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The intricate cause of the aging process in humans and animals, at present a matter of intense speculation, has given rise to many theories. Despite its uncertain cause, aging constitutes the most significant and universal problem confronting physicians today. Age-related physiologic deterioration and age-associated diseases are of immense concern to physicians because of the "old-age boom" anticipated in the first part of the twenty-first century. Biomedical research achievements in the twentieth century have permitted more persons to approach the fixed upper limit of the human lifespan. We discuss the functional decline of the aging heart and the underlying mechanisms of that decline; quantitative and qualitative changes in the immune system; and normal aging of the human brain contrasted to the brain changes seen in Alzheimer disease. With our growing geriatric population, we greatly need to increase our understanding of both the causes of human aging and the goals of gerontology and geriatrics and to expand research into the significant problem of Alzheimer disease.

Carboxypeptidase B (peptidyl- l -lysine(- l -arginine) hydrolase, EC 3.4.12.3) has been isolated and purified to apparent homogeneity from activated extracts of human pancreas tissue. The purified enzyme has been shown to be a single polypeptide of 34 000 daltons. In this respect the enzyme from pancreatic tissue, designated native human carboxypeptidase B, differs from the two forms present in human pancreatic juice (fractions I and II), both of which are composed of two polypeptides of approximately 24 000 and 9000 daltons. In addition, the three forms of human carboxypeptidase B differ in electrophoretic mobility in polyacrylamide gel electrophoresis and in chromatographic behavior on DEAE-cellulose. Two immunological methods, micro-complement fixation and radioimmunoassay, have shown a high degree of structural similarity between the three forms of human carboxypeptidase B. Micro-complement fixation experiments indicate that the amino acid sequences of the three enzymes differ by less than one percent. In vitro digestion studies have indicated that trypsin alone is sufficient to convert native carboxypeptidase B to carboxypeptidase B II. However, no combination of trypsin, chymotrypsin, and/or elastase was capable of converting native carboxypeptidase B to carboxypeptidase B I in vitro.

The degradation of 125I-labeled parathyroid hormone in vitro has been investigated in order to test the hypothesis that proteolytic degradation of PTH may be related to the hypocalcemia associated with acute pancreatitis. A polyacrylamide gel electrophoresis technique has been employed to separate bovine PTH (1-84) from lower molecular weight peptides produced by proteolytic cleavage. It has been demonstrated that trypsin bound to the plasma protease inhibitor α2-macroglobulin rapidly degrades PTH and destroys its biological activity in vitro in a kidney cortex adenyl cyclase assay system. Substantial PTH degrading activity was also detected in serum samples obtained from nine patients with severe acute pancreatitis. In contrast, significant PTH degradation could not be detected in normal serum or plasma. Furthermore, no degradation was observed with sera from two patients with mild pancreatitis due to biliary tract stones or four patients with hyperamylasemia but no evidence of pancreatic disease...

The secretion of amylase and trypsinogen from isolated rat pancreatic acini was greatly stimulated by 3–25 mM nicotine. In the presence of 12.5 mM nicotine, a concentration used in the study, amylase and trypsinogen release was increased by 95 and 400%, respectively, when compared with the corresponding control and showed further a preferential release of trypsinogen. A 90-min time course release of the enzymes revealed that in the presence of nicotine trypsinogen-to-amylase ratio remained two- to threefold elevated over that of the control throughout the incubation period. The nicotine-induced stimulation of trypsinogen and amylase release from the acini could not be blocked by 2.5 mM cycloheximide, a dose that inhibited overall acinar protein synthesis by about 85%. When isolated acini were incubated with [3H]leucine in the presence of nicotine, the released proteins revealed a fourfold higher radioactivity (dpm/microgram acinar DNA) than the control. Cycloheximide dramatically decreased this increment. The rate of release of 3H-pulse-labeled proteins from the acini was greatly accelerated by nicotine. It is concluded that nicotine stimulates the secretion of preformed zymogen granules and newly synthesized proteins from dispersed rat pancreatic acini in vitro.

The secretion of amylase, trypsinogen, chymotrypsinogen and proelastase from isolated rat dispersed pancreatic acini was investigated in the absence (basal) and presence of two concentrations of CCK 8 (50 and 500 pM), carbachol (2.5 and 7.5 μM) and secretin (10 nM and 1 μM). The unstimulated (basal) rate of release of each of the digestive enzymes was essentially the same. However, whereas both doses of CCK 8 and carbachol caused a preferential release of chymotrypsinogen over that of amylase and trypsinogen, the magnitude of stimulated release of amylase, trypsinogen and chymotrypsinogen by 1 μM secretin was found to be similar for each of the enzymes. Furthermore, none of the secretagogues caused a significant enhancement in proelastase release. The present data demonstrate that whereas CCK 8 and carbachol induce a greater release of chymotrypsinogen over that of amylase or trypsinogen, release of all three enzymes was equally stimulated by secretin from isolated pancreatic acini.

This article summarizes the age-related structural and functional alterations in the esophagus, stomach, small and large intestines, liver, pancreas, and vermiform appendix. Also considered are the possible relationships of these changes with the disturbance of homeostatic mechanisms and proneness to certain diseases in the aged.

The kinetics and mechanism of clearance of pancreatic cationic and anionic trypsinogens from the circulation have been investigated in a rat model. 125I-labeled rat cationic trypsinogen is cleared from the bloodstream with a half-life of approximately 4 min. In contrast, 125I-labeled rat anionic trypsinogen has a half-life in the circulation of approximately 55–60 min. The major site of clearance for both enzymes is the kidney. Neither zymogen binds to plasma proteins to a significant extent over a period of three half-lives. The relative rates of clearance of these zymogens from the circulation appears to correlate with their respective isoelectric points.

