A matched-pair study of the leukocyte elastase-like activity in normal persons and in emphysematous patients with and without alpha 1-antitrypsin deficiency.

The elastase-like activities in whole cell extracts of neutrophilic polymorphonuclear leukocytes of 10 emphysematous patients with alpha 1-antitrypsin deficiency (PiZ) and of 7 subjects with alpha 1-antitrypsin deficiency (PiZ or PiSZ) without emphysema were the same as the activities of healthy nondeficient subjects (PiMM) matched according to age, sex, and smoking history. In 16 emphysematous patients without alpha 1-antitrypsin deficiency (PiMM) however, the leukocyte elastase-like activity tended to be higher than that of normal control subjects. We concluded that in persons with alpha 1-antitrypsin deficiency, the leukocyte elastase-like activity is not a deciding factor in the development of emphysema. In persons without alpha 1-antitrypsin deficiency, however, the leukocyte elastase-like activity may be a contributing factor in the development of this disease. Variations in specific anti-leukocyte-elastase-like activity of alpha 1-antitrypsin, which might play a role in the pathogenesis of emphysema, were not found.