Pancreatic proteases and antiproteases in pancreatic disease; biochemical, pathophysiological and clinical aspects.
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Biomarkers↗
Biomedical subjects
M Bohe
Publications and source records attributed to M Bohe.
Immunoreactive pancreatic secretory trypsin inhibitor in sera from patients with acute ulcerative colitis.
The serum levels of immunoreactive pancreatic secretory trypsin inhibitor (irPSTI) and immunoreactive cationic trypsin (irCT) were measured in 14 patients admitted for severe acute attacks of ulcerative colitis. Patients with acute colitis had significantly higher irPSTI levels in serum (35 micrograms/l) as compared with controls (11.5 micrograms/l), while the serum level of irCT was within normal limits. The normal colonic mucosa recently has been shown to contain irPSTI favoring the theory of an extrapancreatic origin of the increased serum levels of irPSTI in patients with severe active ulcerative colitis.
Acute Disease↗
Varying occurrence of gastroduodenal immunoreactive pancreatic secretory trypsin inhibitor.
Operative specimens from various parts of gastroduodenal mucosa were analysed for immunoreactive pancreatic secretory trypsin inhibitor (PSTI) using a peroxidase-antiperoxidase method. Normal gastric mucosa exhibited a varying degree of PSTI immunoreactivity, which was more pronounced in the foveolar cells of gastric mucosa of fundus type than in the non-pepsinogen producing antrum-pyloric mucosa. With the exception of metaplastic Paneth cells and some goblet cells, the intracellular content of PSTI was low in gastric mucosa with intestinal metaplasia. These findings may indicate that a PSTI immunoreactive substance has a role in the normal defence of the gastric mucosa.
Duodenum↗
Pancreatic and granulocytic endoproteases in faecal extracts from patients with active ulcerative colitis.
Faecal samples from 16 patients with acute attacks of ulcerative colitis, 7 with quiescent disease, and 8 healthy subjects were studied with regard to extractable amounts of casein digestion capacity, immunoreactive anionic trypsin, cationic trypsin, chymotrypsin, pancreatic elastase, and granulocytic elastase. Patients with acute attacks of colitis had significantly higher levels of casein digestion, pancreatic elastase, and granulocytic elastase in faecal samples than patients with quiescent disease and controls. The non-specific proteolytic activity in faecal extracts from patients with acute colitis was mainly due to the pancreatic proteases anionic elastase, cationic elastase, and anionic trypsin to the granulocytic proteases elastase and neutral protease. These active proteases may cause further destruction of the already damaged mucosa found in patients with severe ulcerative colitis.
Adult↗
Fertility and outcome of pregnancy in patients operated on for Crohn's disease.
Fertility and outcome of pregnancy were assessed in all 78 women below 40 years of age in a total, unselected series of patients with Crohn's disease, diagnosed during a 17-year period and consecutively treated with resectional surgery, in most cases at an early stage. The median follow-up time after the primary operation was 12.8 years. During the observation time there were 87 pregnancies in 44 patients. Neither the number of live births, nor the frequency of abortions differed from that expected in the general population. There was no still birth. The localization of the disease was not significant. In conclusion, there were no indications of any negative influence of surgical intervention.
Abortion, Spontaneous↗
Pancreatic endoproteases and pancreatic secretory trypsin inhibitor immunoreactivity in human Paneth cells.
Normal and metaplastic gastrointestinal mucosa obtained at surgical resection were studied by light microscopy, using the unlabelled antibody enzyme method for immunohistochemical staining of lysozyme, pancreatic endoproteases, and pancreatic secretory trypsin inhibitor (PSTI). Paneth cells in the mucosa of normal small intestine, gastric mucosa with intestinal metaplasia, and colonic metaplastic mucosa were found to contain anionic trypsin, cationic trypsin, lysozyme, and PSTI immunoreactivity, but not chymotrypsin and elastase immunoreactivity. Normal gastric and colonic mucosa and some goblet cells in the small intestine showed positive PSTI immunoreactivity but no endoprotease immunoreactivity. The presence of immunoreactive trypsin and immunoreactive PSTI in the Paneth cells, which are of secretory type, probably indicates an important extrapancreatic source of these proteins rather than a storage of endocytosed material.