1. Complex formation of trypsin with alpha2 macroglobulin results in marked changes of the Michaelis-Menten constant, pH optimum and sensitivity to ionic strength in a system using N-carbobenzoxy-glycylglycyl-L-arginine-2-naphthylamide as substrate. 2. In contrasts to the inhibition (50%) observed when alpha2 macroglobulin-bound trypsin is assayed under conditions optimal for the free enzyme, there is minimal reduction of activity when determinations are performed at a substrate concentration and pH optimal for the bound enzyme. 3. The changes in substrate concentration and ionic environment required for maximum activity of alpha2 macroglobulin-bound trypsin are similar to those observed with enzymes embedded in polyelectrolyte matrices and may reflect alterations in the microenvironment of the enzyme resulting from conformational changes of the macromolecule during interaction with trypsin. 4. Enzymatic activity of trypsin towards casein is greatly reduced by alpha2 macroglobulin, even under assay conditions optimal for the bound enzyme, confirming previous findings that access to the active center for high-molecular weight substrates is sterically hindered by alpha2 macroglobulin.

Exposure of isolated rat dispersed pancreatic acini to increasing concentrations (10 to 1000 ng/ml) of purified exotoxin-A from Pseudomonas aeruginosa resulted in a progressive inhibition of 3H-leucine incorporation into “cellular” (those remaining in the cells) and “secretory” (those released into the medium) proteins. With each concentration of exotoxin-A, magnitude of reduction was found to be greater for the “secretory” proteins than that observed for the “cellular” proteins. Thus, in the presence of 250 ng/ml of exotoxin-A, a dose that produced maximal inhibition in protein synthesis, 3H-leucine incorporation into “cellular” and “secretory” proteins was found to be decreased by about 19 and 50%, respectively, when compared with the corresponding basal controls. Release of trypsinogen, chymotrypsinogen and amylase from the isolated pancreatic acini was also inhibited by high doses of exotoxin-A. However, whereas the exotoxin concentration of 1000 ng/ml, caused a near complete inhibition of chymotrypsinogen release, trypsinogen and amylase secretion were decreased by 40 and 50%, respectively. It is concluded that in isolated pancreatic acini, exotoxin-A inhibits the synthesis and secretion of proteins.

A rat model has been employed to study the mechanism of clearance of pancreatic proelastase from the circulation. The clearance of 125I-labeled proelastase was shown to be biphasic, with a half-life for clearance of free 25,000-dalton proelastase of approximately 7–10 min. A slow component of clearance possibly due to proelastase associated with plasma protease inhibitors was also observed. At 10 min after injection of 125I-labeled proelastase into the circulation, the major fraction of the 125I was found to be localized in the kidney. However, appearance of 125I in urine is slow, with 16 h being required for excretion of 50% of the injected 125I as acid-soluble material. Subcellular localization experiments on homogenates of kidneys removed at 10 min postinjection revealed that the majority of the 125I-labeled material was associated with the mitochondrial and lysosomal fraction. Sucrose-gradient centrifugation studies of this fraction demonstrated that the labeled material passes from the membrane fraction to the lysosomal fraction with time. These data demonstrate that the rat kidney constitutes the major site for both circulatory clearance and catabolism of circulating pancreatic proelastase.

The N-terminal sixteen residues of the amino acid sequence of reduced and alkylated human pancreatic proelastase 2 have been established, and N-terminal amino acid residue has been shown to be carboxymethylcysteine. A peptide containing an amino acid sequence corresponding to the first twelve residues of proelastase 2 was isolated following activation of proelastase 2 with trypsin, performic acid oxidation, and gel filtration. This peptide was not released prior to performic acid oxidation, suggesting that it remains attached to the major peptide chain via a disulfide bond containing the N-terminal half-cysteine in a manner similar to that found for chymotrypsinogens. However, the amino acid sequence of the activation peptide is not strongly homologous to either porcine chymotrypsinogen A or porcine proelastase 1.

The action of Pseudomonas aeruginosa cytotoxin on isolated pancreatic acini was investigated. The release of amylase and serine protease zymogens from the isolated rat pancreatic acini was induced with increasing amounts of cytotoxin in vitro. The stimulated release of amylase reached 30% of total cellular content with 100 micrograms/mL of the purified cytotoxin. The induced release of amylase, trypsinogen, proelastase, and chymotrypsinogen reached the maximum after 75 minutes of incubation while lactate dehydrogenase began to appear after 15 minutes of incubation with a secondary biphasic increase at 75 min of incubation. The concentrations of acinar mRNAs of amylase, trypsinogen, proelastase, and chymotrypsinogen, as measured by dot-blot hybridization with the cloned cDNAs of amylase, trypsinogen I, proelastase II, and chymotrypsinogen B of the rat, decreased with time and were significantly lower than in the untreated acini. It is concluded that cytotoxin stimulates the release of amylase and protease zymogens with a concomitant increase in membrane permeability and a decrease of cellular mRNA levels. The inhibition of gene expression is attributable merely to a generalized toxic effect upon cellular metabolism.

Human pancreatic cationic trypsinogen has been purified to homogenity from an acetone powder of pancreatic tissue. After an initial ion exchange chromatography step on sulfopropyl (SP)-Sephadex at pH 2.6, cationic trypsinogen was separated from the majority of trypsin activity by passage through an affinity column of lima bean trypsin inhibitor-agarose at high ionic strength. The zymogen was then further purified by affinity chromatography on the same material at low ionic strength. Highly purified trypsinogen was resolved from containing chymotrypsinogen by ion exchange chromatography on SP-Sephadex at pH 6.0. The purified zymogen was shown to be homogeneous by polyacrylamide gel electrophoresis at pH 2.1 and at pH 4.3 as well as by discontinuous sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The autoactivation of human trypsinogen was investigated at pH 5.6 and at pH 8.0. The rate of autoactivation of the human zymogen is rapid at pH 5.6 and is maximal in approximately 1 mM Ca2+. These results are in marked contrast to those previously reported for autoactivation of bovine trypsinogen, which is extremely slow at pH 5.6 and which shows a dependence on at least 50 mM Ca2+ for maximum rate of activation (MacDonald, M. R., AND Kunitz, M. (1941) J. Gen. Physiol. 25, 53-73).

A specific radioimmunoassay for human pancreatic anionic trypsin has been developed. The trypsin employed as radioiodinated tracer in the assay was inactivated with tosyl-L-lysine chloromethyl ketone in order to prevent binding of the tracer to the serum inhibitors alpha1-antitrypsin and alpha2-macroglobulin. A normal serum level of immunoreactive anionic trypsin of 5.45 ng/ml was determined. The results of experiments in which serum was fractionated by Sephadex G-200 gel filtration suggest that essentially all of the immunoreactive material in normal human serum is trypsinogen. This finding implies that a small fraction of the zymogens synthesized in the pancreas are released directly into the circulation.

