Increased elastinolytic activity has been correlated with the degree of lung damage occurring in a variety of lung diseases including cystic fibrosis; serine proteinase inhibitors are currently on trial for the treatment of some lung disorders. ttowever, human lung lavage cells also secrete metallo-dependent elastases. Here we show, for the first time, that whilst these are readily inhibited by EDTA, inhibition of serine elastases using serpins (serine proteinase inhibitors) is not always possible. This may reflect inactivation of serpins by uninhibited metalloproteinases and oxidants in a low protein milieu. Thus, the therapeutic inhibition of excessive elastinolytic activity may require a combination of inhibitors to work efficiently.
~. IntroductionAn increase in the proteolytic activity of respiratory tract ~ecretions, in particular an excess of elastinolytic activity, has been implicated in the pathology of a number of pulmonary ,onditions including cystic fibrosis and acute lung injury, as well as in diseases of tobacco smokers such as bronchitis and ~mphysema [1][2][3][4][5].Elastinolytic enzymes are released by the polymorphonucear neutrophil, which produces at least two serine-dependent ~lastases, neutrophil elastase (EC 3.4.21.37) and proteinase 3 EC 3.4.21.76), and the alveolar macrophage which can ,ynthesize cysteinyl-and metalloenzymes with elastinolytic acivity (reviewed in [6]). The first elastinolytic enzyme to be dentified was neutrophil elastase, an enzyme with a broad ,pectrum of pro-inflammatory activity; in addition to its elasinolytic properties, it can act as a secretagogue, stimulate GM-CSF release from alveolar macrophages and act as a aeutrophil chemoattractant by activating C5a and stimulating IL-8 production by epithelial cells. Recently, attention has bcused on the matrix metalloproteinases (MMPs). Alveolar nacrophages constitutively produce MMPs-2, 3, 9, 10 and 12 md, thus, can degrade a variety of connective tissue compoaents, including elastin.The relative importance of the extracellular release of these iifferent classes of enzyme into the airspaces is unclear since ':hey have differing activities on a molar basis epithelial secretions contain inhibitors for all three classes of enzyme. Furthermore, the enzymes of one class may inactivate the inhibitors and activate the proenzymes of another class; either action could potentially amplify the elastinolytic burden of the lung. For example, neutrophil elastase can both activate metalloelastase (MMP-12; EC 3.4.24) and cleave its inhibitors; conversely, MMP-12 can inactivate at least one serine proteinase inhibitor (or serpin), ct-l-proteinase inhibitor [7]. As alveolar macrophages and neutrophils are often found in close proximity in the respiratory tract, particularly in pathological states, for example cystic fibrosis, such interactions may amplify the total elastase burden, so increasing the severity of tissue damage.To evaluate the elastinolytic potential of proteases released by mixed populations of bronchoalveolar lav...