title: Role of proteases and antiprotease in the etiology of chronic pancreatitis.
abstract: OBJECTIVE
  Chronic pancreatitis (CP) is the progressive and irreversible destruction of the pancreas characterized by the permanent loss of endocrine and exocrine function. Trypsin, the most important digestive enzyme plays a central role in the regulation of all other digestive enzymes. Chymotrypsin, an endopeptidase hydrolyzes peptides at amino acids with aromatic side chains. Alpha-1-antitrypsin is a principal antiprotease which protects the mucosal tissue from the proteolytic effects of trypsin and chymotrypsin by the formation of molar complexes. The present study is aimed at examining the role of proteases (trypsin and chymotrypsin) and anti-protease (α1-anti-trypsin) in the etiopathogenesis of chronic pancreatitis.
  
  
  METHODS
  A total of 90 CP patients and 110 age and sex matched controls were considered for the study. Serum trypsin, chymotrypsin and α1-anti-trypsin levels were determined prospectively in CP patients and compared to healthy controls as described previously.
  
  
  RESULTS
  The mean activity of trypsin were found to be increased in CP patients (X ± SD = 0.82 ± 0.838) in comparison to normal control group (X ± SD = 0.55 ± 0.328), (P = 0.001). Chymotrypsin activity were also found to be elevated in CP patients (X ± SD = 0.63 ± 0.278) in comparison to control group (X ± SD = 0.39 ± 0.295), (P = 0.0001). The mean α-1-anti-trypsin activity were found to be lowered in CP patients (X ± SD = 0.42 ± 0.494) in comparison to control group (X ± SD = 0.67 ± 0.465), with the variation being significant (P = 0.0003).
  
  
  CONCLUSIONS
  The findings suggest an imbalance in the synthesis and degradation of proteolytic enzymes and antiprotease indicating an altered aggressive and defensive role in the pathogenesis of chronic pancreatitis.
authors.affiliation: Department of Cell Biology, Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, India.
authors.forename: Srimanjari
authors.initials: S
authors.lastname: Kavutharapu
authors.forename: Balakrishna
authors.initials: B
authors.lastname: Nagalla
authors.forename: Vidyasagar
authors.initials: V
authors.lastname: Abbagani
authors.forename: Shravan K
authors.initials: SK
authors.lastname: Porika
authors.forename: Jyothy
authors.initials: J
authors.lastname: Akka
authors.forename: Pratibha
authors.initials: P
authors.lastname: Nallari
authors.forename: Venkateshwari
authors.initials: V
authors.lastname: Ananthapur
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000378:metabolism*; D050500:Pancreatitis, Chronic / Q000097:blood*; D010447:Peptide Hydrolases / Q000097:blood*; D014357:Trypsin / Q000097:blood*; D000515:alpha 1-Antitrypsin / Q000097:blood*
chemical_list: D015415:Biomarkers; D000515:alpha 1-Antitrypsin; D010447:Peptide Hydrolases; D014357:Trypsin