Human carboxypeptidase B fraction II has been purified from pancreatic juice by DEAE-‘Sephadex’ chromatography, isoelectric focusing, and ‘Sephadex’ G-100 gel filtration. The enzyme has been characterized by analytical polyacrylamide disc-gel electrophoresis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, amino acid analysis, K m determination, molecular weight determination on ‘Sephadex’ G-100, zinc analysis, and inhibition by metal chelating agents. Human carboxypeptidase B fraction II appeared homogeneous in analytical polyacrylamide disc-gel electrophoresis, but showed two components of 23,500 and 9,200 daltons in sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Zinc analysis revealed 0.96 gram atoms of zinc per mole of enzyme, and a K m of 65 ± 3 μ M was determined for hydrolysis of hippuryl- l -arginine.

Acetaldehyde inhibited both amylase secretion induced by maximal concentrations (300 pM) of cholecystokinin octapeptide and the binding of radioiodinated cholecystokinin to receptors on isolated rat pancreatic acini. This inhibition was concentration dependent (10 mM to 1M for amylase secretion and 100 mM to 1M for binding). However, a correlation between the two inhibitory effects could not be obtained. Furthermore, the inhibitory effects were not reversible. Acetaldehyde did not alter the basal amylase secretion between 6 and 45 mM concentrations. However, 60, 100 and 300 mM acetaldehyde significantly decreased basal amylase secretion; no significant change in amylase secretion was observed at 600 mM and 1M. Higher concentrations of acetaldehyde produced a 2- to 10-fold increase in basal amylase secretion. 51 Cr release from prelabeled acini revealed no significant cell membrane damage between 10 and 600 mM acetaldehyde. These data suggest that acetaldehyde inhibition of cholecystokinin-induced amylase secretion is intracellularly mediated.

Exposure of isolated dispersed pancreatic acini to increasing concentrations of ethanol (5 to 500 m m ) or acetaldehyde (0.5 to 100 m m ) produced a progressive inhibition of [ 3 H ] leucine incorporation into both “cellular” (those remaining in the cell) and “secretory” (those released into the medium) proteins. Whereas 500 m m ethanol caused 90–95% inhibition in the synthesis of “cellular” and “secretory” proteins, the concentration of acetaldehyde needed to produce a similar inhibition was found to be 50 m m . All subsequent experiments were performed with 12.5 m m acetaldehyde, a concentration that consistently inhibited acinar protein synthesis by about 50%. The acetaldehyde-mediated inhibition of acinar protein synthesis was partially normalized when this metabolite was removed after 30 min during a 90-min incubation period. In the presence of acetaldehyde, the secretion of 3 H - pulse - labeled proteins , but not amylase, trypsinogen, or chymotrypsinogen, was greatly depressed. Acetaldehyde also caused a marked reduction in [ 3 H ] uridine incorporation into acinar RNA. The entry of [ 3 H ] uridine , [ 3 H ] leucine , and [ 3 H ] aminoisobutyric acid into isolated acini was found to be slightly (15–25%) decreased by acetaldehyde. It is concluded that acetaldehyde exerts a direct toxic effect on isolated dispersed pancreatic acini as evidenced by diminution of both protein and RNA synthesis and decreased secretion of the newly synthesized proteins. This inhibitory effect of acetaldehyde could be partially reversed.

Human α1-protease inhibitor which is an important plasma protein, contains a methionine residue at its reactive site. A model synthetic peptide substrate, succinyl-L-alanyl-L-alanyl-L-prolyl-L-methionine p-nitroanilide, has been employed to study the effect of oxidation of methionine on the rate of hydrolysis of this substrate by human elastases. The methionine sulfoxide derivative obtained by mild oxidation of this substrate is hydrolyzed by pancreatic elastase 2 and leukocyte elastase at rates that are 5% and 0.3% of the rates measured for hydrolysis of the parent compound by the respective enzymes. These results suggest that oxidation of the active site methionine residue of human α1-protease inhibitor may decrease the rate of reaction of pancreatic or leukocyte elastase with this inhibitor.

Pancreatic juice from four patients with acute pancreatitis was collected at 4° C from uncomplicated fistulae or by catheterization of the pancreatic duct. The concentration of free trypsin, chymotrypsin, and elastase, as well as the corresponding zymogens in the specimens, was estimated. With the exception of the juice from one patient with a fistula, who secreted zymogens and free chymotrypsin only during the first two postoperative days, all specimens contained free enzymes exclusively, including those specimens obtained by catheter during the period of observation. The apparent lack of pancreatic trypsin inhibitor in the secretions of our patients, and earlier reports of low levels or absence of this inhibitor after abdominal operations, may reflect a prerequisite in the development of acute pancreatitis. In this scheme, the trigger mechanism in the premature activation of pancreatic zymogens may be provided by autoactivation of trypsinogen or its activation by enzymes of the blood-clotting or fibrinolytic systems. Some evidence in support of this hypothesis is presented.

The inactivation of human pancreatic elastase 2 (EC 3.4.21.11) by a series of peptide chloromethyl ketones has been investigated. Among a series of compounds with the structure X-Ala-Ala-Pro-Y-CH2Cl (where X=acetyl-, succinyl-, methylsuccinyl-, or H-), the kinetic parametrs for inhibition of elastas 2 depend markedly on the amino acid (Y) in the P1 position. Succinyl-Ala-Ala-Pro-Leu-CH2Cl was found to be an extremely effective inhibitor of human elastase 2, qith a first-order rate constant for covalent bond formation (k3) of 0.033s-1 and a dissociation constant, Ki, for the enzyme inhibitor complex of 7.4 . 10(-7) M. The second-order rate constant k3/Ki for inhibition of elastase 2 by the analogous compound containing a free amino group in place of the succinyl moiety is 150 times lower than that found for the succinyl or acetyl derivative, suggesting that the presence of a positive charge at this position reduces the proper binding of the inhibitor to the enzyme.

