Neutrophil elastase in postoperative pleural effusion of patients who had undergone pulmonary resections

We determined whether activity of neutrophil elastase increases in pleural effusion after lobectomy for the neoplasm in the lung. Samples of pleural effusion were obtained 3 and 24 h postoperatively and samples of the peripheral blood were obtained preoperatively, 3 h, 24 h, and 1 w postoperatively, then the neutrophil counts, the levels of neutrophil elastase and alpha 1-antitrypsin by enzyme-linked immunosorbent assay, the activity of neutrophil elastase using succinyl-(L-alanine) 3-p-nitroanilide were measured. We found that the levels of neutrophil elastase increased 170 times greater in pleural effusion than in peripheral blood 3 h after lobectomy. However, the levels of alpha 1-antitrypsin did not increase in pleural effusion. The activity of neutrophil elastase increased to 0.54 +/- 0.1 mumol/min/l in pleural effusion 3 h after lobectomy, however the activity of neutrophil elastase was under the sensitivity level of detection in the peripheral blood after lobectomy. In conclusion, there is an imbalance between the levels of neutrophil elastase and alpha 1-antitrypsin in pleural effusion after lobectomy, the imbalance resulting in the increased activity of neutrophil elastase which probably is relating to tissue injury in the pleural spaces.