Adenoma↗
Metabolism of 131I-labelled human pancreatic cationic trypsin after intraduodenal administration.
Human pancreatic cationic trypsin labelled with 131I was administered into the duodenum in 9 healthy individuals. Five had earlier been proctocolectomized and had ileostomies. Radioactivity was measured in plasma, urine, ileostomy content and feces for a period of 72 h. Radioactivity was present in plasma 15 min after administration. The total recovery of radioactivity was 78-98%, the largest amount being observed in urine during the first 24-hour period. About 20% of the administered radioactive dose was recovered in ileostomy content and 10% in feces. The recovered radioactivity in plasma, urine and extracts of ileostomy content and feces was characterized with dialysis and gel filtration. All radioactivity in plasma and urine corresponded to free 131I, whereas in the extracts radioactivity corresponding to intact enzyme and degradation products as well as a small amount of free 131I was observed. It is concluded that pancreatic trypsin is degraded during intestinal passage as with other proteins. Due to a deiodinating mechanism in the intestine, only free 131I is absorbed into the circulation. This deiodination does not take place in duodenal juice. The absence of high molecular weight radioactivity in plasma argues against an enteropancreatic circulation.
Adult↗
Protease inhibitors in plasma and faecal extracts from patients with active inflammatory bowel disease.
The level and functional activity of the major protease inhibitors in plasma and faecal extracts were analysed in 26 consecutive patients admitted during their first attack of acute severe colitis. The patients were retrospectively divided into two groups: one with total colitis and another with distal colitis. The patients with total colitis had a significantly lower alpha 2-macroglobulin level in plasma than normal individuals and patients with distal disease, whereas no difference in the levels of alpha 1-protease inhibitor, antichymotrypsin, antithrombin III, and alpha 2-antiplasmin was noted between the two groups. The protease-inhibiting capacity was saturated, and free proteolytic activity was present in the faecal extracts. In the extracts complex formation was demonstrated between leukocyte proteases and the antiproteases alpha 1-protease inhibitor and alpha 2-macroglobulin. It is concluded that the low plasma level of alpha 2-macroglobulin in patients with severe total colitis is mainly due to a consumption caused by complex formation with proteases, as earlier demonstrated in patients with acute pancreatitis and sepsis.
Adult↗
Characterization of radioactivity in plasma after intraduodenal administration of 131I-labelled human cationic trypsin.
Active human pancreatic cationic trypsin labelled with 131I was administered into the duodenum in nine healthy individuals pretreated with "cold", i.e. non-radioactive iodine. Radioactivity in plasma was measured during 72 hours and was present in plasma after 15 minutes with a maximum 1 hour after administration. The recovered radioactivity in plasma was characterized using dialysis and gel-filtration and the radioactive iodine was found to be in the form of free 131I. Our results are in agreement with recent experimental studies indicating the presence of de-iodinases in the intestine. Furthermore, it was found that pretreatment with "cold" iodine prevented isotope binding to circulating plasma proteins.
Adult↗
Immunohistochemical demonstration of pancreatic secretory proteins in human paneth cells.
Gastro-intestinal mucosa obtained at surgical resection was studied by light microscopy using the unlabelled antibody enzyme method for immunohistochemical staining of lysozyme, anionic trypsin, cationic trypsin and pancreatic trypsin inhibitor (PSTI). Paneth cells, identified by their content of lysozyme, contained anionic trypsin, cationic trypsin and PSTI-like immunoreactivity. The demonstration of immunoreactive trypsin and immunoreactive PSTI is a further indication of the resemblance between Paneth cells and the pancreatic acinar cells.
Epithelial Cells↗
Prospective randomized double-blind comparison of nephrotoxicity and auditory toxicity of tobramycin and netilmicin.
Netilmicin or tobramycin was administered to 197 patients in a prospective randomized double-blind trial. Of these patients, 140 recipients of nine or more doses of netilmicin or tobramycin could be evaluated for nephrotoxicity. Fifty-five patients were able to cooperate in the administration of serial audiograms. Nephrotoxicity of similar severity developed in 7 of 73 (9.6%) recipients of tobramycin and in 7 of 67 (10.4%) recipients of netilmicin (P greater than 0.05). Mild or slight auditory toxicity developed in 5 of 28 (17.8%) recipients of tobramycin and in 2 of 27 (7.4%) recipients of netilmicin (P greater than 0.05).
