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    "titulo" => "Alfa 1 antitripsina y alfa 2 macroglobulina en esputo infectado y no infectado de pacientes con enfermedad pulmonar obstructiva cronica. Significacion fisiopatologica de ambas proteinas en el pulmon"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Alfa 1 antitripsina &#40;&#945;<span class="elsevierStyleInf">1</span> AT&#41; y alfa 2 macroglobulina &#40;&#945;<span class="elsevierStyleInf">2</span> MG&#41; son inhibidores enzim&#225;ticos con importantes funciones en la protecci&#243;n del tejido conectivo pulmonar&#46;En el presente trabajo se determinaron ambas prote&#237;nas a nivel s&#233;rico y en fase sol de esputo en dos grupos de pacientes portadores de enfermedad pulmonar obstructiva cr&#243;nica con y sin infecci&#243;n respiratoria del tracto inferior&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Durante los per&#237;odos de infecci&#243;n pulmonar&#44; los niveles s&#233;ricos de &#945;<span class="elsevierStyleInf">1</span> AT aumentaron significativamente probablemente por incremento del metabolismo proteico&#44; mientras que la concentraci&#243;n de &#945;<span class="elsevierStyleInf">2</span> MG durante este mismo per&#237;odo decreci&#243; de forma significativa&#44; sugiriendo bien un aumento del catabolismo proteico&#44; una reducci&#243;n de la capacidad de s&#237;ntesis o la formaci&#243;n de complejos estables &#945;<span class="elsevierStyleInf">2</span> MG-endopeptidasas bacterianas&#46; Por otra parte&#44; las tasas de &#945;<span class="elsevierStyleInf">1</span> AT y &#945;<span class="elsevierStyleInf">2</span> MG en esputo y su relaci&#243;n &#40;esputo&#47;suero&#41; aumentaron significativamente en el transcurso de las infecciones pulmonares&#44; evidenciando un importante aumento de la difusi&#243;n pasiva proteica desde el plasma a la secreci&#243;n bronquial&#46; Cuando la relaci&#243;n esputo&#47;suero de ambas macromol&#233;culas fue corregida para la alb&#250;mina&#44; no existieron diferencias significativas al comparar las distribuciones de ambaspoblaciones analizadas&#44; sugiriendo un mecanismo de g&#233;nesis com&#250;n en los grupos con y sin infecci&#243;n pulmonar&#46; La buena correlaci&#243;n existente entre &#945;<span class="elsevierStyleInf">1</span>&#44; AT y alb&#250;mina en presencia de infecci&#243;n respiratoria del tracto inferior confirma que la trasudaci&#243;n proteica es un mecanismo fisiopatol&#243;gico preferencial&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Las bajas concentraciones detectadas de &#945;<span class="elsevierStyleInf">1</span> AT y &#945;<span class="elsevierStyleInf">2</span> MG en la secreci&#243;n bronquial en el grupo de sujetos sin infecci&#243;n pulmonar&#44; son indicativas de su limitada contribuci&#243;n antiproteasa en este medio biol&#243;gico&#46; Durante la infecci&#243;n pulmonar la prote&#237;na &#945;<span class="elsevierStyleInf">2</span> MG aument&#243; significativamente en esputo por efecto de la difusi&#243;n pasiva desde el plasma y quiz&#225; por estimulaci&#243;n inespec&#237;fica de la producci&#243;n local&#44; pudiendo en esta circunstancia desarrollar una importante funci&#243;n inhibidora de la actividad enzim&#225;tica libre&#46; Sin embargo&#44; a pesar de la contribuci&#243;n de &#945;<span class="elsevierStyleInf">2</span> MG a la correcci&#243;n del disbalance entre proteasas neutras e inhibidores&#44; los sujetos portadores de EPOC con infecci&#243;n pulmonar intercurrente mantienen un estado de desequilibrio enzim&#225;tico con elevado riesgo para la integridad del tejido conectivo pulmonar&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Both proteins were determined in this study in the serum and in a colloidal solution of sputum in two groups of patients with chronic obstructive lung disease &#40;COLD&#41; with infection and without lower respiratory infection&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The serum levels of &#945;<span class="elsevierStyleInf">1</span> AT augmented significantly during pulmonary infection probably due to protein metabolism&#44; while &#945;<span class="elsevierStyleInf">2</span> MG concentration decreased significantly during the same period suggesting either an increase in the protein catabolism&#44; a reduction of the synthetic capacity&#44; or the formation of stable complexes of &#945;<span class="elsevierStyleInf">2</span> MG-bacterial endopeptidases&#46; On the other hand&#44; the levels of &#945;<span class="elsevierStyleInf">1</span> AT and &#945;<span class="elsevierStyleInf">2</span> MG in sputum and their ratio &#40;sputum&#47;serum&#41; augmented markedly during pulmonary infection&#44; demonstrating a significant increase in the protein passive diffusion from the plasma to the bronchial secretions&#46; There were no significant differences in the</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">ratio sputum&#47;serum of both macromolecules when comparing the 2 groups analyze after correcting for the albumin&#46; This suggests a common original mechanism in the groups with and without pulmonary infection&#46; The strong correlation between &#945;<span class="elsevierStyleInf">1</span> AT and albumin with lower respiratory infection confirms that protein transudate is a preferential physiopathological mechanism&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The low concentrations of &#945;<span class="elsevierStyleInf">1</span> AT and &#945;<span class="elsevierStyleInf">2</span> detected in bronchial secretions of patients without pulmonary infection indicate their limited contribution to antiprotease activity in this biological medium&#46; &#945;<span class="elsevierStyleInf">2</span> MG protein increased in the sputum significantly during pulmonary infection due to the passive diffusion from the plasma and perhaps too to the nonspecific stimulation of local production&#46; An important inhibitory function of the free enzyme activity could be developed in this case&#46; Nevertheless&#44; patients with COLD and recurrent pulmonary infections mantain a State of enzymatic disequilibrium in spite of the contribution of &#945;<span class="elsevierStyleInf">2</span> MG in the correction of the disequilibrium between neutral proteases and inhibitors&#46; This constitutes an important risk for the integrity of the pulmonary connective tissue&#46;</p></span>"
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Vol. 20. Issue 2.
Pages 60-69 (March - April 1984)
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Vol. 20. Issue 2.
Pages 60-69 (March - April 1984)
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Alfa 1 antitripsina y alfa 2 macroglobulina en esputo infectado y no infectado de pacientes con enfermedad pulmonar obstructiva cronica. Significacion fisiopatologica de ambas proteinas en el pulmon
Alpha 1-antitrypsin and alpha 2-macroglobulin in infected and non-infected sputum from patients with chronic obstructive pulmonary disease. Physiopathological significance of the two proteins in the lung
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L. Oteo Ochoa, M. Maties Prats, J.L. De La Cruz Rios, A. Izquierdo Del Amo, J.L. Cruz Ramos, C. Martin Serrano, J. Picher Nuñez, A. Sueiro Bendito
Servicio de Neumología. C.E. Ramón y Cajal de la S.S. Madrid
M. Diaz Enriquez*
* Servicio de Bioquímica. C.E. Ramón y Cajal de la S.S. Madrid
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Alfa 1 antitripsina (α1 AT) y alfa 2 macroglobulina (α2 MG) son inhibidores enzimáticos con importantes funciones en la protección del tejido conectivo pulmonar.En el presente trabajo se determinaron ambas proteínas a nivel sérico y en fase sol de esputo en dos grupos de pacientes portadores de enfermedad pulmonar obstructiva crónica con y sin infección respiratoria del tracto inferior.

