Human cationic, pancreatic elastase in acute pancreatitis.

Immunoreactive cationic pancreatic elastase (irPE) in serum and peritoneal exudate from 8 patients with severe acute pancreatitis was found mainly in complex with alpha-1-proteinase-inhibitor (alpha 1PI). Only minor amounts of irPE were found in a molecular form corresponding to the free proenzyme. The presence of alpha-2-macroglobulin (alpha 2M)-bound, elastase-like activity in the exudates indicates that active elastase was bound to this inhibitor. The results indicate that pancreatic cationic elastase is released to some extent as active enzyme in acute pancreatitis. However, no free elastolytic activity was present in the exudates.