GRANULOCYTE ELASTASE ACTIVITY MEASUREMENT IN THE CEREBROSPINAL-FLUID OF PATIENTS WITH PURULENT-MENINGITIS

Measurements were made of the granulocyte elastase activity and the co ncentration of granulocyte elastase alpha(1)-proteinase inhibitor comp lex (E-alpha(1)PI) in the cerebrospinal fluid (CSF) of patients with p urulent meningitis and aseptic meningitis. Granulocyte elastase activi ty was determined by the cleavage of methoxysuccinyl-L-(alanyl)(2)-pro lyl-valyl peptide substrate. The E-alpha(1)PI concentration was assaye d with an enzyme immunoassay technique. Granulocyte elastase activity in the CSF on admission was significantly higher in patients with puru lent meningitis (800 +/- 539 mu g/L; mean +/- SD) than in patients wit h aseptic meningitis (< 10 mu g/L). Granulocyte elastase activity in t he CSF of patients with purulent meningitis decreased rapidly except f or two patients who subsequently developed hydrocephalus. There was a weak correlation between granulocyte elastase activity and the concent ration of E-alpha(1)PI in the CSF with purulent meningitis (n = 67, r = 0.48, P < 0.01). However, some samples of CSF showed a marked discre pancy between granulocyte elastase activity and E-alpha(1)PI concentra tion, indicating the importance of measuring granulocyte elastase acti vity in the CSF to estimate tissue injury.