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[Elastase activity in bronchoalveolar lavage fluid from patients with diffuse panbronchiolitis]
H Ninomiya1, Y Ichikawa, H Koga
1First Department of Internal Medicine, Kurume University, Japan.
Summary
Diffuse panbronchiolitis (DPB) involves a protease-antiprotease imbalance, with neutrophil elastase playing a key role in its pathogenesis. Erythromycin treatment reduced elastase activity in patients with DPB.
Area of Science:
- Pulmonary Medicine
- Biochemistry
Background:
- Diffuse panbronchiolitis (DPB) is a chronic inflammatory lung disease with unknown pathogenesis.
- Protease-antiprotease imbalance is implicated in various lung diseases.
Purpose of the Study:
- To investigate the role of protease-antiprotease imbalance in DPB pathogenesis.
- To evaluate elastase activity and alpha 1 antitrypsin concentration in bronchoalveolar lavage fluid (BALF) of DPB patients.
Main Methods:
- Bronchoalveolar lavage (BAL) was performed on patients with DPB, chronic bronchitis (CB), and controls.
- Elastase activity and alpha 1 antitrypsin (alpha 1 AT) concentration in BALF were measured.
- Neutrophil percentage in BALF was correlated with elastase activity.
Main Results:
- Elevated elastase activity was detected in BALF of most DPB patients, but not in CB patients or controls.
- Alpha 1 AT concentration was elevated in DPB patients, but elastase burden exceeded inhibitory capacity.
- Neutrophil elastase was identified as the primary enzyme, and its activity decreased with erythromycin treatment.
Conclusions:
- Neutrophil elastase significantly contributes to DPB pathogenesis.
- Erythromycin's therapeutic effect in DPB may stem from reducing neutrophil elastase burden.