Levels of free granulocyte elastase in bronchial secretions from patients with cystic fibrosis: effect of antimicrobial treatment against Pseudomonas aeruginosa.
Large amounts of free granulocyte elastase (GE), an enzyme capable of mediating airway damage, have been found in bronchial secretions of patients with cystic fibrosis who are infected with Pseudomonas aeruginosa. This finding indicates an imbalance between GE and its antiproteases, alpha 1-proteinase inhibitor (alpha 1-PI) and bronchial mucosal inhibitor (BMI), in the airways of these individuals. The effect of intravenous antimicrobial treatment against P. aeruginosa on activity and concentration of GE, BMI, and alpha 1-PI was evaluated in 30 treatment courses of 20 patients with cystic fibrosis. Although sputum volume and level of immunoreactive GE decreased and concentrations of alpha 1-PI and BMI increased significantly (P less than .05), a high level of free GE persisted. No active alpha 1-PI and BMI were detectable after treatment. High levels of GE correlated with a poor pulmonary condition (rs = .98, P less than .001). In vitro, elastolytic activity of bronchial secretions from patients with cystic fibrosis was significantly inhibited by eglin C and an oxidation-resistant variant of alpha 1-PI, both compounds currently produced by recombinant DNA technology.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001390:Azlocillin / Q000627:therapeutic use; D001798:Blood Proteins / Q000378:metabolism / Q000494:pharmacology; D001980:Bronchi / Q000201:enzymology* / Q000378:metabolism; D003550:Cystic Fibrosis / Q000150:complications / Q000201:enzymology*; D006098:Granulocytes / Q000201:enzymology; D006801:Humans; D009428:Netilmicin / Q000627:therapeutic use; D010196:Pancreatic Elastase / Q000378:metabolism*; D011480:Protease Inhibitors / Q000378:metabolism / Q000494:pharmacology; D011506:Proteins / Q000032:analysis / Q000494:pharmacology; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy*; D015843:Serpins; D013183:Sputum / Q000032:analysis / Q000201:enzymology; D013982:Ticarcillin / Q000627:therapeutic use; D000515:alpha 1-Antitrypsin
D000900:Anti-Bacterial Agents; D001798:Blood Proteins; D011480:Protease Inhibitors; D011506:Proteins; D015843:Serpins; D000515:alpha 1-Antitrypsin; C028656:eglin proteinase inhibitors; D009428:Netilmicin; D010196:Pancreatic Elastase; D013982:Ticarcillin; D001390:Azlocillin