Durante los períodos de infección pulmonar, los niveles séricos de α1 AT aumentaron significativamente probablemente por incremento del metabolismo proteico, mientras que la concentración de α2 MG durante este mismo período decreció de forma significativa, sugiriendo bien un aumento del catabolismo proteico, una reducción de la capacidad de síntesis o la formación de complejos estables α2 MG-endopeptidasas bacterianas. Por otra parte, las tasas de α1 AT y α2 MG en esputo y su relación (esputo/suero) aumentaron significativamente en el transcurso de las infecciones pulmonares, evidenciando un importante aumento de la difusión pasiva proteica desde el plasma a la secreción bronquial. Cuando la relación esputo/suero de ambas macromoléculas fue corregida para la albúmina, no existieron diferencias significativas al comparar las distribuciones de ambaspoblaciones analizadas, sugiriendo un mecanismo de génesis común en los grupos con y sin infección pulmonar. La buena correlación existente entre α1, AT y albúmina en presencia de infección respiratoria del tracto inferior confirma que la trasudación proteica es un mecanismo fisiopatológico preferencial.

Las bajas concentraciones detectadas de α1 AT y α2 MG en la secreción bronquial en el grupo de sujetos sin infección pulmonar, son indicativas de su limitada contribución antiproteasa en este medio biológico. Durante la infección pulmonar la proteína α2 MG aumentó significativamente en esputo por efecto de la difusión pasiva desde el plasma y quizá por estimulación inespecífica de la producción local, pudiendo en esta circunstancia desarrollar una importante función inhibidora de la actividad enzimática libre. Sin embargo, a pesar de la contribución de α2 MG a la corrección del disbalance entre proteasas neutras e inhibidores, los sujetos portadores de EPOC con infección pulmonar intercurrente mantienen un estado de desequilibrio enzimático con elevado riesgo para la integridad del tejido conectivo pulmonar.

Both proteins were determined in this study in the serum and in a colloidal solution of sputum in two groups of patients with chronic obstructive lung disease (COLD) with infection and without lower respiratory infection.

The serum levels of α1 AT augmented significantly during pulmonary infection probably due to protein metabolism, while α2 MG concentration decreased significantly during the same period suggesting either an increase in the protein catabolism, a reduction of the synthetic capacity, or the formation of stable complexes of α2 MG-bacterial endopeptidases. On the other hand, the levels of α1 AT and α2 MG in sputum and their ratio (sputum/serum) augmented markedly during pulmonary infection, demonstrating a significant increase in the protein passive diffusion from the plasma to the bronchial secretions. There were no significant differences in the

ratio sputum/serum of both macromolecules when comparing the 2 groups analyze after correcting for the albumin. This suggests a common original mechanism in the groups with and without pulmonary infection. The strong correlation between α1 AT and albumin with lower respiratory infection confirms that protein transudate is a preferential physiopathological mechanism.

The low concentrations of α1 AT and α2 detected in bronchial secretions of patients without pulmonary infection indicate their limited contribution to antiprotease activity in this biological medium. α2 MG protein increased in the sputum significantly during pulmonary infection due to the passive diffusion from the plasma and perhaps too to the nonspecific stimulation of local production. An important inhibitory function of the free enzyme activity could be developed in this case. Nevertheless, patients with COLD and recurrent pulmonary infections mantain a State of enzymatic disequilibrium in spite of the contribution of α2 MG in the correction of the disequilibrium between neutral proteases and inhibitors. This constitutes an important risk for the integrity of the pulmonary connective tissue.

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Copyright © 1984. Sociedad Española de Neumología y Cirugía Torácica
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