Diagnostic value of elastase-α<sub>1</sub>-proteinase inhibitor in cerebrospinal fluid

Speer, C.-H. P.; Rocchetti, Chiara; Rethwilm, M; Hohenwallner, W

doi:10.1111/j.1600-0404.1988.tb03696.x

Cited by 4 publications

(4 citation statements)

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“…Our present data may suggest that formation of the inhibi tor is too late to prevent BBB opening. More over, it is known that cq-PI may be rendered ineffective by oxygen radicals released togeth er with E by neutrophils [16], E-cp-PI levels measured correspond well to the literature data both in CSF [4,5,13] and sera [1,4,5,17] in newborns with meningeal bacterial in fections. Regarding the serum levels 4 h after the E challenge, a similar range was recently seen in newborns with septicemia or pneumo nia [ 18], Our experiments give no explanation as far as the origin of E-op-PI located in CSF is concerned.…”

Section: Discussionsupporting

confidence: 66%

“…White blood cell (WBC) counts were determined immediately in sam ples taken from both body fluids. CSF and serum sam ples were stored a t-2 0°C until E-op-PI concentrations were measured by an enzyme-linked sandwich immu noassay method (the lower limit of detection was 1.0 p.g/1; intra-and interassay variances were <10%) (Merck, Darmstadt, Germany) [1,4,5,13].…”

Section: A Nimal Preparationmentioning

confidence: 99%

“…E is rap idly inactivated by elastase-ai-proteinase in hibitor, and this complex (E-ai-PI) is highly stable [1,2,[4][5][6]. Because it had been re ported that the increase in the concentration of E-apPI is an early sign of septicemia and meningitis [4,5,13], we measured E-cti-PI levels in cerebrospinal fluid (CSF) and serum samples of the animals.…”

Section: Introductionmentioning

confidence: 99%

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Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets

et al. 1995

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The effect of elastase on the blood-brain barrier (BBB) permeability was intravitally studied by fluorescence photomacroscope using the open cranial window technique in newborn piglets. Eleven animals (group 1) were given intracisternal injection of porcine elastase (1.0 μg), while 7 piglets served as controls (group 2). Elastase administration resulted in spotty sodium fluorescein (MW 376 daltons) extravasations in pial venules in all animals of group 1 78 ± 4 min (mean ± SEM) after the challenge, and in a 2-fold increase (p < 0.05) in brain sodium fluorescein uptake both in occipital cortex and white matter. The concentration of elastase-α₁-proteinase inhibitor complex increased significantly (p < 0.05) in cerebrospinal fluid samples in group 1 2 and 4 h after the inject; m, while it did not change in sera. A significant pleocytosis and leukocytosis was also seen in group 1 while there was no change in laboratory data and BBB remained tight in group 2. BBB permeability changes during neonatal meningitis may be caused, at least partially, by elastase.

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Section: Discussionsupporting

confidence: 66%

Section: A Nimal Preparationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets

et al. 1995

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“…The assay of this enzyme-inhibitor complex, called (PMN) elastase for short, is already commonly used as a sensitive inflammation parameter in several areas of medicine [3,10,13,15,17]. In intensive care medicine, for example, it is possible to obtain predictive information on inflammatory complications with the aid of elastase [13].…”

Section: Introductionmentioning

confidence: 99%

PMN granulocyte elastase ? An early indicator of postoperative spondylodiscitis?

Schneider¹,

Wildförster²,

Diekmann

1995

Acta neurochir

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The diagnosis of spondylodiscitis after lumbar disc surgery has been based so far on clinical abnormalities, non-specific changes in chemical laboratory parameters [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)] and radiological examinations such as MRI. Such techniques do not enable any clear diagnosis to be made before the 3rd postoperative week. The PMN elastase released from stimulated polymorphonuclear granulocytes has been proved to be a good laboratory parameter by which it is possible to prognosticate bacterial and abacterial organ complications in surgical patients with a high degree of probability. Under investigation were 12 patients with spondylodiscitis out of 1162 operations on herniated lumbar discs. PMN elastase was determined on the 7th postoperative day. In patients with spondylodiscitis and a mean value of 110.5 micrograms/l, the elastase was on average higher by a factor of 2.6 as compared to 88 randomly selected control patients. Since spondylodiscitis is a rare complication, this results in a positive value of only 7%, which does not allow a reliable diagnosis of spondylodiscitis by the elastase assay. But because the negative predictive value is 100%, it is possible to exclude a postoperative spondylodiscitis already on the 7th postoperative day, if the elastase value is normal.

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Proteinase — Antiproteinase imbalance in meningitis: Determination of α 1 proteinase inhibitor (α 1PI), elastase — α-1PI complex, and elastase inhibition capacity in cerebrospinal fluid

et al. 1990

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Mortality and long-term neurologic sequelae are still frequent complications of meningitis despite effective antibiotic treatment. This suggests that pathogen-independent inflammatory mechanisms may play an important role in the course of this illness. Neutrophil granulocytes form the primary immune defense in meningitis. Once activated, these cells release elastase into the cerebrospinal fluid (CSF). Elastase may induce tissue damage if local antiproteinase capacity is low as under normal conditions. To define the relevance of this mechanism we studied 22 patients with meningitis. Concentrations of elastase in complex with the main antiproteinase alpha 1-proteinase inhibitor (elastase-alpha 1 PI), alpha 1-proteinase inhibitor (alpha 1PI), and elastase inhibition capacity (EIC) were measured in CSF of 9 patients with bacterial meningitis (BM), aged 1 month-14 years; 13 patients with non-bacterial meningitis (NBM), aged 1 month-15 years; and 20 patients in whom meningitis was excluded after spinal tap (control group), aged 6 months-15 years. The concentration of elastase-alpha 1PI in the BM group (median 552 micrograms/l) was significantly higher than in either the NBM group (median 30 micrograms/l, p less than 0.01) or the control group (median 30 micrograms/l, p less than 0.01). Similarly, the alpha 1PI-concentration in the BM group was significantly higher (median 113 mg/l) than either the NBM group (median 13.7 mg/l, p less than 0.025) or the control group (median 6.3 mg/l, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

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Diagnostic value of elastase-α₁-proteinase inhibitor in cerebrospinal fluid

Cited by 4 publications

References 5 publications

Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets

Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets

PMN granulocyte elastase ? An early indicator of postoperative spondylodiscitis?

Proteinase — Antiproteinase imbalance in meningitis: Determination of α 1 proteinase inhibitor (α 1PI), elastase — α-1PI complex, and elastase inhibition capacity in cerebrospinal fluid

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Diagnostic value of elastase-α1-proteinase inhibitor in cerebrospinal fluid

Cited by 4 publications

References 5 publications

Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets

Elastase Given Intracisternally Opens Blood-Brain Barrier in Newborn Piglets

PMN granulocyte elastase ? An early indicator of postoperative spondylodiscitis?

Proteinase — Antiproteinase imbalance in meningitis: Determination of α 1 proteinase inhibitor (α 1PI), elastase — α-1PI complex, and elastase inhibition capacity in cerebrospinal fluid

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Diagnostic value of elastase-α₁-proteinase inhibitor in cerebrospinal fluid