bile and pancreatic secretions in the pancreas, which in turn causes damage to the gland. Kidney failure can also result in increased alpha-amylase levels, as the excretion of the enzyme via the kidney is reduced. Malignant as well as benign tumors of the pancreas and, according to the latest findings, psychological stress can also lead to an increase in the laboratory parameter. However, for all possible causes of increased alpha-amylase activity, it should be borne in mind that increased amylase levels can be detected in just under 10% of the population without a cause being found despite extensive diagnostics. As with numerous other laboratory parameters, altered alpha-amylase values do not necessarily have a disease value.
