GELATINASES IN EPITHELIAL LINING FLUID OF PATIENTS WITH ADULT-RESPIRATORY-DISTRESS-SYNDROME

Gelatinases A and B are matrix metalloproteinases secreted as inactive pro forms and are capable of degrading basement membrane components a fter activation in the extracellular environment. To determine whether the presence of gelatinases A (noninflammatory cells) and B (inflamma tory cells) in epithelial lining fluid (ELF) is associated with the ad ult respiratory distress syndrome (ARDS), we studied 28 patients divid ed into four groups based on the presence of ARDS and/or multiple orga n failure (MOF). Gelatinase activities were quantified in ELF using zy mography. ARDS patients had larger ELF volumes than non-ARDS patients: 9.2 +/- 8.5 ml/100 mi recovered lavage fluid (n = 18) vs. 1.9 +/- 1.7 ml/100 mi (n = 11), respectively (P < 0.001). The presence of activat ed gelatinase A in ELF was a sensitive (16 out of 18 ARDS patients, 89 %) and specific (0 out of 11 non-ARDS patients with or without MOF) ma rker for ARDS. Activated gelatinase (A + B) activities per microliter ELF were correlated with albumin concentrations in ELF (P < 0.01), and activated gelatinase activities in ELF were correlated with the volum e of ELF (P < 0.0005). This could suggest an involvement of these gela tinases in alveolar-capillary permeability increase.