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Am. J. Respir. Crit. Care Med., Volume 157, Number 2, February 1998, 505-511

Increased Levels of Elastase and alpha 1-Antitrypsin in Sputum of Asthmatic Patients

ANTONIO M. VIGNOLA, ANNA BONANNO, ANGELA MIRABELLA, LOREDANA RICCOBONO, FRANCO MIRABELLA, MIRELLA PROFITA, VINCENZO BELLIA, JEAN BOUSQUET, and GIOVANNI BONSIGNORE

Istituto di Fisiopatologia Respiratoria, Consiglio Nazionale delle Ricerche and Istituto di Medicina Generale e Pneumologia, Università di Palermo, Palermo, Italy; and Departement des Maladies Respiratoires Unit 454 INSERM, Montpellier, France

Asthma and chronic bronchitis are inflammatory diseases associated with remodeling of the extracellular matrix (ECM). Elastin, a major component of the ECM in the airways, has been previously found to be disrupted in asthma and chronic bronchitis. This study was aimed at evaluating whether elastin disruption might be associated with an imbalance between elastase (active and total) and alpha 1-proteinase inhibitor (alpha 1-PI), the main inhibitor of elastase. We measured elastase and alpha 1-PI in induced sputum obtained from 16 control subjects, 10 healthy smokers, 19 asthmatic patients, and 10 chronic bronchitis patients. We also assessed the possible origin of elastase, evaluating its levels in sputum with reference to differential cell counts. We found that in induced sputum obtained from asthmatic and chronic bronchitis patients, the levels of both total and active elastase were significantly increased as compared with those of control subjects and healthy smokers and were significantly correlated with the percentage of neutrophils. In addition, in asthma and chronic bronchitis patients, the levels of active and total elastase were inversely correlated with the degree of airway obstruction as assessed from FEV1 values. This study shows that airway inflammation in asthma and chronic bronchitis is associated with high levels of active elastase, which may play a role in the pathogenesis of airway remodeling.




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