Evaluation of elastase and antielastase balance in patients with chronic bronchitis and pulmonary emphysema

J. Fujita, N. L. Nelson, D. M. Daughton, C. A. Dobry, J. R. Spurzem, S. Irino, S. I. Rennard

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Abstract

On the basis of the 'protease-antiprotease imbalance' theory for the pathogenesis of pulmonary emphysema, we hypothesized that measurement of elastase burden and antielastase capacity in the alveolar space might correlate with emphysema. To evaluate this, the severity of emphysema, the elastase burden, and the elastase inhibitory capacity were estimated in 28 patients with chronic bronchitis and variable degrees of emphysema, none of whom had congenital deficiency of alpha-1-protease inhibitor, and all of whom underwent bronchoalveolar lavage. Emphysema was assessed by both computed tomography and diffusing capacity. To examine 'elastase burden,' elastase:alpha-1-protease inhibitor complex and free elastase activity in alveolar lavage fluids were measured. To evaluate 'antielastase' capacity, elastase inhibiting capacity in alveolar lavage fluid was measured. Elastase burden correlated directly and antielastase capacity correlated inversely with emphysema. These data provide direct support for the 'protease-antiprotease imbalance' theory of emphysema in a group of smokers without congenital deficiency of alpha-1-protease inhibitor.

Original languageEnglish (US)
Pages (from-to)57-62
Number of pages6
JournalAmerican Review of Respiratory Disease
Volume142
Issue number1
DOIs
StatePublished - Jan 1 1990

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Fujita, J., Nelson, N. L., Daughton, D. M., Dobry, C. A., Spurzem, J. R., Irino, S., & Rennard, S. I. (1990). Evaluation of elastase and antielastase balance in patients with chronic bronchitis and pulmonary emphysema. American Review of Respiratory Disease, 142(1), 57-62. https://doi.org/10.1164/ajrccm/142.1.57