MOLECULAR AND FUNCTIONAL-ASPECTS OF ALTERATIONS IN THE KALLIKREIN-KININ SYSTEM ACTIVITY IN HUMAN BLOOD-PLASMA AT DIFFERENT STAGES OF PERITONITIS AND CHRONIC-RENAL-FAILURE

We are concerned with the investigation of dynamics of the plasma kall ikrein-kinin system, elastase-like activity and some serpins, alpha(1) -protease inhibitor, alpha(2)-macroglobulin and antithrombin III, in p atients suffering from general peritonitis and chronic renal failure. The results indicate that activation of the kallikrein-kinin system, a s well as elastase-like activity are elevated and while decreased inhi bitory potential becomes more intensive with disease progression. Howe ver, sharply decreased levels of kallikrein, prekallikrein and the ser pins were seen in patients a few days before death. We suggest that ex haustion of these components during the end-stage of general peritonit is and chronic renal failure (in the cases with lethal outcome) may be produced by leukocyte elastase release. Evidence is presented for the destructive action of leukocyte elastase on components of the kallikr ein-kinin system.