Inter-alpha-Trypsininhibitor im Serum und Sekretinhibitoren im Bronchialschleim bei chronisch obstruktiven Atemwegserkrankungen

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Abstract
Diseases in the bronchial tract release proteases, mainly from disintegrated leukocytes. These elastase-like enzymes, chiefly from granulocytes, are capable of increasing the bronchial resistance. The feeble, monovalent, humoral protease inhibitor inter-.alpha.-trypsin inhibitor (ITI) has to be regarded as a stage for different secretory, low-molecular, polyvalent protease inhibitors, among others for the bronchial mucus inhibitor. Thus, kallikreins act as inhibitor-releasing enzymes. Patients with severe, chronic obstructive bronchitis did not show significantly increased serum levels of the proinhibitor ITI; there was a high transformation increase of a single, immunologically active derivatives as the intermediate stage towards bronchial mucus. The transformation extent depended on the airway resistance; it was highest at a high resistance of about Rt = 10; at a normal or only slightly increased resistance it almost corresponded to the normal value. In the case of purulent sputum, the concentrations of the bronchial mucus inhibitor were higher than for mucous sputum, thus showing some correlation between protease appearance and concentration of the bronchial mucus inhibitor. If it is supposed that the derivatives of ITI which are no longer seen in the serum develop locally, the enzymatic reduction in the damaged mucosa seems to be inhibited in the case of none or only low concentrations of the bronchial mucus inhibitor. No correlation between ITI in the serum and bronchial mucus inhibitor in the sputum could be found.