[Dynamic changes in polymorphonuclear cell elastase-alpha 1 protease inhibitor complex, a stress marker, in various pulmonary diseases].

Polymorphonuclear cell elastase-alpha 1 protease inhibitor complex (PMN elastase-alpha 1 PI complex), which increased in peripheral venous blood during many inflammatory diseases, showed significant transpulmonary difference (ie. mixed venous blood < arterial blood, p < 0.05) in patients with pulmonary disorders (N = 64) but not in those with nonpulmonary disorders (N = 15). Further, PMN elastase-alpha 1 PI complex exhibited higher values in arterial blood than in peripheral venous blood (p < 0.01). Taken together, this evidence suggests intrapulmonary production of PMN elastase-alpha 1 PI complex and suggests potential lung damage due to released PMN elastase. Increased and sustained elevated levels of PMN elastase-alpha 1 PI complex in acute respiratory failure with/without adult respiratory distress syndrome showed resistance to intensive medication suggesting that PMN elastase may be a good prognostic marker.