A peak of immunoreactive pancreatic elastase 2 with a molecular weight consistent with that of a complex of elastase 2 and alpha 1-protease inhibitor (also referred to as alpha 1-antitrypsin) can be detected by radioimmunoassay in normal human serum or plasma (Geokas et al., J. Biol. Chem. 252:61-67, 1977). This material has been purified by gel filtration on Sephadex G-200 and by ion-exchange chromatography on DEAE-cellulose. The alpha 1-protease inhibitor-bound immunoreactive elastase 2 has been dissociated by incubation with hydroxylamine, and the resulting immunoreactive product isolated by gel filtration on Sephadex G-100. The dissociated immunoreactive elastase 2 was shown by affinity chromatography on turkey egg white inhibitor-bound agarose, before and after activation by bovine trypsin, to consist only of proelastase 2. A second peak of immunoreactive material associated with the high molecular weight fraction of plasma has been shown to result from a specific interaction of the 125I-labeled phenylmethanesulfonyl-elastase 2 employed as tracer in the radioimmunoassay with alpha 2-macroglobulin, resulting in apparent immunoreactivity. These results demonstrate that all of the detectable immunoreactive pancreatic elastase 2 in normal human plasma is proelastase 2 bound to alpha 1-protease inhibitor.

This study demonstrates that a serine endopeptidase of pancreatic origin (elastase 2) circulates in human blood. A specific and highly sensitive radioimmunoassay has been developed for pancreatic elastase 2 in human serum. The inactivation of elastase 2 employed as radioiodinated tracer with an active site-specific reagent (phenylmethanesulfonyl fluoride) was necessary to prevent its binding by serum alpha1-antitrypsin and alpha2-macroglobulin while maintaining its immunoreactivity. The assay is based upon competition of standard human pancreatic elastase 2 with 125I-labeled phenylmethanesulfonyl elastase 2 for specific antibody binding sites, after which a second antibody precipitation step is used to separate bound from free 125I-labeled phenylmethanesulfonyl elastase 2. The minimum detectable concentration of elastase 2 was 0.9 ng/ml. The average normal fasting serum level determined was 71 ng/ml, approximately 80-fold greater than the minimum detectable amount. The form of radioimmunoassayable elastase 2 in normal human serum has been investigated by gel filtration of serum samples on Sephadex G-200 followed by radioimmunoassay of column fractions. The majority of the immunoreactive elastase 2 is eluted from G-200 in the void volume. While a minor amount of elastase 2 is eluted in a position consistent with alpha1-antitrypsin-elastase 2 complex, no free elastase or free proelastase is detectable. Addition of exogenous elastase 2 to normal serum prior to gel filtration on G-200 produced an increase only in the peak of radioimmunoassayable elastase bound to alpha1-antitrypsin. In vitro experiments have demonstrated that while elastase 2 bound to alpha1-antitrypsin is immunologically reactive, alpha2-macroglobulin-bound elastase 2 cross-reacts less than 2% in this radioimmunoassay. The assay has been shown to be specific for elastase 2. Human pancreatic elastase 1, anionic trypsin, chymotrypsin I, and chymotrypsin II do not cross-react in this assay system. The major advantages of this radioimmunoassay over enzymatic assays are its high sensitivity and ability to measure the enzyme in terms of its total protein concentration.

Two proteases with elastolytic activity (elastases 1 and 2) have been isolated from activated extracts of human pancreatic tissue. The purification procedure for both elastases included ammonium sulfate fractionation followed by ion-exchange chromatography on CM-Sephadex C-50. Elastase 1 was further purified by chromatography on DEAE-Sephadex A-50. The homogeneity of both enzymes was demonstrated by Sephadex G-75 gel filtration, analytical polyacrylamide disc gel electrophoresis at pH 2.3, 4.5, and 8.3, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis at pH 8.3. Both enzymes hydrolyzed undyed elastin as well as Remazol brilliant blue elastin and Congo red elastin. Activities and kinetic parameters using several synthetic substrates are also reported. The enzymes were further characterized in terms of molecular weight, amino acid composition, and N-terminal and penultimate amino acid residues. Their inhibition by the human serum protease inhibitors alpha2-macroglobulin and alpha1-antitrypsin was also studied. Elastase 1 appears to be very similar to human protease E (Mallory, P. A., and Travis, J. (1975), Biochemistry 14, 722). Elastase 2 is distinct from all human pancreatic proteases which have been characterized to date.

In a previous report [Largman, C., Brodrick, J.W., Geokas, M.C., Sischo, W.M., & Johnson, J.H. (1979) J. Biol. Chem. 254, 8516-8523] it was demonstrated that human proelastase 2 and alpha 1-protease inhibitor react slowly to form a complex that is stable to denaturation with sodium dodecyl sulfate and beta-mercaptoethanol and that the zymogen can be recovered from the isolated complex following dissociation by hydroxylamine. The present report demonstrates that bovine chymotrypsinogen A reacts with human alpha 1-protease inhibitor in a very similar manner. The rate of complex formation was measured by two methods. In the first, the reaction was followed by determining the loss of the inhibitory activity of alpha 1-protease inhibitor as a function of time. A second-order rate constant for complex formation formation (pH 7.6, 36 degrees C) of 12.9 +/- 2.4 M-1s-1 was obtained. In the second procedure, the reaction of fluorescein isothiocyanate labeled chymotrypsinogen A with alpha 1-protease inhibitor was measured by fluorescence polarization. A second-order rate constant (pH 7.6, 37 degrees C) of 13.9 +/- 2.1 M-1s-1 was obtained. The rate of complex formation is approximately 10(-5) of that measured for the reaction of bovine chymotrypsin with alpha 1-protease inhibitor. Dissociation of the complex was not observed after dilution or the addition of excess bovine alpha-chymotrypsin. As judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis experiments, human chymotrypsinogens I and II react with alpha 1-protease inhibitor at rates that are approximatley equivalent to that determined for bovine chymotrypsinogen A. In contrast, bovine trypsinogen reacts very slowly with alpha 1-protease inhibitor, at a rate that is at most 10(-2) of that of bovine chymotrypsinogen A. These results suggest that zymogens react with alpha 1-protease inhibitor by virtue of partially formed active sites and that the potential active-site specificity of the zymogen in part determines the rate of complex formation.

