CHARACTERIZATION OF PROTEIN-ANTIPROTEINASE IMBALANCE IN BRONCHOALVEOLAR LAVAGE FROM PATIENTS WITH PNEUMONIA
CHARACTERIZATION OF PROTEIN-ANTIPROTEINASE IMBALANCE IN BRONCHOALVEOLAR LAVAGE FROM PATIENTS WITH PNEUMONIA
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DOI：
10.1183/09031936.94.07010127
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发表时间：
1994-01-01
影响因子：
24.3
通讯作者：
WIESSMANN, KJ
中科院分区：
文献类型：
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作者：
BRAUN, J;DALHOFF, K;WIESSMANN, KJ
为了阐明α（1）-蛋白酶抑制剂（α（1）-PI）在肺炎中的失活模式，对21名免疫功能正常的急性肺炎患者和19名免疫功能低下的急性肺炎患者（I组和II组）进行了研究。成功治疗肺炎的 9 名患者和 10 名健康志愿者作为对照（分别为 m 组和 IV 组）。使用发光测定法测定支气管肺泡灌洗液 (BALF) 中的 α(1)-PI、弹性蛋白酶和髓过氧化物酶 (MPO) 浓度。使用比色测定法测定弹性蛋白酶抑制能力。由此计算出α(1)-PI的功能活性。与其他组相比，I组的弹性蛋白酶和MPO均显着升高。急性肺炎患者α(1)-PI平均浓度(I组13 mg.l(-1)、II组4.22 mg.l(-1))显着高于III组和IV组(分别为2.65和0.33 mg.l(-1))，而I组活性α(1)-PI比例显着低于其他组。只有一小部分以与弹性蛋白酶的复合物形式（约 5.9%）或氧化形式（约 4.8%）存在，85% 的 α(1)-PI 被不可逆地蛋白水解。这导致 40 名急性肺炎患者中有 7 名 (18%) 出现游离弹性蛋白酶活性。我们得出结论，尽管免疫浓度较高，但由于急性肺炎中的不可逆蛋白水解，α(1)-PI 的功能活性明显受损。
In order to clarify the mode of inactivation of alpha(1)-proteinase inhibitor (alpha(1)-PI) in pneumonia, 21 immunocompetent patients and 19 immunocompromised patients with acute pneumonia (Groups I and II) were studied. Nine patients successfully treated for pneumonia and 10 healthy volunteers served as controls (Groups m and IV, respectively).The concentrations of alpha(1)-PI, elastase and myeloperoxidase (MPO) in bronchoalveolar lavage fluid (BALF) were determined using a luminometric assay. Elastase inhibition capacity was determined using a colorimetric assay. Thus, the functional activity of alpha(1)-PI was calculated.Both elastase and MPO were significantly higher in group I, when compared with the other groups. The mean concentration of alpha(1)-PI was significantly higher in patients with acute pneumonia (Group I 13 mg.l(-1), Group II 4.22 mg.l(-1)) than in Groups III and IV (2.65 and 0.33 mg.l(-1) respectively), whereas, the proportion of active alpha(1)-PI was significantly lower in Group I than in the other groups. Only a small proportion was present as a complex with elastase (ca. 5.9%) or in oxidised form (ca. 4.8%), 85% of alpha(1)-PI was irreversibly proteolized. This resulted in free elastase activity in 7 of the 40 patients (18%) with acute pneumonia.We conclude that functional activity of alpha(1)-PI is markedly impaired due to irreversible proteolysis in acute pneumonia, despite high immunological concentrations.