title: A pilot study of fecal serine-protease activity: a pathophysiologic factor in diarrhea-predominant irritable bowel syndrome.
abstract: OBJECTIVE
  The pathogenesis of irritable bowel syndrome (IBS) remains only partially understood, and no specific or universally effective patient management procedure has been developed to date. Our study was designed to evaluate if colonic luminal serine-proteases may be a relevant pathophysiologic marker of IBS.
  
  
  METHODS
  Fecal samples of 38 IBS patients, 15 patients with ulcerative colitis (UC), and 15 healthy controls were studied. Fecal serine-protease activity was determined photometrically by using azocasein as a proteolytic substrate; fecal pancreatic elastase-1 and mast cell tryptase content were measured by enzyme-linked immunosorbent assay. Fecal secretory leukocyte protease inhibitor concentration was determined by enzyme-linked immunosorbent assay in control subjects and in patients with diarrhea-predominant IBS.
  
  
  RESULTS
  Fecal serine-protease activity was 3-fold higher in patients with diarrhea-predominant IBS than in both controls and IBS patients with either constipation or alternating bowel habits. Fecal serine-protease activity was not correlated with the frequency of bowel movements in all groups. Increased serine-protease activity also was detected in stools of UC patients. No significant difference was observed in the fecal mast cell tryptase and pancreatic elastase concentrations between all groups, or in the fecal secretory leukocyte protease inhibitor concentration between controls and diarrhea-predominant IBS patients.
  
  
  CONCLUSIONS
  Fecal serine-protease activity is increased markedly in patients with diarrhea-predominant IBS. This increase, however, is not coupled with changes in either mast cell tryptase or pancreatic elastase concentrations. Thus, serine-protease activity in the colon may be a pathophysiologic factor in the development of diarrhea-predominant IBS.
authors.affiliation: Institut National de la Recherche Agronomique, Neuro-Gastroenterology & Nutrition Unit, Toulouse, France.
authors.forename: Richárd
authors.initials: R
authors.lastname: Róka
authors.forename: András
authors.initials: A
authors.lastname: Rosztóczy
authors.forename: Mathilde
authors.initials: M
authors.lastname: Leveque
authors.forename: Ferenc
authors.initials: F
authors.lastname: Izbéki
authors.forename: Ferenc
authors.initials: F
authors.lastname: Nagy
authors.forename: Tamás
authors.initials: T
authors.lastname: Molnár
authors.forename: János
authors.initials: J
authors.lastname: Lonovics
authors.forename: Rafael
authors.initials: R
authors.lastname: Garcia-Villar
authors.forename: Jean
authors.initials: J
authors.lastname: Fioramonti
authors.forename: Tibor
authors.initials: T
authors.lastname: Wittmann
authors.forename: Lionel
authors.initials: L
authors.lastname: Bueno
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000201:enzymology* / Q000209:etiology / Q000503:physiopathology; D003967:Diarrhea / Q000201:enzymology* / Q000209:etiology / Q000503:physiopathology; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D053481:Secretory Leukocyte Peptidase Inhibitor / Q000378:metabolism; D012697:Serine Endopeptidases / Q000378:metabolism*
chemical_list: C506814:SLPI protein, human; D053481:Secretory Leukocyte Peptidase Inhibitor; D012697:Serine Endopeptidases