Concentrations of plasma immunoreactive anionic and cationic trypsin(ogen) were monitored in unanesthetized dogs to investigate diurnal variation, response to food intake, and effects of cholecystokinin octapeptide (CCK-8) plus secretin administration. Identical meals were consumed at the beginning and end of a 24-h period. Plasma levels of both trypsin(ogen)s increased significantly within 30 min of feeding. Second-meal responses were much larger than those following the first meal. Plasma cationic trypsin(ogen) was also elevated during the normal feeding period when food was withheld and dogs in adjacent cages were fed. Small, irregular variations in plasma trypsin(ogen)s occurred during the interdigestive period when blood was sampled every 2 h. CCK-8 plus secretin, in doses shown previously to stimulate exocrine secretion of enzymes submaximally, increased plasma levels of both trypsin(ogen)s dose dependently. Most (greater than 80%) of the immunoreactive cationic trypsin(ogen) in plasma before and after feeding and following CCK-8 was in proenzyme form. We conclude that plasma levels of pancreatic trypsinogens are increased by food intake and low doses of CCK-8. Furthermore, cephalic mechanisms appear to play an important role in mediating the response to food intake.

The acute and chronic effects of ethanol on pancreatic structure and function are discussed. Acute necrotizing, acute edematous, acute relapsing, chronic relapsing, and painless pancreatitis have an established association with ethanol abuse. The management of these disorders is outlined.

HARPEL and Mosesson1 observed that α2-macroglobulin-bound trypsin hydrolysed low molecular weight ester and amide substrates at rates comparable with those of free protease, but degradation of high molecular weight proteins was markedly inhibited. To account for this finding, Barrett and Starkey2 introduced the novel concept of steric entrapment of endopeptidases by α2-macroglobulin. Neurath and Walsh3 have recently reviewed the role of proteolytic enzymes in the conversion of a variety of enzymes, hormones, and other physiologically active proteins from inactive precursors to active forms by limited proteolysis. Many of these physiologically active proteins exist in the bloodstream in both precursor and active forms. We report here that proinsulin, a large polypeptide of 9,000 molecular weight, is rapidly hydrolysed by α2-macroglobulin-bound trypsin. This finding suggests that pro-teases bound to α2-macroglobulin may be involved in limited proteolytic cleavage associated with activation of precursor molecules as well as the degradation of biologically active polypeptides in the circulation.

Previous studies on the pathogenesis of abdominal aortic aneurysms have shown both elastase-like activity in the aortic wall and a decreased elastin content. The present study, using specific radioimmunoassays for pancreatic elastase 2 (IRE2) and cationic trypsin(ogen) (IRCT), investigates the concentrations of these proteases which are known to circulate in blood, in abdominal aortic aneurysms. Aortic specimens were obtained from 32 patients with aneurysms and 21 patients with atherosclerotic occlusive disease. Aortic tissue, obtained at autopsy from young adults, served as controls. Elastase-like activity was 300% and 800% higher, respectively, in aortic homogenates from aneurysms in comparison to occlusive disease and control aortic tissue. This was associated with 1.4-fold higher level of IRE2 and 2.7-fold higher levels of IRCT as compared to occlusive disease. Although there was no significant difference in the aortic collagen concentration among all 3 groups, the elastin content of aneurysmal aorta was 85% and 74% lower, respectively, in comparison to control and occlusive aorta. The results of this investigation demonstrate the presence of pancreatic elastase 2 and cationic trypsin(ogen) in abdominal aortic aneurysmal tissue and suggest that circulating pancreatic proteases contribute to the pathophysiology of aneurysms of the infrarenal aorta.

A new substrate for chymotrypsin, succinyl-Ala—Ala—Pro—Phe-p-nitroanilide has been synthesized. Kinetic analysis of the hydrolysis of this peptide by bovine chymotrypsin gave a Km of 0.043 m m and akcat of 45 s−1. This substrate is readily soluble and stable to hydrolysis in Tris buffer at pH 8. Chymotrypsin levels down to 1.0 ng can be rapidly determined spectrophotometrically.

The early differentiation between acute edematous and hemorrhagic pancreatitis is crucial for prognosis and treatment. By testing serum and ascites or pleural effusion for methemalbumin th...

Total protein, alpha1-antitrypsin, alpha2-macroglobulin, amylase, methemalbumin, tryptic amidase activity, radioimmunoassayable elastase 2, and three lysosomal hydrolases were determined in the ascites fluid from patients with acute pancreatitis. In eight patients methemalbumin was detected in ascites and serum, supporting the diagnosis of hemorrhagic pancreatitis. Significant levels (4-45 microgram/ml) of tryptic amidase activity were detected in ascites samples from all patients. Evidence is presented which demonstrates that the tryptic amidase activity is due to alpha2-macroglobulin-bound trypsin. Pancreatic elastase 2, determined with a new sensitive and specific radioimmunoassay, ranged from 400 to 2100 ng/ml in serum and from 650 to 4460 ng/ml in ascites fluid. Substantial amounts of alpha2-macroglobulin-bound trypsin and elastase 2, entering the circulation from the peritoneal cavity, might be responsible for certain serious complications seen in acute pancreatitis. However, with the exception of serum calcium and methemalbumin and the ascites fluid methemalbumin and total protein, none of the biochemical parameters studied showed a distinct correlation with the patient's outcome.

