Elastolytic activity of alveolar macrophages in chronic bronchitis: comparison of current and former smokers.

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Abstract
Comparisons were made of the macrophage elastolytic activity of a group of current and former smokers with irreversible airflow obstruction. Elastolytic activity was determined in an initial bronchoalveolar lavage cell population and in alveolar macrophages cultured for 3 days, to investigate whether enhanced macrophage elastolytic activity alone is a determining factor in the susceptibility of some smokers to obstructive lung disease. Twenty current smokers and 12 former smokers who had abstained from smoking for at least 3 yr were studied. All patients had spirometric evidence of irreversible air flow obstruction. Current smokers had a cell yield (mean .+-. SD) of 138.7 .+-. 36.4 .times. 106 cells (alveolar macrophages 94.2% .+-. 2.1%) compared with 31.4 .+-. 14.1 .times. 106 cells (macrophages 86.5% .+-. 4.7%) in former smokers. Elastolytic activity in the initial lavage cell population from current and former smokers, measured with the synthetic elastase substrate succinyl-L-alanyl-L-alanyl-L-alanine-p-nitroanilide, and expressed as the equivalent of 1 .mu.g of porcine pancreatic elastase was, respectively, 0.113 .+-. 0.003 and 0.096 .+-. 0.004 .mu.g pancreatic elastase/mg cell protein. After 3 days in culture macrophage elastolytic activity in the current and former smokers'' cells was, respectively, 0.107 .+-. 0.006 and 0.011 .+-. 0.001 .mu.g pancreatic elastase/mg cell protein (P < 0.05). The elastase activity of the cultured alveolar macrophages from 5 current smokers had the inhibitor profile of a metalloproteinase. Enhanced macrophage elastolytic activity alone apparently is not a determining factor in the susceptibility of some smokers to develop obstructive lung disease.