Leucocyte Elastase in Chronic Inflammatory Bowel Diseases: A Marker of Inflammatory Activity?

Abstract

Leucocyte elastase is a neutral proteinase which plays an important role in the pathogenesis of inflammatory disorders. Infiltration of bowel mucosa by neutrophil and eosinophilic granulocytes is a characteristic feature of chronic inflammatory bowel diseases. We studied plasma elastase in 44 patients suffering from Crohn’s disease or ulcerative colitis. Plasma levels were significantly higher in these patients compared to 7 patients with noninflammatory bowel diseases or 53 healthy controls. Elevated plasma levels were more often found in patients with active inflammation than in those with inactive disease. Elastase did neither correlate with leucocyte counts, serum albumin, ESR, α₁-proteinase inhibitor and orosomucoid nor with clinical indices or the faecal excretion of ¹¹¹In-labelled granulocytes. In serial studies of 15 patients, elastase did not always run parallel to the disease activity. We conclude that plasma elastase does not reliably indicate the inflammatory activity in chronic inflammatory bowel diseases.

Clinical Relevance of Activity Parameters in Crohn’s Disease Estimated by the Faecal Excretion of ¹¹¹In-Labeled Granulocytes

“…However, the local turn over of activated granulocytes in bowel in flammation is not mirrored by the number of circulating leukocytes in a reliable man ner. The lacking correlate with elastase may be surprising, but supports previous findings [11], From both activity indices, the CDAI did not correlate with fecal m In excretion (table 1). However, the CDAI rather reflects the severity of CD than it indicates the intes tinal inflammatory activity.…”

Faecal neutrophil elastase-antiprotease balance reflects colitis severity

“…Elevated levels of NE are detected in colonic mucosal tissue and plasma samples from UC patients and therefore measurement of NE abundance has previously been explored as a biomarker for IBD. [35][36][37] However, NE abundance does reliably indicate active disease in IBD, 38 and is inferior to other faecal markers, for example, calprotectin and lactoferrin. 35 This is likely due to the concatenate release of endogenous NE inhibitors.…”

Determination of Leukocyte Elastase Concentration in Plasma and Serum by a Simple Method Using a Specific Synthetic Substrate

“…Furthermore, concentra tions in plasma and serum have been mea sured by methods other than ELISA [2,9,10,13,[15][16][17], These results indicate that the ELP assay in plasma and other sub stances is an important diagnostic factor in various pathological states. ELP released from leukocytes is a significant early indica tor of septicemia and bacterial meningitis in children [1], a marker of the acute state in SLE [7], and of inflammatory activity [5] and fibrinolytic protease in leukemia [4,16], This study had three purposes, namely to compare the two methods, to investigate the relationship between plasma ELP and serum Table 4. ELP levels in plasma from healthy donors (control) and patients with leukemia ELP, and to detect factors involved in the elevation of ELP in plasma or serum.…”

“…Recently, investigators in the pediatric [ 1,2], surgical [3] and internal medicine [4][5][6][7] fields have used ELISA to reveal the patho logical significance of leukocyte elastase (ELP) released from leukocytes into the blood. As still greater quantities of ELP are released from leukocytes during blood coag ulation [8], investigation has concentrated on plasma levels; however, serum ELP levels have also been studied [9,10], The primary reason for this may be that, although plasma is preferable in determining levels in the cir culation, it is difficult to obtain samples in patients with various diseases, especially at research laboratories and central laborato ries in hospitals.…”