The levels of pancreatic digestive enzymes, lysosomal hydrolases, and protease inhibitors were evaluated in ascites fluid from 24 patients with acute pancreatitis diagnosed as alcoholic, gallstone-induced, or idiopathic. In this group the concentrations of amylase (354 +/- 98 ng/ml), immunoreactive cationic trypsinogen (1840 +/- 238 ng/ml), and immunoreactive elastase 2 (1492 +/- 262 ng/ml) were greatly elevated in comparison to the corresponding serum values. Enzyme levels in ascites from the idiopathic pancreatitis group tended to be higher than the levels from the other two groups. Activity of acid phosphatase and beta-glucuronidase was significantly higher in ascites compared to serum in all groups. On the other hand, levels of immunoreactive alpha 1-protease inhibitor and alpha 2-macroglobulin in ascites fluid were about half the average concentrations reported for normal serum. Significant amounts of tryptic amidase activity (61.7 +/- 13.7 micrograms/ml) were observed, indicating a trypsin-alpha 2-macroglobulin complex. These data indicate an imbalance in the protease-to-inhibitor ratio in ascites fluid from patients with acute pancreatitis. Coupled with elevated ribonuclease activity (27.4 +/- 3.4 units), a positive methemalbumin test in 23 of 24 patients (1.1 +/- 0.4 mg hematin/100 ml), and an average protein concentration of 4.0 +/- 0.2 g/100 ml, these observations demonstrate that abdominal paracentesis and the biochemical analyses of ascites fluid provide useful information related to the biochemical events in acute pancreatitis and may be useful in the diagnosis of difficult cases, but their predictive value of severity remains to be established.

Publisher Summary This chapter describes the radioimmunoassay determination of circulating pancreatic endopeptidases. The radioimmunoassay technique has been applied to the detection of pancreatic endopeptidases in plasma and serum. These studies have demonstrated that, while the bulk of the digestive enzymes enter the pancreatic ductal system, a small fraction enters the bloodstream. The application of the radioimmunoassay methodology has permitted the characterization of the circulating molecular forms of human cationic trypsin, anionic trypsin, elastase 2, and chymotrypsin. The ability to quantitate the levels of total immunoreactive trypsin in biological fluids as well as to identify the molecular forms of trypsin present in the sample has resulted in several reports of clinical applications for the radioimmunoassay of cationic trypsin. The lack of cross-reactivity in the radioimmunoassay of a given pancreatic endopeptidase, with the same protease, from other mammalian species, demonstrates that a separate radioimmunoassay must be developed for each enzyme to be investigated. The lack of cross-reactivity between the various pancreatic endopeptidases of the same species permits the specific identification of each protease in a biological sample.

The kidney has previously been shown to be a major site for the plasma clearance of pancreatic trypsinogens in the rat. This study investigated plasma concentrations of anionic and cationic trypsinogen in chronic renal failure and anephric patients. Plasma concentrations were significantly elevated in both groups of patients. Hemodialysis did not change their plasma levels. The plasma levels of anionic and cationic trypsinogens were highly correlated in patients and normal subjects; however, the relative concentrations of anionic trypsinogen were significantly higher in renal failure patients. This suggests that in patients with renal failure the secondary clearance mechanisms for these plasma proteins more efficiently clear cationic molecules. In normal dogs, intravenous infusion of synthetic octapeptide of cholecystokinin (CCK-8) resulted in small transitory increases in plasma trypsinogen levels. After nephrectomy, basal levels of anionic and cationic trypsinogen were elevated, and intravenous infusion of CCK-8 resulted in prolonged, high levels of plasma trypsinogens.

Chronic renal failure (CRF) was produced in female Sprague-Dawley rats by 7/8 nephrectomy. Creatinine clearance was depressed significantly (P less than 0.005) and blood urea nitrogen (BUN) increased in CRF rats when compared with the sham-operated (S) controls. CRF caused no apparent change in body weight but significantly increased pancreatic weight as well as increased DNA, RNA, and protein content. Pancreatic protein-to-DNA and RNA-to-DNA ratios were also found to be significantly higher in CRF rats than in the S controls. Trypsin-like activity and immunoreactive cationic trypsinogen levels were both increased in the pancreas of CRF rats, but not in their serum. On the other hand, protease inhibitory activity in the pancreas and serum was significantly decreased by CRF. The ability of the dispersed pancreatic acini isolated from CRF rats to incorporate [3H]-leucine into protein, in the absence and presence of 0.25 nM cholecystokinin octapeptide (CCK-8), was found to be lower than in the controls. Furthermore, discharge of both trypsinogen and chymotrypsinogen induced by CCK-8 was markedly reduced from acini of CRF rats as compared with the S controls. In contrast, lactate dehydrogenase (LDH) was released more readily from pancreatic acini of CRF. It is concluded that mild CRF produces hyperplasia and hypertrophy of the pancreas and lowers the responsiveness of acini to CCK-8 with respect to synthesis and secretion of proteins.

The role of extracellular Ca 2+ in pancreatic acinar membrane damage (cellular injury) by nicotine, membrane-active agents (mellitin, snake venom and Ca 2+ ionophore A23187) and secretagogues (CCK-8 and secretin) was investigated. Freshly isolated dispersed pancreatic acini from 18 h fasted adult rats were incubated with one of the aforementioned agents, in the absence and presence of Ca 2+ . Cellular injury was assessed by measuring the release of pulse-labeled 51 Cr and LDH. In addition, release of amylase, trypsinogen and chymotrypsinogen was also determined. In the absence of Ca 2+ nicotine (6 mM) caused a profound release of 51 Cr and LDH as well as amylase, trypsinogen and chymotrypsinogen from the isolated pancreatic acini. Release of these enzymes and 51 Cr decreased sharply with addition of increasing concentrations (0.25-5 mM) of Ca 2+ . Release of 51 Cr and amylase by snake venom (50 μg/ml) was found to be 100 and 25% higher, respectively,in the absence of Ca than in its presence. On the other hand, the Ca 2+ ionophore A23187 (7 μg/ml) was found to be effective in releasing 51 Cr and amylase only in the presence of Ca 2+ . CCK-8, (0.25nM), secretin (1μM) and mellitin (0.5 μg/ml) although significantly stimulated amylase secretion (225–350%) in the presence of Ca 2+ , none of the agents induced 51 Cr release from acini, either in the absence or in the presence of extracellular Ca 2+ . It is concluded that the extracellular Ca 2+ plays no specific role in cytotoxic injury in isolated pancreatic acini.

A 1:1 stoichiometry of inhibition of human pancreatic elastase 2 by human α 1 -antitrypsin has been determined. The molar binding ratio was calculated using the results of a titration curve for elastase 2 inhibition by α 1 -antitrypsin, an experimentally determined concentration of active sites in human elastase 2, and an extinction coefficient calculated from ultracentrifugation studies using interference optics.