Adult↗
Fate of intravenously injected trypsin in dog with special reference to the existence of an enteropancreatic circulation.
In 3 mongrel dogs the pancreatic duct and bile duct were cannulated. After intravenous injection of 125I-labelled anionic dog trypsin bile, pancreatic juice and blood samples were collected during 3 h. 125I-trypsin is eliminated from the circulation in dogs with a half time of 15 min. Only 0.15% of the radioactivity is secreted in the pancreatic juice and 0.75% in the bile during 3 h. 10% of the radioactivity in pancreatic juice is protein bound and 45% in the bile is protein bound. The results argue against biologically significant enteropancreatic circulation of trypsin in dogs.
Animals↗
Trypsin-like immunoreactivity in human Paneth cells.
Human intestinal Paneth cells characterized by their content of lysozyme were shown to contain cationic trypsin immunoreactivity. This trypsin-like immunoreactivity was shown in the Paneth cells at their normal localization at the basis of the crypts of Lieberkühn and also in Paneth cells of metaplastic areas in gastric mucosa. This original finding is a further indication of a resemblance between Paneth and acinar pancreatic cells.
Duodenum↗
Metabolic epidemiology of colon cancer: dietary pattern and fecal sterol concentrations of three populations.
The nutrient intake, fecal neutral sterol concentration, and bile acid concentration of populations with a varied risk for colon cancer development were investigated. High-risk populations in the metropolitan New York area and Malmo, Sweden, were compared with an intermediate-risk population in Umea, Sweden. The mean daily intake of protein and fat was comparable in all groups, but the total daily fiber intake was higher in Umea, as was the total daily stool output. There was no difference in the total fiber intake and stool output between Malmo and metropolitan New York. The fecal secondary bile acid concentration was lower in Umea than in the other two areas; no difference was observed between Malmo and metropolitan New York. These results suggest that high fiber intake may be considered protective against colon cancer even in a population with a high risk intake. A high dietary fiber intake may limit colon cancer risk by increasing stool bulk, and thus diluting and/or binding tumor promoters.
Adult↗
Determination of immunoreactive trypsin, pancreatic elastase and chymotrypsin in extracts of human feces and ileostomy drainage.
The total daily amount of extractable cationic trypsin, chymotrypsin, and pancreatic elastase 2 in feces and ileostomy fluids has been studied in normal individuals and healthy colectomized subjects. Quantitation was performed using immunological assays with polyethylene glycol as a fecal marker. The extractable amount of each of these enzymes in the feces of normal individuals was less than 1 mg/24 h. However, in fecal extracts from antibiotic-treated normal individuals a 100-fold increase in immunoreactive cationic trypsin was observed, while chymotrypsin and elastase 2 were only 2- to 3-fold higher. In extracts from ileostomy fluids cationic trypsin, elastase, and chymotrypsin all showed mean values in the order of 50-200 mg/24 h. The characterization of the immunoreactivity of pancreatic proteases showed no qualitative differences when measured in duodenal juice or fecal and ileostomy extracts.
Adult↗
Carcinoma of the anal canal.
A 20-year retrospective study of all anal canal carcinomas in the city of Malmö has been performed. The series consists of 29 patients, 23 women and 6 men, with a mean age of 66 years. Eight patients had non-keratinizing squamous cell carcinoma, 7 had keratinizing squamous cell carcinoma, 12 had basaloid squamous cell carcinoma, and 2 patients had mucoepidermoid carcinoma. Two of four patients operated on for curative purposes with local excision survived 5 years, as did seven of nine patients operated on curatively with abdominoperineal resection. In discussing the results, an overview of the literature is presented. It is concluded that adjuvant combined chemotherapy and radiotherapy appears to result in a higher survival rate for patients with tumours growing at or above the dentate line.
Aged↗
[Voice and speech disorders in the Parkinsonian syndrome].
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Female↗
[Indications for portacaval shunt operation].
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Journal Article↗