To clarify the relationship between the diminution of the serum protease inhibitor capacity and the severity of pancreatitis, the binding capacity of serum protease inhibitors for exogenous elastase 1 (El) was investigated by gel filtration, the elastase activity of the α2-macroglobulin (α2-M)-elastase complex was measured, and the relationship between these findings and the severity of pancreatitis was studied in 13 patients with pancreatic disease and 6 healthy subjects. When 12fT-labeled El was added to the sera of healthy subjects, it bound to α2-M and α1-protease inhibitor (α,-PI) with a mean ratio of 72:28. In mild acute pancreatitis (n = 5), the binding capacity of α2-M was less than that in healthy subjects. In severe pancreatitis (n = 4), most of the exogenous El bound to α1PI (α2-M vs. α1-PI, 13:87). This diminution in the binding capacity of α2-M correlated well with the severity of acute pancreatitis. In the sera of patients (n = 4) with pancreatic cancer containing much immunoreactive El, the proportion of exogenous El bound by α2-M and a,-PI (25:75) was similar to that seen in severe acute pancreatitis. A significant inverse relationship between the binding capacity of α2-M and the activity of the endogenous elastase bound to α2-M was seen in various pancreatic diseases. These findings suggest that in acute pancreatitis, the decreased binding capacity of serum α2-M and the increased enzymatic activity of the α2-M-protease complex correlate with the severity of the pancreatitis. In pancreatic cancer, however, this is not necessarily the case.
All Science Journal Classification (ASJC) codes
- Internal Medicine
- Endocrinology, Diabetes and Metabolism