60 ENZYMES 



of the lipoids. Soaps of saturated fatty acids do not inhibit serum 

 protease. 



Opie^2 has found that the serum of inflammatory exudates con- 

 tains an anti-enzymatic substance, destroyed at 75° and by acids; 

 it is not present in normal cerebrospinal fluid, but appears here as 

 in other serous cavities during- inflammation (Dochez).''^ Antitrypsin 

 has also been found in pathological urines (v. Schoenborn).^'* 



The power of the blood serum to inhibit the activity of trypsin and 

 leucocytic protease has been found to vary greatly in disease, and, as 

 having diagnostic possibilities, this property has been considerably 

 investigated.''^ It is especially increased in conditions associated with 

 cell destruction, such as pneumonia and cancer, which suggests that 

 the increased antitryptic activity results from the formation of specific 

 antibodies for the intracellular proteases liberated during the disease, 

 but as yet this has not been satisfactorily established, so we do not 

 know whether the "antitrypsin reaction" depends upon an antibody 

 for trypsin or upon some entirely different factor. In cachexia the 

 inhibiting effect of the serum is especially marked and it is therefore 

 usually pronounced in cancer, but the increased inhibition is some- 

 times absent in cancer (10 per cent, of all cases) and often present in 

 other conditions, so that the positive diagnostic value is slight. It 

 may also be present without cachexia and often seems to parallel the 

 number of leucocytes in the circulating blood. Sarcoma shows it 

 less than carcinoma, while in exophthalmic goitre and tuberculosis 

 an antitryptic increase is said to be quite constant (Waelli).''® In 

 pregnancy there is usually an increase demonstrable after the fourth 

 to sixth months, continuing until two weeks after delivery, and highest 

 in cases of pregnancy toxemias (Ecalle)." Severe traumatism may 

 also cause an increase.''^ 



As normal serum contains a tryptic enzyme as well as a substance 

 inhibiting trypsin, the antitryptic activity is at most but a measure of 

 the difference between these (Weil), and might depend on either 

 lowered trypsin or increased antitrypsin content. Doblin^^ and 

 many others believe with Jobling that the active agent is not a true 

 immune antibody, but as yet general agreement has not been reached 

 on this point (see Meyer). Kirchheim*" has found that the union of 

 trypsin and antitrypsin does not follow the physico-chemical laws to a 

 true antigen-antibody reaction. Rosenthal has advanced evidence 



^2 Jour. Exp. Med.; 1905 (7), 316. 

 "Jour. Expcr. Med., 1909 (11), 718. 

 ''* Zeit. f. Biol, 1910 (53), 386. 



^^ For literature and review see Wiens, Ergebnisse Phj'siol., 1911 (15), 1; 

 Weil, Arch. Int. Med., 1910 (5), 109; Meyer, Folia Serologica, 1911 (7), 471. 

 '« Mitt. Grenz. Med. u. Chir., 1912 (25), 184. 

 " Arch. Mens. Obst. Gvn., 1917 (6), 97. 

 " Zunz and Govaerts, C. R. Soc. Biol., 1918 (81), 146. 

 '» Zeit. f. Immunitilt, 1909 (4), 229 

 80 Arch. exp. Path., 1913 (73), 139. 