The mechanisms of pancreatic adaptation to dietary changes and whether these changes are reflected in the serum are not fully understood. The present study investigates secretagogue-induced release of digestive enzymes from dispersed pancreatic acini as well as the concentrations of these enzymes in serum and pancreas after adaptation to a high protein diet. Adult rats were fed an 8.5% casein diet ad libitum. After 14 d the rats were divided into three groups and fed isoenergetic diets constituting 8.5, 24 or 40% protein for an additional 6 d. No significant differences in final body weight or pancreatic weight were observed among the groups of rats. Rats adapted to the 40% protein diet showed significantly higher trypsin and chymotrypsin activity in pancreatic homogenates than rats fed the 8.5% protein diet. These changes in pancreatic enzyme content were not reflected in serum. Pancreatic acini isolated from the 8.5% protein group showed a markedly reduced responsiveness to cholecystokinin (CCK-8), secretin- and carbachol-induced enzyme release in comparison to the other two dietary groups, although basal enzyme release was the same in all groups. These results indicate that the secretion of pancreatic enzymes following a physiological stimulus is affected by a low protein, high carbohydrate diet.

The molecular forms of immunoreactive pancreatic cationic trypsin in sera of patients with acute pancreatic inflammation have been characterized using a radioimmunoassay technique that is capable of detecting trypsinogen as well as trypsin bound to alpha 1-antitrypsin. Trypsin bound to alpha 2-macroglobulin is not immunoreactive under normal assay conditions. However, alpha 2-macroglobulin-bound trypsin can be detected after gel filtration of serum on Bio-Gel A-0.5 m and acid treatment of column fractions. The average serum level of immunoreactive cationic trypsin from 20 patients with acute pancreatic inflammation was 1,590 ng/ml. An average normal value of 26 ng/ml has been obtained previously. Serum samples from 14 patients with pancreatic inflammation were chromatographed under conditions that resolve trypsinogen, alpha 1-antitrypsin-bound trypsin, and alpha 2-macroglobulin-bound trypsin. In each case, the major portion of the immunoreactive material eluted at a position corresponding to free trypsinogen, while a minor fraction of the immunoreactive material appeared to be trypsin bound to alpha 1-antitrypsin. The zymogen nature of the major peak was confirmed in one case by activation with human enteropeptidase. In 11 of 14 patients, acid treatment of the alpha 2-macroglobulin peak yielded immunoreactive trypsin.

Cholecystokinin octapeptide (CCK 8 )-stimulated amylase release in isolated rat pancreatic acini was inhibited over 30% by 600 mM ethanol. The configuration of the dose-response curve for CCK 8 , however, in the presence of ethanol was similar to that of the control. Amylase release elicited by maximal concentrations of CCK 8 (300 pM) was inhibited by increasing concentrations of ethanol (0.3 to 1.3 M), and this inhibition was concentration dependent. In addition, the binding of [ 125 I]CCK 33 to specific membrane receptors on acini was inhibited by ethanol in a dose-dependent manner. A positive correlation between the inhibitory effects of ethanol on CCK binding and CCK-induced amylase release was observed. Furthermore, these inhibitory effects of ethanol were reversible. Basal amylase release, however, was increased 20–50% by ethanol between the concentrations of 0.3 and 1.3M; higher concentrations caused a leakage of amylase from the acini both in the absence and presence of 300 pMCCK 8 . This is confirmed by 51 Cr release from prelabeled acini which revealed no significant damage to acinar cell membrane between 0.3 and 1.6 M ethanol, but significant damage to acini at higher concentrations. These data suggest that the 600 mM ethanol-induced inhibition of CCK action in acini is due to reversible perturbation of the acinar cell membrane.

Summary: Plasma immunoreactive cationic trypsin(ogen) levels were determined in 32 control subjects and 43 patients with varying degrees of pancreatic insufficiency including 35 with cystic fibrosis (CF) and eight with Shwachman's syndrome. In six CF infants less than 2 years of age, plasma trypsin(ogen) levels were significantly elevated (97.3 ± 62.2 ng/ml) above the normal range for nine controls (7.0 ± 5.9 ng/ml; P < 0.025). Four of these infants had steatorrhea, three of whom had undetectable duodenal trypsin activity after stimulation with secretin-cholecystokinin. In two CF infants, molecular size fractionation by gel filtration of plasma followed by radioimmunoassay of the column fractions demonstrated that trypsinogen was the only immunoreactive species in the circulation. In contrast, in older CF patients with steatorrhea (mean age, 15.3 ± 4.6 years), plasma cationic trypsin(ogen) levels were undetectable or low (1.1 ± 1.7 ng/ml). This finding clearly distinguished them from older CF patients without steatorrhea (mean age, 14.3 ± 3.9 years) in whom cationic trypsin(ogen) levels were significantly higher (23.3 ± 17.6 ng/ml; P < 0.01). The mean trypsin(ogen) concentration in the older CF patients without steatorrhea did not differ from the mean value for 23 normal subjects of similar age. Plasma cationic trypsin(ogen) levels in two Shwachman's patients with steatorrhea (0.19 and 0.86 ng/ml) were significantly lower than the values found in six Shwachman's patients without steatorrhea (5.9 ± 2.3 ng/ml; P < 0.025). Furthermore, in nine older CF patients and eight Shwachman's patients, circulating trypsin(ogen) levels were highly correlated with duodenal trypsin output after secretin-cholecystokinin stimulation (r = 0.946, P < 0.01; r = 0.899, P < 0.01, respectively). These results suggest that in CF infants high levels of circulating trypsin(ogen) persist even in those with complete pancreatic insufficiency. In older CF patients and those with Shwachman's syndrome, however, circulating trypsin(ogen) accurately reflects residual pancreatic function. Speculation: Cystic fibrosis (CF) infants often possess viable but ductally obstructed pancreatic tissue, which may be destroyed with disease progression. The correlation between pancreatic exocrine function and circulating trypsin(ogen) in older CF patients and Shwachman's patients, however, indicates that ductal obstruction is not a prominent feature in these patients.

