[Protein catabolism and tourniquet shock: the role of proteolytic enzymes].
In the plasma and/or serum ultrafiltrates of a 20-year-old patient with tourniquet shock and post-traumatic acute renal failure it was possible to identify free proteolytic activity during the oligoanuric phase. Plasma alpha 2-macroglobulin values were significantly lowered, whereas the plasma concentrations of antithrombin III were unchanged. alpha 1-Antitrypsin values, however, were markedly enhanced. In contrast, urinary excretion of alpha 1-antitrypsin and antithrombin III were enhanced during the oligoanuric phase. Addition of kallikrein and/or trypsin resulted in strong inhibition of urinary proteolytic activity. These effects were not seen during the polyuric and recovery phase. From our results it can be concluded that proteolytic enzymes may be involved in protein catabolism of patients with tourniquet shock and hypercatabolic acute renal failure.
D058186:Acute Kidney Injury / Q000209:etiology / Q000652:urine; D000328:Adult; D000991:Antithrombins / Q000652:urine; D001002:Anuria / Q000201:enzymology / Q000378:metabolism; D004791:Enzyme Inhibitors; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007610:Kallikreins / Q000378:metabolism; D008297:Male; D010447:Peptide Hydrolases / Q000097:blood / Q000378:metabolism*; D012769:Shock / Q000209:etiology* / Q000378:metabolism; D013978:Tibial Fractures / Q000601:surgery*; D014111:Tourniquets / Q000009:adverse effects*; D014357:Trypsin / Q000378:metabolism; D000515:alpha 1-Antitrypsin / Q000652:urine; D000511:alpha-Macroglobulins / Q000378:metabolism
D000991:Antithrombins; D004791:Enzyme Inhibitors; D000515:alpha 1-Antitrypsin; D000511:alpha-Macroglobulins; D010447:Peptide Hydrolases; D007610:Kallikreins; D014357:Trypsin
Proteinkatabolismus und Tourniquet-Schock: Rolle proteolytischer Enzyme.