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Elastase-type enzymes and their relation to blood lipids in atherosclerotic patients
A Landi1, M Bihari-Varga, L Keller
11st Department of Medicine, Istvan Hospital, Budapest, Hungary.
Insights
Patients with ischemic vascular disease have lower serum elastase activity and higher inhibitory capacity. Changes in elastase activity during myocardial infarction correlate with disease severity and cardiac enzyme levels.
Area of Science:
- Biochemistry
- Cardiology
- Vascular Biology
Background:
- Elastase-type activity and its inhibitors are implicated in vascular disease.
- Lipid profiles are known risk factors for cardiovascular events.
Purpose of the Study:
- To investigate serum elastase-type activity, elastase inhibitory capacity, and their relationship with lipids in patients with ischemic vascular disease.
- To examine these parameters during acute myocardial infarction.
Main Methods:
- Serum elastase activity and inhibitory capacity were measured in 140 male patients with ischemic vascular disease and 60 controls.
- Lipid profiles (HDL-cholesterol, HDL2-cholesterol, apo A, triglycerides) were analyzed.
- Parameters were also monitored in 24 patients with acute myocardial infarction.
Main Results:
- Patients with ischemic vascular disease showed significantly lower elastase activity and higher inhibitory capacity compared to controls.
- HDL-cholesterol, HDL2-cholesterol, and apo A negatively correlated with elastase inhibitory capacity.
- During myocardial infarction, elevated elastase activity correlated with increased cardiac enzyme levels and transmural infarction.
Conclusions:
- Altered serum elastase activity and inhibitory capacity are associated with ischemic vascular disease.
- These markers may play a role in the pathophysiology of atherosclerosis and acute myocardial infarction.
- Elastase activity changes during myocardial infarction may predict disease severity.
Abstract:
Serum elastase-type activity, elastase inhibitory capacity and their relation to lipids were examined in 140 male patients with ischemic vascular disease (coronary, cerebral, peripheral) and in 60 control subjects. In a further 24 patients with acute myocardial infarction elastase activity, inhibitory capacity and lipids during the course of the illness have also been investigated. Serum elastase-type activity was found to be significantly lower and inhibitory capacity significantly higher in the groups of patients than in the controls. HDL- and HDL2-cholesterol as well as apo A concentration showed significant negative correlation with elastase inhibitory capacity both in atherosclerotic and in control subjects. During the course of myocardial infarction a significant elevation of serum elastase-type activity could be observed at the end of the first week; serum triglyceride levels increased, HDL- and HDL2-concentrations decreased significantly in the first 3 weeks, than gradually approached the initial values. In the patients with an elevation of serum elastase-like activity by more than 30% in the first week, there was a significantly higher elevation of serum GOT and LDH1 and a greater occurrence of transmural (Q) infarction than in those with a smaller variation of elastase-like activity.