Plasma and synovial fluid levels of granulocytal elastase-α-1-protease inhibitor complex in patients with rheumatoid arthritis

Abstract

Plasma and synovial fluid levels and granulocytal elastase-alpha-1-protease inhibitor complex (EIC) in patients with rheumatoid arthritis (RA) were measured by enzyme-linked immunoassay and the results compared with those in patients with osteoarthrosis (OA). It was found that the plasma and synovial fluid levels of EIC in RA patients were higher than those in OA patients. There was a positive correlation between plasma EIC level in RA patients in Lansbury's index score of disease activity, as this tends to be higher when titer of RAHA in the plasma is high. The level of EIC in the synovial fluids correlated positively with granulocyte count and alpha-1-protease inhibitor (alpha-1-PI) level, and this, too, tends to be higher when titer of RAHA in synovial fluid is high. The results suggested that the level of EIC in the plasma or synovial fluids can be a good marker for the systemic or localized activation of the granulocytes and that IgM rheumatoid factor (IgMRF) is involved in the mechanism of the release of elastase.

Complexes between proteinase 3, α1‐antitrypsin and proteinase 3 anti‐neutrophil cytoplasm autoantibodies: a comparison between α1‐antitrypsin PiZ allele carriers and non‐carriers with Wegener's granulomatosis

“…Thus, some of the patients may be beyond the initial inflammatory phase and therefore have low levels of PR3/ 1 AT complexes. Elevated levels of elastase/ 1 AT and PR3/ 1 AT complexes have previously been found in diseases such as pancreatitis, inflammatory bowel disease, rheumatoid arthritis and sepsis [30][31][32][33]. Activation of the neutrophils independent of disease activity may explain the raised level of PR3/ 1 AT complexes in some patients during remission.…”

Complexed plasma elastase as an in vivo marker for leukocyte activation in antineutrophil cytoplasmic antibody‐associated vasculitis

“…However, concomitant infectious complications have to be excluded, since they would lead to increased elastase levels as well. Furthermore, it must be kept in mind that increased elastase levels do not represent a specific diagnostic marker for ANCAassociated vasculitis, since elevated levels have previously been found in other inflammatory or infectious diseases such as pancreatitis, inflammatory bowel disease, rheumatoid arthritis, and sepsis (25)(26)(27)(28).…”

The importance of plasma polymorphonuclear (PMN) elastase determination in patients with uveitis

“…In recent studies (Deger et al 1995(Deger et al , 1996Gross et al 1990;Hastka 1988;hamoglu et al 1993;Kuramut & Yoshida 1990;Lang et al 1985;, elevated levels of plasma PMN elastase or its complex with alpha 1 -proteinase inhibitor were reported with postoperative sepsis and in a variety of inflammatory and malignant disorders. Uveitis is believed to be an inflammatory reaction in ocular tissues caused by biological or physical agents (Narsing et al 1987).…”