Serum protease inhibitor capacity for elastase and the severity of pancreatitis

Toshinari Kimura, Tetsuhide Ito, Toshihiko Sumii, Hajime Nawata

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6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)680-685
Number of pages6
JournalPancreas
Volume7
Issue number6
DOIs
Publication statusPublished - Nov 1992

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All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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