The purpose of this study was to determine whether subtilisin, a potent serine proteinase derived from Bacillus species contaminating smokeless tobacco, increases macromolecular efflux from the oral mucosa and, if so, whether local elaboration of bradykinin mediates this response. Using intravital microscopy, I found that suffusion of subtilisin elicits significant, concentration-dependent leaky site formation and an increase in the clearance of fluorescein isothiocyanate-labeled dextran (molecular mass, 70 kDa) from the in situ hamster cheek pouch (P < 0.05). Heat-inactivated subtilisin had no significant effects on macromolecular efflux. Subtilisin-induced responses were significantly attenuated by Hoe 140 and NPC 17647, two structurally distinct selective bradykinin B 2 receptor antagonists, but not by des-Arg 9 -[Leu 8 ]bradykinin, a selective bradykinin B 1 receptor antagonist, or CP-96,345, a selective neurokinin-1 receptor antagonist. Aprotinin, but not leupeptin, significantly attenuated subtilisin-induced increase in macromolecular efflux. Indomethacin had no significant effects on subtilisin-induced responses. Collectively, these data indicate that subtilisin increases the macromolecular efflux from the in situ hamster cheek pouch in a catalytic-site-dependent fashion through local elaboration of bradykinin. This response does not involve the stimulation of local afferent nerves or the production of prostaglandins.A growing body of clinical evidence suggests that the regular use of smokeless tobacco is associated with oral mucosa injury and inflammation in humans (3,11,32,35). A cardinal feature of this response is plasma exudation from postcapillary venules that leads to interstitial edema and tissue dysfunction (7,11). Although the mechanisms underlying smokeless-tobacco-induced plasma exudation from the oral mucosa are uncertain, previous work from my laboratory has established that local elaboration of bradykinin, a potent phlogistic 9-amino-acid peptide released from kininogen (1, 4, 38), mediates a smokeless-tobacco-induced increase in macromolecular efflux from the in situ hamster cheek pouch (7). However, the nature of the putative factor(s) in smokeless tobacco that activates the kallikrein/kinin metabolic pathway in the oral mucosa to release bradykinin is uncertain (1,12,19,25).To this end, spore-producing Bacillus species which elaborate subtilisin, a potent serine proteinase that activates the kallikrein/kinin system (1,13,17,19,29), have been shown to contaminate tobacco leaves used to prepare smokeless tobacco for commercial use (34). Once smokeless tobacco is placed on the oral mucosa, the local microenvironment is conducive for the sporulation of Bacillus species and the release of subtilisin (7,13,17,21,29,34,38). Whether subtilisin thus released activates the kallikrein/kinin system and evokes plasma exudation from the in situ oral mucosa is uncertain.Hence, the purpose of this study was to begin to address this issue by determining whether subtilisin increases the macromolecular eff...