BACKGROUND AND OBJECTIVE: Neutrophil elastase (NE) may play a key role in the development of acute lung injury (ALI) or ARDS. NE activity (NEA) was measured in patients with ALI treated with a selective NE inhibitor. METHODS: NEA and NE-alpha1-antitrypsin (NE-AT) complex were measured in plasma before, during and after the administration of the selective NE inhibitor, sivelestat, in 32 patients with a diagnosis of ALI or ARDS. NEA index (NEAI) was calculated as NEA/NE-AT. The sequential organ failure assessment (SOFA) score and the ratio PaO(2)/fraction of inspired oxygen (FiO(2)) were measured. RESULTS: NEA and NE-AT was raised in all patients. Sivelestat reduced NEAI and NEA (P < 0.01 for both) but not NE-AT and NEA, and NEAI returned to pretreatment levels. NEA correlated closely with NE-AT before, but not after treatment. No relationship was observed between these indices and SOFA score or PaO(2)/FiO(2) ratio. CONCLUSIONS: Sivelestat reduced NEA and NEAI in patients with ALI or ARDS suggesting NE inhibition. A larger study is needed to determine the relationship of NEA, NE-AT and NEAI with the outcome of ALI/ARDS.
BACKGROUND AND OBJECTIVE:Neutrophil elastase (NE) may play a key role in the development of acute lung injury (ALI) or ARDS. NE activity (NEA) was measured in patients with ALI treated with a selective NE inhibitor. METHODS: NEA and NE-alpha1-antitrypsin (NE-AT) complex were measured in plasma before, during and after the administration of the selective NE inhibitor, sivelestat, in 32 patients with a diagnosis of ALI or ARDS. NEA index (NEAI) was calculated as NEA/NE-AT. The sequential organ failure assessment (SOFA) score and the ratio PaO(2)/fraction of inspired oxygen (FiO(2)) were measured. RESULTS: NEA and NE-AT was raised in all patients. Sivelestat reduced NEAI and NEA (P < 0.01 for both) but not NE-AT and NEA, and NEAI returned to pretreatment levels. NEA correlated closely with NE-AT before, but not after treatment. No relationship was observed between these indices and SOFA score or PaO(2)/FiO(2) ratio. CONCLUSIONS: Sivelestat reduced NEA and NEAI in patients with ALI or ARDS suggesting NE inhibition. A larger study is needed to determine the relationship of NEA, NE-AT and NEAI with the outcome of ALI/ARDS.
Authors: Paula Tejera; D Shane O'Mahony; Caroline A Owen; Yongyue Wei; Zhaoxi Wang; Kushagra Gupta; Li Su; Jesus Villar; Mark Wurfel; David C Christiani Journal: Am J Respir Cell Mol Biol Date: 2014-08 Impact factor: 6.914
Authors: Michelle L Manni; Lauren P Tomai; Callie A Norris; L Michael Thomas; Eric E Kelley; Russell D Salter; James D Crapo; Ling-Yi L Chang; Simon C Watkins; Jon D Piganelli; Tim D Oury Journal: Am J Pathol Date: 2011-06 Impact factor: 4.307
Authors: Caio P Gomes; Danilo E Fernandes; Fernanda Casimiro; Gustavo F da Mata; Michelle T Passos; Patricia Varela; Gianna Mastroianni-Kirsztajn; João Bosco Pesquero Journal: Front Cell Infect Microbiol Date: 2020-12-08 Impact factor: 5.293
Authors: Zhaoxi Wang; Feng Chen; Rihong Zhai; Lingsong Zhang; Li Su; Xihong Lin; Taylor Thompson; David C Christiani Journal: PLoS One Date: 2009-02-06 Impact factor: 3.240