PLASMA POLYMORPHONUCLEAR LEUKOCYTE ELASTASE LEVELS AND ITS RELATION TO DISEASE-ACTIVITY IN PSORIASIS

Although some increased enzyme activities in PMN leukocytes isolated f rom the circulation of psoriatic patients have been previously describ ed, none of these enzymes had been studied in plasma for determination of disease activity. The purpose of this study was to evaluate whethe r plasma PMN elastase levels might be a good marker for determination of disease activity of psoriatic patients. Plasma PMN elastase and som e acute phase reactants including alpha-1 antitrypsin, alpha-2 macrogl obulin, fibrinogen, erythrocyte sedimentation rate(ESR), and transferr in were studied in thirty-nine patients with psoriasis, including 16 c ontrolled patients, and forty healthy control subjects. PMN elastase a nd the acute phase reactants except transferrin were found to be signi ficantly higher in the psoriatic patients than in control subjects. Th e PMN elastase level in the patients was about 6-fold higher than that of the control group. The PMN elastase levels in the patients in the inactive period was two-fold higher than in the control subjects. PMN elastase was found to correlate significantly with PMN leukocyte count and alpha-1 antitrypsin in active and inactive periods of the disease , but with fibrinogen and psoriasis area and severity index (PASI) onl y in the active period of the disease. We conclude that plasma PMN ela stase level may be a more specific and sensitive inflammatory marker t han alpha-1 antitrypsin, alpha-2 macroglobulin, ESR, and may be a good marker for diagnosis and follow up of the disease activity of the pso riatic patients. (C) 1997 Elsevier Science B.V.