Bile salt-stimulated lipase (BSSL)

Frontiers in Nutrition
Breast milk contains bile salt-stimulated lipase (BSSL), which significantly increases the fat digestion
capacity of newborns who have limited pancreatic lipase secretion in the first few months after birth.
Newborn infants have low fat digestion capacity for the first few months of life due to immature
pancreatic development and low lipase secretion. Both term and preterm infants have low pancreatic
lipase activity from birth to the first motnh of life compared with older children. For preterm infants, 20-
30% of human milk-derived dietary fat is not digested and absorbed in the first months of life. Impaired
fat digestion can limit weight gain and infant development.
Breast milk contains bile salt-stimulated lipase (BSSL) that is activated by bile salts when milk reaches
the infant’s intestine and contributes to fat digestion ability for infants.

Journal of Pediatric Gastoenterology and Nutrition

Fat is a major source of energy for young infants. In adults, fat digestion occurs principally in the
duodenum under the influence of pancreatic lipolytic enymes. Howerer, at birth, pancreatic lipase
activity is only 10% of that found in adults, rising to mature values by 2 years of age. The early lack of
pancreatic lipase is partially compensated by the presence of preduodenal lipase. Esterase and lipase
activites are also present in human milk as bile salt-stimulated lipase (BSSL). Th presence of this enzyme
may explain the increased fat absorption described in preterm infants in whom formula milks were
supplemented with expressed breast milk.

Journal of Cystic Fibrosis

There are two lipases in human milk, the bile salt inhibited lipoprotein lipase and the bile salt stimulated
lipase (BSSL). The former is located in the plasma membrane and after activation by a serum factor
apoprotein C11 hydrolyses triglyceride for the formation of breast milk fat. It appears to leak into breast
milk but has no known function, as it is inactive due to the absence of its activator in milk. The BSSL is
produced in the mammary gland and is an analogue of pancreatic CEH. Based on the in vitro properties,
BSSL has been proposed to be used in oral pancreatic enzyme replacement therapy (PERT) for cystic
fibrosis (CF) patients with pancreatic insufficiency. Howere, the role of BSSL in vivo is enigmatic.

OMIM
The human lactating mammary gland and pancreas produce a lipolytic enzyme, carboxyl-ester lipase
(CEL), earlier called bale salt-stimulated lipase (BSSL) or bile salt-dependent lipase (BSDL). CEL is a major
component of pancreatic juice and is responsible for the hydrolysis of cholesterol esters as well as a
variety of other dietary esters. The enzyme exerts its function in duodenal juice, is activated when
mexied with bile salts, and plays an important role in the digestion of milk fat in newborn infants
(summary by Nilsson et al., 1993).
Wikipedia
Bile salt-dependent lipase (or BSDL), also known as carboxyl ester lipase (or CEL) is an enzyme produced
by the adult pancreas and aids in the digestion of fats. Bile salt-stimulated lipase (or BSSL) is an
equivalent enzyme found within breast milk. BSDL has been found in the pancreatic secretions of all
species in which it has been looked for. BSSL, originally discovered in the milk of humans and various
other primates, has since been found in the milk of many animals.

Enzymatic activity
More than 95% of the fat present in human milk and in infant formulas is in the form of triacylglycerols
(TG) or triglycerides. In adults, TGs are thought to be broken down or hydrolyzed mainly by the colipase-
dependent lipase enzyme. In the newborn, CDL activity in the duodenum is lower than in adults.
Botn BSDL and BSSL have a broad substrate specificity and, like CDL, are capable of hydrolyzing
triacylglycerides (in adition to phospholipids, esters of cholesterol, and lipid-soluble vitamins). In
particular, they can hydrolyze esters of the essential fatty acids (n-3 and n-6 PUFAs) and DHA.
BSDL production in the newborn pancreas is quite low when compared with production in the mammary
gland or adult pancreas.
However, newborn infants absorb lipids relatively well, considering the low level of CDL and BSDL they
produce. This observation has led to the suggestion that BSDL produced by lactating mammary gland
and present within milk, may compensate for the low levels of other TG-digesting enzymes and aid
newborns in lipid absorption. The importance of BSSL in breast milk for the preterm infant nutrition was
suggested at 2007. It was also directly shown recently.