Relationship between alpha-tocopherol and polymorphonuclear leukocyte elastase in septic adult respiratory distress syndrome.

To elucidate the interrelationship between active oxygen and polymorphonuclear leukocyte elastase (PMN elastase) in patients with septic adult respiratory distress syndrome (ARDS), we examined the relationship between alpha-tocopherol, which has an antioxidant action, and PMN elastase. Serial blood samples were collected from 16 patients with septic ARDS. Serum levels of alpha-tocopherol were determined by HPLC. PMN elastase was determined by ELISA. The serum alpha-tocopherol level in a nonsurviving group was significantly lower than that in a surviving group at the time that septic ARDS was diagnosed (p = 0.0068). The level of PMN elastase in the nonsurviving group was significantly higher than that in the surviving group (p = 0.0058). A significant negative correlation existed between the serum levels of alpha-tocopherol and those of PMN-elastase (r = -0.659, p = 0.0043). Both the serum alpha-tocopherol level and the PMN elastase level appeared to be good indices of the severity of ARDS. The results suggested that an interaction between active oxygen and PMN elastase may increase the clinical severity of this disease.