Absence of Plasma Protease-Antiprotease Imbalance in the Formation of Saccular Cerebral Aneurysms

Absence of Plasma Protease-Antiprotease Imbalance in the Formation of Saccular Cerebral Aneurysms AbstractOBJECTIVE:We examined the hypothesis that a plasma protease-antiprotease imbalance contributes to the formation of saccular cerebral aneurysms and the suggestion that the assay of these enzymes might be a screening tool for people at higher risk for aneurysm formation.METHODS:From June 1997 through May 1998, the plasma leukocyte elastase, which is an important proteolytic enzyme, and α2-antitrypsin and α2-macroglobulin, which are important antiproteolytic enzyme plasma proteins, were examined in 18 patients with ruptured aneurysms, 9 patients with unruptured aneurysms, and 22 controlsRESULTS:The elastase:α1-antitrypsin ratio and the elastase:α2-macroglobulin ratios were significantly higher in patients with ruptured aneurysms within 24 hours after subarachnoid hemorrhage (SAH) than in the controls. The protease-antiprotease imbalance depended on the elevation of the elastase level, which might be correlated with leukocytosis after SAH. The elastase level decreased to the control level 3 months after the onset of SAH. No significant difference in the elastase:α2-antitrypsin and elastase:a2-macroglobulin ratios was observed between the patients with unruptured aneurysms and the controls.CONCLUSION:These results do not support the hypothesis that a plasma protease-antiprotease imbalance is a potential marker to predict the formation of saccular cerebral aneurysms. The increase in plasma elastase levels in patients with ruptured aneurysms might be attributable to leukocytosis after SAH. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Absence of Plasma Protease-Antiprotease Imbalance in the Formation of Saccular Cerebral Aneurysms

Absence of Plasma Protease-Antiprotease Imbalance in the Formation of Saccular Cerebral Aneurysms

Absence of Plasma Protease-Antiprotease Imbalance in the Formation of Saccular Cerebral Aneurysms Naoto Sakai, M.D., Koichi Nakayama, Ph.D., Yoshiyuki Tanabe, Ph.D., Yoshiaki Izumiya, M.D., Shigeru Nishizawa, M.D., Kenichi Uemuara, M.D., Department of Neurosurgery (NS, Yl), Shimizu Kosei Hospital, Shimizu; Department of Pharmacology (KN, YT), Faculty of Pharmaceutical Sciences, University of Shizuoka, Shizuoka; and Department of Neurosurgery (SN, KU), Hamamatsu University School of Medicine, Hamamatsu, |apan O BJEC T IV E: W e examined the hypothesis that a plasma protease-antiprotease imbalance contributes to the forma­ tion of saccular cerebral aneurysms and the suggestion that the assay of these enzymes might be a screening tool for people at higher risk for aneurysm formation. M ETH O D S: From June 1997 through May 1998, the plasma leukocyte elastase, which is an important proteolytic enzyme, and a,-antitrypsin and a 2-macroglobulin, which are important antiproteolytic enzyme plasma proteins, were examined in 18 patients with ruptured aneurysms, 9 patients with unruptured aneurysms, and 22 controls. RESULTS: The elastase:a,-antitrypsin ratio and the elastase:a2-macroglobulin ratios were significantly higher in patients with ruptured aneurysms within 24 hours after subarachnoid hemorrhage (SAH ) than in the controls. The protease-antiprotease imbalance depended on the elevation of the elastase level, which might be correlated with leukocytosis after SAH. The elastase level decreased to the control level 3 months after the onset of SAH . No significant difference in the elastase:^-antitrypsin and elastase:a2-macroglobulin ratios was observed between the patients with unruptured aneurysms and the controls. C O N C L U S IO N : These results do not support the hypothesis that a plasma protease-antiprotease imbalance is a potential marker to predict the formation of saccular cerebral aneurysms. The increase in plasma elastase levels in patients with ruptured...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199907000-00010
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:We examined the hypothesis that a plasma protease-antiprotease imbalance contributes to the formation of saccular cerebral aneurysms and the suggestion that the assay of these enzymes might be a screening tool for people at higher risk for aneurysm formation.METHODS:From June 1997 through May 1998, the plasma leukocyte elastase, which is an important proteolytic enzyme, and α2-antitrypsin and α2-macroglobulin, which are important antiproteolytic enzyme plasma proteins, were examined in 18 patients with ruptured aneurysms, 9 patients with unruptured aneurysms, and 22 controlsRESULTS:The elastase:α1-antitrypsin ratio and the elastase:α2-macroglobulin ratios were significantly higher in patients with ruptured aneurysms within 24 hours after subarachnoid hemorrhage (SAH) than in the controls. The protease-antiprotease imbalance depended on the elevation of the elastase level, which might be correlated with leukocytosis after SAH. The elastase level decreased to the control level 3 months after the onset of SAH. No significant difference in the elastase:α2-antitrypsin and elastase:a2-macroglobulin ratios was observed between the patients with unruptured aneurysms and the controls.CONCLUSION:These results do not support the hypothesis that a plasma protease-antiprotease imbalance is a potential marker to predict the formation of saccular cerebral aneurysms. The increase in plasma elastase levels in patients with ruptured aneurysms might be attributable to leukocytosis after SAH.

Journal

NeurosurgeryOxford University Press

Published: Jul 1, 1999

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