title: The alpha1-antitrypsin/elastase complex as an experimental model for hemodialysis in acute catabolic renal failure, extracorporeal blood circulation and cardiocirculatory bypass.
abstract: A modified polyethersulphone graft membrane was loaded with antiproteases, with the aim of reducing the active protease blood concentration during hemodialysis in acute catabolic renal failure or cardiopulmonary bypass. As protease/antiprotease system, elastase and alpha1-antitrypsin were used. The concentration of active elastase in aqueous solutions decreased as function of contact time with the membrane, approaching saturation. A 40% loss of elastase activity was obtained at pH 7.4, which was not due to autolysis, which accounted for 5% of the loss. The highest reduction was achieved at pH 9.0 (25% higher than at pH 7.4). The saturation level of elastase decrease, calculated by means of the Einstein equation, was reached after more than 47 minutes. We speculate that a time reduction might be achieved either increasing the concentration of immobilized antiproteases, or increasing the rate of elastase movement across the membranes by hydraulic, osmotic, or temperature gradients. This technology can be applied to hemodialysis, and in extracorporeal blood circulation to promote elastase release.
authors.affiliation: International Institute of Genetics and Biophysics of CNR, Naples, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Grano
authors.forename: N
authors.initials: N
authors.lastname: Diano
authors.forename: M
authors.initials: M
authors.lastname: Portaccio
authors.forename: U
authors.initials: U
authors.lastname: Bencivenga
authors.forename: A
authors.initials: A
authors.lastname: De Maio
authors.forename: N
authors.initials: N
authors.lastname: De Santo
authors.forename: A
authors.initials: A
authors.lastname: Perna
authors.forename: F
authors.initials: F
authors.lastname: Salamino
authors.forename: D G
authors.initials: DG
authors.lastname: Mita
mesh_terms: D058186:Acute Kidney Injury / Q000378:metabolism* / Q000628:therapy; D002315:Cardiopulmonary Bypass; D002352:Carrier Proteins; D004800:Enzymes, Immobilized; D005112:Extracorporeal Circulation; D066298:In Vitro Techniques; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors / Q000737:chemistry*; D008567:Membranes, Artificial; D011108:Polymers; D011480:Protease Inhibitors / Q000737:chemistry; D006435:Renal Dialysis; D012697:Serine Endopeptidases / Q000737:chemistry; D013450:Sulfones; D000515:alpha 1-Antitrypsin / Q000737:chemistry* / Q000378:metabolism
chemical_list: D002352:Carrier Proteins; D004800:Enzymes, Immobilized; D008567:Membranes, Artificial; D011108:Polymers; D011480:Protease Inhibitors; D013450:Sulfones; D000515:alpha 1-Antitrypsin; C022840:polyether sulfone; D012697:Serine Endopeptidases; D019272:Leukocyte Elastase