Saitoh O, Sugi K, Matsuse R, Uchida K, Matsumoto H, Nakagawa K, Takada K, Yoshizumi M, Hirata I, Katsu K
Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.
Am J Gastroenterol. 1995 Mar;90(3):388-93.
To compare the form of polymorphonuclear leukocyte (PMN)-elastase in feces with that in plasma and to investigate the usefulness of measuring fecal PMN-elastase levels in patients with colorectal diseases.
We examined PMN-elastase complexed with alpha 1-antitrypsin (alpha 1-AT), chymotrypsin, and alpha 2-macroglobulin by ELISA in feces and plasma. Fecal levels of total PMN-elastase were determined in patients with colonic polyp (N = 19), colonic cancer (N = 20), ulcerative colitis (UC; N = 36), colonic Crohn's disease (CD; N = 26), and in control subjects (N = 20).
Most PMN-elastase was not complexed with alpha 1-AT, chymotrypsin, or alpha 2-macroglobulin in feces, whereas most plasma PMN-elastase was complexed with alpha 1-AT. Fecal concentrations and daily fecal excretion of PMN-elastase were significantly increased in patients with active UC (medians 54.8 micrograms/g, 15.14 mg/day) and active CD (41.5 micrograms/g, 10.24 mg/day) compared to those values in control subjects (0.6 micrograms/g, 0.11 mg/day) and in patients with colonic cancer (2.5 micrograms/g, 0.33 mg/day). In inactive UC and CD, these values (3.4 micrograms/g, 0.52 mg/day and 5.2 micrograms/g, 0.59 mg/day, respectively) were significantly lower than in active UC and CD, respectively. In UC, all patients whose rectal biopsies showed infiltration of PMN had high fecal PMN-elastase levels.
Our results suggest that the measurement of fecal PMN-elastase concentrations are useful for monitoring the disease activity of UC and CD, especially when evaluating whether intestinal inflammation has disappeared completely.
比较粪便中多形核白细胞（PMN）弹性蛋白酶与血浆中该酶的形式，并研究测定结直肠疾病患者粪便中PMN弹性蛋白酶水平的实用性。
我们通过酶联免疫吸附测定法（ELISA）检测粪便和血浆中与α1抗胰蛋白酶（α1-AT）、糜蛋白酶和α2巨球蛋白复合的PMN弹性蛋白酶。测定了结肠息肉患者（n = 19）、结肠癌患者（n = 20）、溃疡性结肠炎（UC；n = 36）、结肠克罗恩病（CD；n = 26）以及对照受试者（n = 20）的粪便中总PMN弹性蛋白酶水平。
粪便中大多数PMN弹性蛋白酶未与α1-AT、糜蛋白酶或α2巨球蛋白复合，而血浆中大多数PMN弹性蛋白酶与α1-AT复合。与对照受试者（0.6μg/g，0.11mg/天）和结肠癌患者（2.5μg/g，0.33mg/天）相比，活动期UC患者（中位数54.8μg/g，15.14mg/天）和活动期CD患者（41.5μg/g，10.24mg/天）的粪便中PMN弹性蛋白酶浓度和每日粪便排泄量显著增加。在非活动期UC和CD中，这些值（分别为3.4μg/g，0.52mg/天和5.2μg/g，0.59mg/天）分别显著低于活动期UC和CD。在UC中，所有直肠活检显示PMN浸润的患者粪便中PMN弹性蛋白酶水平都很高。
我们的结果表明，测定粪便中PMN弹性蛋白酶浓度有助于监测UC和CD的疾病活动，尤其是在评估肠道炎症是否已完全消失时。
