Diagnostic significance of immunological assay of pancreatic elastases in acute pancreatitis.

ABSTRACT

Pancreatic elastases have been assumed to be implicated in the pathogenesis of the vascular injury in acute hemorrhagic pancreatitis. We reported the purification and some properties of human pancreatic elastases. In the present study, the value of the determination of serum pancreatic elastases was investigated. 39 patients with acute hemorrhagic and acute edematous pancreatitis were studied. Serum elastase 1(E-1) and elastase 2(E-2) were measured by radioimmunoassay recently developed in our laboratory. The molecular form of exogenous and endogenous elastases in serum was studied by gel filtration on Sephadex G-200. The mean and standard deviation of serum pancreatic E-1 and E-2 were 1.49 +/- 0.49 ng/ml and 292 +/- 82 ng/ml, respectively. In acute pancreatitis, both E-1 and E-2 had markedly raised serum concentrations. However, no significant difference was observed between acute hemorrhagic and acute edematous pancreatitis. Endogenous immunoreactive E-1 and E-2 were present in serum in complex form with alpha 1-antitrypsin. In contrast, exogenous elastases were bound to alpha 1-antitrypsin and alpha 2-macroglobulin.