TIME COURSE OF APPEARANCE AND DISAPPEARANCE OF HUMAN MAST-CELL TRYPTASE IN THE CIRCULATION AFTER ANAPHYLAXIS
TIME COURSE OF APPEARANCE AND DISAPPEARANCE OF HUMAN MAST-CELL TRYPTASE IN THE CIRCULATION AFTER ANAPHYLAXIS
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DOI：
10.1172/jci114051
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发表时间：
1989-05-01
影响因子：
15.9
通讯作者：
DULL, D
中科院分区：
文献类型：
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作者：
SCHWARTZ, LB;YUNGINGER, JW;DULL, D
胰蛋白酶是人类肥大细胞的一种中性蛋白酶，是肥大细胞参与各种临床疾病的潜在重要指标。本研究检测了过敏事件后胰蛋白酶在循环中出现和消失的时间过程，以及内源性和外源性胰蛋白酶在冻融和温度方面的稳定性。在实验诱导的全身过敏反应后，三名受试者中胰蛋白酶的峰值出现在蜜蜂蜇伤后1-2小时，而组胺的峰值出现在5-10分钟。在某些情况下，在最初的15-30分钟内可能无法检测到胰蛋白酶水平升高。胰蛋白酶水平在一级动力学下明显下降，为。apprx的t1/2。2小时。在急诊室出现的两名受试者中，观察到类似的消失动力学，其中一名受试者在摄入吲哚美辛后出现严重哮喘，另一名受试者在蜜蜂叮咬后出现全身性过敏反应。组胺水平迅速下降，15-60分钟后恢复到基线水平。血清或血浆中胰蛋白酶的测定水平在四个冻融循环中都没有降低。从22度和37度胰蛋白酶水平升高的受试者身上提取血清样本进行孵育。C表示4 d后仍能检测到bbbb50 %的内源性胰蛋白酶。纯化后的胰蛋白酶添加到血清或血浆中，按上述方法孵育，其稳定性较差：.apprx。50%的血清外源性胰蛋白酶和。apprx。培养2 d后血浆中检测到15%。因此，最佳样品应冷冻保存，但即使在室温下保存4天也应令人满意。获得胰蛋白酶测定样品的最佳时间是沉淀事件发生后1-2小时，但根据初始反应的程度，胰蛋白酶的升高水平可能在循环中存在数小时。
Tryptase, a neutral protease of human mast cells, is a potentially important indicator of mast cell involvement in various clinical conditions. The current study examined the time course of appearance and disappearance of tryptase in the circulation after an anaphylactic event and the stability of both endogenous and exogenous tryptase in terms of freeze-thawing and temperature. The peak level of tryptase after an experimentally induced systemic anaphylactic reaction occurred 1-2 h after the initiating bee sting in each of three subjects, in contrast to histamine levels which peaked at 5-10 min. In some cases elevated levels of tryptase may not be detected during the initial 15-30 min. Tryptase levels then declined under apparent first order kinetics with a t1/2 of .apprx. 2 h. Similar disappearance kinetics were observed for two subjects presenting in the emergency room with immediate type reactions, one with severe asthma after indomethacin ingestion, the other with systemic anaphylaxis after a bee sting. Histamine levels declined rapidly and were back to baseline by 15-60 min. Measured levels of tryptase in serum or plasma were not diminished by up to four freeze-thaw cycles. Incubation of serum samples taken from subjects with elevated levels of tryptase at 22 and 37.degree. C indicated that > 50% of endogenous tryptase was still detected after 4 d. Purified tryptase added to serum or plasma and incubated as above was less stable: .apprx. 50% of exogenous tryptase in serum and .apprx. 15% in plasma was detected after 2 d of incubation. Therefore, optimally samples should be stored frozen, but even those stored at room temperature for up to 4 d should be satisfactory. The best time to obtain samples for tryptase determinations is 1-2 h after the precipitating event, but depending on the magnitude of the initial response elevated levels of tryptase may be present in the circulation for several hours.