trypsinogen and Kidney-Diseases

Topics: Amino Acid Metabolism, Inborn Errors; Amylases; Child, Preschool; Cholecystokinin; Cystic Fibrosis; Dicloxacillin; Humans; Infant; Infant, Newborn; Kidney Diseases; Lipase; Lipid Metabolism, Inborn Errors; Pancreas; Pancreatic Cyst; Pancreatic Diseases; Pancreatic Extracts; Prognosis; Secretin; Triglycerides; Trypsinogen; Uric Acid

A simple method for the purification of anionic and cationic trypsinogen and trypsin from human pancreatic juice applying affinity chromatography on aprotinin coupled Sepharose is described together with the N-terminal amino acid sequences for both trypsinogens. In addition, enzyme-linked immunoabsorbent assay (ELISA) methods for the determination of anionic and cationic trypsin-like immunoreactivity (irAT and irCT) are described. Normal serum levels are 21.3 +/- 7.4 micrograms/l and 27.8 +/- 9.0 microgram/l for irAT and irCT respectively and the accuracy of these assays is 6-10%. In our population, the normal ratio between irCT and irAT in serum is 1.36 +/- 0.42. In normal serum trypsin-like immunoreactivity consists solely of trypsinogen. In acute pancreatitis there is an increase over normal of both irAT and irCT with a proportionally greater increase in irAT than irCT. Similar changes are also found in uremic patients.

Topics: Acute Disease; Amino Acid Sequence; Anions; Cations; Chromatography, Affinity; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Humans; Kidney Diseases; Molecular Sequence Data; Molecular Weight; Pancreatic Juice; Pancreatic Neoplasms; Pancreatitis; Trypsin; Trypsin Inhibitors; Trypsinogen

In order to investigate the role of circulating free trypsinogen and renal tubular dysfunction in affecting trypsin plasma-urine transfer, serum immunoreactive trypsin (IRT), its urinary output, IRT molecular size distribution, filtrable immunoreactive trypsin, gamma-glutamyltransferase and alpha-glucosidase outputs were studied in 6 control subjects, 9 patients with pancreatic cancer and 15 with chronic pancreatitis. The majority of immunoreactivity was always eluted at a molecular weight of about 24,000 and might therefore be considered as free trypsinogen. Variable amounts of IRT at higher molecular weights, possibly represented by trypsin-inhibitor complexes, were also detected. Increasing IRT levels were generally accounted for by free trypsinogen, regardless of the nature of the disease. Unlike serum free trypsinogen levels, renal tubular damage, evaluated by means of the excretion of two high-molecular weight urinary enzymes, seems to play a prominent role in explaining trypsin plasma-urine transfer.

Topics: Adolescent; Adult; Aged; alpha-Glucosidases; Carcinoma, Intraductal, Noninfiltrating; Chronic Disease; Female; gamma-Glutamyltransferase; Humans; Kidney Diseases; Kidney Tubules; Male; Metabolic Clearance Rate; Middle Aged; Molecular Weight; Pancreatic Neoplasms; Pancreatitis; Trypsin; Trypsinogen