Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.37 (neutrophil elastase)
 4,078 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of various chemical mediators in the development of complications after major surgery was investigated. Phospholipase A2 activity (PLA2), and the levels of pancreatic secretory trypsin inhibitor (PSTI), polymorphonuclear leukocyte elastase (PMNE), thromboxane B2 (TxB2), 6-keto-PGF1 alpha (6-KF), leukotriene (LT) B4, C4, D4, interleukin-beta (IL-1 beta), tumor necrosis factor (TNF), and endotoxin (Et) in the serum were measured in 134 surgical patients of whom 36 developed postoperative complications. PLA2, arterial TxB2 and 6-KF showed significant changes in the patients with post-operative complications, associated with elevated Et levels. The majority of these patients had a significantly higher ratio of TxB2/6-KF. These results suggest TxB2 and 6-KF, and the TxB2/6-KF ratio are useful indices of outcome in critically ill patients with hepatic failure. Our findings revealed marked production of prostanoids in sepsis and indicate a severity of the complication in balance of the thromboxane/prostacyclin axis. It was also suggested that the opsonin and eicosanoid levels are closely related to the serum endotoxin level. LTB4, C4 and D4 were increased in the patients with postoperative sepsis or DIC, especially at the initial onsets. The increased levels of IL-1 beta or TNF were observed in some patients with postoperative complications, especially those with severe postoperative complications.
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PMID:[The relationship between opsonin, endotoxin and chemical mediators in postoperative complications after surgery]. 194 9

The prognosis of septicaemia depends on the occurrence of complications such as shock and coagulation defects. The damage to haemostasis is usually explained by the action of the main coagulation and fibrinolysis enzymes, thrombin and plasmin. This paper presents data concerning the role of a third protease, granulocytic elastase. 82 patients who had been admitted to our hospital with suspected septicaemia were examined. Septicaemia was proven in 22 patients by the growth of microorganisms in blood cultures, and was clinically diagnosed in 9 patients. The plasma levels of neutrophil elastase-like protease complexed to a1antitrypsin (a1AT-ELP) were measured by zone immunoelectrophoresis assay (ZIA). The a1AT-ELP values were significantly increased in the 31 septic as compared to the 51 non-septic patients. In patients with complicated septicaemia, negative correlations of a1AT-ELP with factor XIII and the coagulation inhibitor antithrombin III were demonstrable. Among the patients with septic complications, the 3 who survived exhibited a dramatic decrease of a1AT-ELP, whereas in the other 16 patients who died the levels remained elevated. It might be of therapeutic significance that in 9 patients receiving fresh plasma and AT III-concentrate substitution for DIC the a1AT-ELP levels dropped, whereas they remained high in the other septicaemia patients. There were no correlations between a1AT-ELP and the a2antiplasmin-plasmin complexes (a2AP-P1), but strong correlations with signs of coagulation. The data suggest an interaction of coagulation and elastase release, probably involving the Hageman factor.
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PMID:Participation and interactions of neutrophil elastase in haemostatic disorders of patients with severe infections. 329 74

We tested the hypothesis that activated neutrophil-endothelial cell interaction in DIC can cause endothelial injury contributing to multiple organ dysfunction syndrome (MODS) and a poor outcome after trauma. Fifty-eight severe trauma patients, 29 with DIC and 29 without DIC were studied. Serial levels of soluble L-, P-, and E-selectins, ICAM-1, VCAM-1, thrombomodulin, and neutrophil elastase were measured on days 0-4 after trauma. The numbers of systemic inflammatory response syndrome (SIRS) criteria that patients met were determined, simultaneously. In the DIC patients, higher DIC scores, lower platelet counts, and a longer duration of SIRS were found compared with the non-DIC patients. The incidence of ARDS and MODS were higher in patients with DIC than in those patients without DIC, and the DIC patients had poor outcome. Soluble L-selectin (sL-selectin) level on Day 1 in the DIC patients who died was markedly lower than those in the non-DIC patients. The levels of sP- and sE-selectins, sICAM-1, and sVCAM-1 were more elevated in the patients with DIC than in those without DIC on days 2 to 4. Neutrophil elastase and sThrombomodulin levels in the DIC patients persistently increased during the study period compared to those in the non-DIC patients. Maximum DIC scores in the DIC group showed good correlations with peak levels of sICAM-1, sVCAM-1, neutrophil elastase, sThrombomodulin, and the number of dysfunctioning organs. Highly activated and sustained inflammation caused by neutrophil-endothelium interaction in DIC gives rise to MODS and poor outcome in patients with severe trauma. These results suggest a close relationship between inflammation and thrombosis in posttrauma DIC.
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PMID:Combined activation of coagulation and inflammation has an important role in multiple organ dysfunction and poor outcome after severe trauma. 1252 43