Daily intraperitoneal injections of acetaldehyde for 10 days to adult rats produced distinct morphological and biochemical changes in the exocrine pancreas, without affecting the body weight, pancreatic weight, and DNA, RNA, and protein content of the pancreas. By electronmicroscopy, although the number and size of the acinar zymogen granules appeared to be the same between the saline- and acetaldehyde-treated rats, the zymogen granules of the latter group showed decreased osmiophilia. Acinar mitochondria of the acetaldehyde-treated rats were found to be slightly swollen with dense granules, and plasma membrane fragments were often seen in the acinar lumen. Administration of acetaldehyde significantly decreased immunoreactive cationic trypsin (ogen) and total amylase activity in the pancreas, but not in the serum, where amylase activity was markedly increased. Basal secretion of amylase, trypsinogen, and chymotrypsinogen from isolated dispersed pancreatic acini of acetaldehyde-treated rats was increased by 40-50%. Nicotine (5-25 mM) induced a profound increase in secretion of the same enzymes from isolated acini of both saline- and acetaldehyde-treated rats, but in the latter group there was a concomitant rise in LDH release. Furthermore, CCK-8 (1 nM), secretin (1 microM), and carbachol (10 microM) either alone or in combination with nicotine (12.5 mM) produced a profound stimulation in amylase, trypsinogen, and chymotrypsinogen secretion from acini of both groups of rats. On the other hand, secretion of 3H-pulse-labeled proteins from isolated acini of acetaldehyde-treated rats by nicotine was decreased by approximately 50% compared with the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

The substrate specificity of human pancreatic elastase 2 was investigated by using a series of peptide p-nitroanilides. The kinetic constants, kcat and Km, for the hydrolysis of these peptides revealed that this serine protease preferentially hydrolyzes peptides containing P1 amino acids which have medium to large hydrophobic side chains, except for those which are disubstituted on the first carbon of the side chain. Thus, human pancreatic elastase 2 appears to be similar in peptide bond specificity to the recently described porcine pancreatic elastase 2 [Gertler, A., Weiss, Y., & Burstein, Y. (1977) Biochemistry 16, 2709] but differs significantly in specificity from porcine elastase 1. The best substrates for human pancreatic elastase 2 were glutaryl-Ala-Ala-Pro-Leu-p nitroanilide and succinyl-Ala-Ala-Pro-Met-p-nitroanilide. However, there was little difference among substrates with leucine, methionine, phenylalanine, tyrosine, norvaline, or norleucine in the P1 position. Changes in the hydrolysis rate of peptides with differing P5 residues indicate that this enzyme has an extended binding site which interacts with at least five residues of peptide substrates. The overall catalytic efficiency of human pancreatic elastase 2 is significantly lower than that of porcine elastase 1 or bovine chymotrypsin with the compounds studied.

The present study investigates the effects of nicotine treatment on exocrine pancreatic function. Adult male, Sprague-Dawley rats received nicotine via a time-release pellet, at a rate of 1.65 μg/min for 3 weeks. At the end of the experimental period, it was observed that although nicotine did not affect final body or pancreatic weight, the activities of amylase, trypsin, and chymotrypsin in pancreatic homogenates from nicotine-treated rats were 51, 29, and 35% higher, respectively, than in controls. Levels of immunoreactive cationic trypsin(ogen) were significantly higher in pancreatic homogenates and serum from nicotine-treated rats as compared with controls. In addition, concentrations of mRNA, encoding for pancreatic amylase, were higher in pancreatic homogenates from the nicotine-treated rats than in controls. In dispersed pancreatic acini isolated from nicotine-treated rats, basal secretion of amylase, trypsinogen, and chymotrypsinogen was 50% higher than controls and enzyme release following CCK-8 (100 p m ), secretin (1 μ m ), and carbachol (7.5 μ m ) stimulation was also significantly higher. These dat indicate that nicotine treatment, at levels comparable to those expected in moderate cigarette smokers, increases the content of digestive enzymes in rat pancreas, as well as their basal and secretagogue-induced release.

1. 1. Current methods for the determination of enterokinase (enteropeptidase, EC 3.4.4.8) involve two steps: (a) activation of trypsinogen under conditions which minimize autocatalytic activation, conversion of trypsinogen to inert products and autodigestion of trypsin, and (b) estimation of liberated trypsin by conventional procedures. We have developed a simple, highly sensitive single stage assay for enterokinase in which complicating side reactions are competitively inhibited by the presence of a large excess of specific trypsin substrate such as GANA or RBB-hide. The new method requires the equivalent of 2 μl or less of duodenal juice (or other source of enterokinase) and furnishes results of excellent reproducibility within 5–15 min. 2. 2. Enterokinase separated by customary gel filtration of duodenal juice is contaminated with a small amount of α 2 -macroglobulin-bound trypsin. Our procedure permits isolation of an enterokinase fraction free from this contaminant. 3. 3. Human enterokinase is extremely sensitive to changes in ionic strength. It is most active at an ionic strength far below that of its physiological environment. An increase in salt concentration is accompanied by a striking decrease in activity. Physiological saline almost completely inhibits the enzyme in our system. However, inhibition is diminished progressively by increasing trypsinogen concentrations and in vivo activation of the zymogen proceeds freely under such conditions. These observations are of critical importance in the determination of enterokinase. They also may be relevant to the symptomatology of partial enterokinase deficiency. 4. 4. Ca 2+ at very low concentrations (0.025–0.1 mM) is an effective activator of enterokinase in our fluorometric assay system. However, Ca 2+ concentrations higher than 0.5 mM strongly inhibit the enzyme. The presence of other components in the reaction mixture may modify this effect. Thus, maximum activation in our colorimetric assay, with RBB-hide as trypsin substrate, requires 2–5 mM Ca 2+ . 5. 5. Human enterokinase is inhibited by TLCK and thus appears to belong to the group of serine—histidine proteases.

The radioimmunoassay technique, first developed for the determination of hormones, has been applied to many substances of biologic interest by clinical and research laboratories around the world. It has had an enormous effect in medicine and biology as a diagnostic tool, a guide to therapy, and a probe for the fine structure of biologic systems. For instance, the assays of insulin, gastrin, secretin, prolactin, and certain tissue-specific enzymes have been invaluable in patient care. Further refinements of current methods, as well as the emergence of new immunoassay techniques, are expected to enhance precision, specificity, reliability, and convenience of the radioimmunoassay in both clinical and research laboratories.