title: Change in the concentration of neutrophil elastase in bronchoalveolar lavage fluid during anesthesia and its inhibition by cholesterol sulfate.
abstract: Cholesterol sulfate (CS) in the gastrointestinal tract exhibits a mucosal protective activity in mouse ulcer model. To clarify the possible role of CS for protection from the epithelial injury due to neutrophil elastase in the tracheobronchi, the authors determined the concentrations of CS and neutrophil elastase in bronchoalveolar lavage fluid (BALF) from patients under anesthesia, and they examined the inhibitory activity of CS toward neutrophil elastase. The concentrations of CS and neutrophil elastase were determined by thin-layer chromatography and enzyme-linked immunosorbent assaying, respectively, and the effect of CS on the activity of elastase was determined with a chromogenic substrate. CS was found to be present in human lung, tracheal mucosa, and BALF, and a high synthesis of it was detected in the tracheal mucosa, in which cellular cholesterol sulfotransferase was induced depending on the density of tracheal cells. Among lipids in the tracheal mucosa, only CS was demonstrated to exhibit inhibitory activity toward neutrophil elastase, a powerful erosive agent in inflammation. The secretion of elastase from neutrophils into BALF was stimulated during the course of general anesthesia. In contrast, the amount of CS in BALF gradually decreased during anesthesia. On immune-precipitation of neutrophil elastase in BALF, CS was detected in the immune precipitate, which indicates a possible association of CS with neutrophil elastase in BALF.
  
  
  CONCLUSIONS
  CS, which is a major acidic lipid in the tracheobronchial epithelium, might function as an epithelial inhibitor toward neutrophil elastase secreted in response to several stimuli such as anesthesia.
authors.affiliation: Department of Anesthesiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Ito
authors.forename: Keiko
authors.initials: K
authors.lastname: Hirota
authors.forename: Kanako
authors.initials: K
authors.lastname: Momoeda
authors.forename: Masao
authors.initials: M
authors.lastname: Iwamori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D002788:Cholesterol Esters / Q000378:metabolism* / Q000494:pharmacology*; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D066298:In Vitro Techniques; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors* / Q000378:metabolism*; D050356:Lipid Metabolism; D008055:Lipids / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D020545:Respiratory Mucosa / Q000378:metabolism; D014132:Trachea / Q000378:metabolism
chemical_list: D002788:Cholesterol Esters; D004791:Enzyme Inhibitors; D008055:Lipids; D019272:Leukocyte Elastase; C007045:cholesteryl sulfate