Antiproteases: Effective Treatment with Gabexate Mesilate

Abstract

Since the introduction of Chiari’s concept of “tryptic autodigestion” of the pancreatic gland in 1869 [7], several pancreatic enzymes have been implicated as triggers of acute pancreatitis. However, the initiating factor(s) has still not been clarified. Many of the pancreatic enzymes have been suggested. Activated proteases, such as trypsin [5, 10] and elastase [33, 36], have been found in complex with protease inhibitors in both blood and peritoneal fluid [24, 25]. The probable role of granulocyte proteases has also been emphasized [6, 20]. All these findings indicate liberation of active proteases during the disease. In addition, some studies have shown activation of the different cascade systems of the body, such as the complement, kinin, coagulation and fibrinolytic systems. A similar activation has also been shown in other conditions in which active proteases are set free, for example, sepsis [26, 31], abscesses [17], burns [17] and multiple trauma [17, 19]. The clinical importance of these biochemical events and of their interrelation is, as yet, not fully understood.