SERUM ENZYMATIC CHANGES MODULATED USING TRYPSIN - CHYMOTRYPSIN PREPARATION DURING BURN WOUNDS IN HUMANS

The levels of marker enzymes for liver function, namely transaminases (SGPT, SGOT), creatine phosphokinase (CPK), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were estimated in the sera of burn pa tients by administering trypsin:chymotrypsin preparation and comparing with an untreated group. Neutrophil proteolytic activity was also mea sured by assaying the lysosomal enzymes, namely neutrophil elastase an d cathepsin D. Our earlier studies have already proved the efficacy of the above enzyme preparation to burn patients on the enhancement of v ascular responses during the acute phase of the burn injury. These ben eficial responses were brought about by the modulation of acute phase proteins expressed in the liver. Hence, it is of interest to study the changes in the above mentioned liver enzymes and certain lysosomal en zymes in the serum during the first 10 days of burn injury. The levels of liver and lysosomal enzymes markedly decreased in the treated grou p when compared with the untreated group. The enzyme studies clearly i ndicated that the initial rise in the liver enzymes axis minimized in the treated group when compared with the untreated group and this help ed in reducing the stress to the liver in the treated eases. The incre ase in the activity of alpha(1)-antitrypsin and alpha(2)-macroglobulin and decreased levels of C-reactive protein are attributed to the redu ction of proteolytic enzyme levels in the treated group and minimizing the degradative changes during wound repair. (C) 1997 Published by El sevier Science Ltd for ISBI.