The forms and the levels of fecal PMN-elastase in patients with colorectal diseases.
OBJECTIVE
To compare the form of polymorphonuclear leukocyte (PMN)-elastase in feces with that in plasma and to investigate the usefulness of measuring fecal PMN-elastase levels in patients with colorectal diseases.


METHODS
We examined PMN-elastase complexed with alpha 1-antitrypsin (alpha 1-AT), chymotrypsin, and alpha 2-macroglobulin by ELISA in feces and plasma. Fecal levels of total PMN-elastase were determined in patients with colonic polyp (N = 19), colonic cancer (N = 20), ulcerative colitis (UC; N = 36), colonic Crohn's disease (CD; N = 26), and in control subjects (N = 20).


RESULTS
Most PMN-elastase was not complexed with alpha 1-AT, chymotrypsin, or alpha 2-macroglobulin in feces, whereas most plasma PMN-elastase was complexed with alpha 1-AT. Fecal concentrations and daily fecal excretion of PMN-elastase were significantly increased in patients with active UC (medians 54.8 micrograms/g, 15.14 mg/day) and active CD (41.5 micrograms/g, 10.24 mg/day) compared to those values in control subjects (0.6 micrograms/g, 0.11 mg/day) and in patients with colonic cancer (2.5 micrograms/g, 0.33 mg/day). In inactive UC and CD, these values (3.4 micrograms/g, 0.52 mg/day and 5.2 micrograms/g, 0.59 mg/day, respectively) were significantly lower than in active UC and CD, respectively. In UC, all patients whose rectal biopsies showed infiltration of PMN had high fecal PMN-elastase levels.


CONCLUSIONS
Our results suggest that the measurement of fecal PMN-elastase concentrations are useful for monitoring the disease activity of UC and CD, especially when evaluating whether intestinal inflammation has disappeared completely.
Saitoh
O
O
Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.
Sugi
K
K
Matsuse
R
R
Uchida
K
K
Matsumoto
H
H
Nakagawa
K
K
Takada
K
K
Yoshizumi
M
M
Hirata
I
I
Katsu
K
K
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D004796:Clinical Enzyme Tests; D003108:Colonic Diseases / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry / Q000201:enzymology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019272:Leukocyte Elastase; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000032:analysis* / Q000737:chemistry; D012002:Rectal Diseases / Q000175:diagnosis*; D012007:Rectum / Q000473:pathology; D000515:alpha 1-Antitrypsin / Q000032:analysis
D015415:Biomarkers; D006454:Hemoglobins; D000515:alpha 1-Antitrypsin; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase