The neutrophilic component in bronchiolitis obliterans syndrome (BOS, the main form of\nchronic lung rejection), plays a crucial role in the pathogenesis and maintenance of the disorder.\nHuman Neutrophil Elastase (HNE), a serine protease responsible of elastin degradation whose\naction is counteracted by alpha 1-antitrypsin (AAT), a serum inhibitor specific for this protease. This\nwork aimed to investigate the relationship between HNE and AAT in bronchoalveolar lavage fluid\n(BALf) from stable lung transplant recipients and BOS patients to understand whether the\nimbalance between proteases and inhibitors is relevant to the development of BOS. To reach this\ngoal a multidisciplinary procedure was applied which included: (i) the use of\nelectrophoresis/western blotting coupled with liquid chromatography-mass spectrometric analysis;\n(ii) the functional evaluation of the residual antiprotease activity, and (iii) a neutrophil count.\nThe results of these experiments demonstrated, for the first time, the presence of the complex\nbetween HNE and AAT in a number of BALf samples. The lack of this complex in a few specimens\nanalyzed was investigated in relation to a patientâ??s lung inflammation.\nThe neutrophil count and the determination of HNE and AAT activities allowed us to speculate that\nthe presence of the complex correlated with the level of lung inflammation.
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