Elevation of Tissue Kallikrein and Kinin in the Airways of Asthmatic Subjects after Endobronchial Allergen Challenge

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Abstract
Bronchial tissue kallikrein is the major kininogenase activity in the airways of asthmatic subjects. The relationship of IgE-mediated events to its release and/or activation is unknown, however, and is the subject of this report. Seven subjects with mild atopic asthma underwent endobronchial challenge with relevant aeroallergen. Baseline pre-allergen lavage and sequential post-challenge lavages were collected over an approximate 10-minute time course. Individual aliquots were analyzed separately and compared with saline control lavages performed in a separate lobe. In five of the seven subjects, an increase in tissue kallikrein activity, measured by cleavage of the synthetic substrate Val-Leu-Arg-pNA, was identified in the post-challenge lavages. The antigenic identity of the enzymatic activity was confirmed as a tissue kallikrein in each case by immunoblotting. Tissue kallikrein activity was highly correlated with the appearance of immunoreactive histamine and kinin (p = 0.0001). High molecular weight kininogen influx and cleavage was detected in the post-challenge samples by immunoblotting and paralleled the detection of kinin in BAL fluid. Two of the subjects, despite clinical profiles similar to those of the five positive responders, failed to react to endobronchial challenge. Saline control lavages contained detectable kallikrein, kinin, and histamine in two subjects; in each case, however, this was significantly less than in the post-allergen samples. The results demonstrate a close association between immediate type hypersensitivity events in the lower airway and the appearance of active kallikrein, kininogen substrate, and the liberation of kinin.