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Urinary trypsin levels observed in pancreas transplant patients with duodenocystostomies promote in vitro fibrinolysis and in vivo bacterial adherence to urothelial surfaces. Urol Res 1992;20(6):409-13

Date

01/01/1992

Pubmed ID

1462479

DOI

10.1007/BF00294497

Scopus ID

2-s2.0-0026447942 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

This study evaluated the role of activated urinary trypsin in mediating the increased incidence of infectious and hemorrhagic lower urinary tract complications in pancreas transplant patients with pancreatico-duodenocystostomies (PDC). The effect of trypsin concentrations corresponding to those observed in the urine of PDC patients were studied using an in vitro assay of clot lysis and an in vivo assay of bacterial-urinary tract adherence. Results were compared with those of parallel assays performed using urine from a pancreas transplant patient with a duodenocystostomy and control human urine. All trypsin concentrations studied demonstrated fibrinolytic activity. Fibrinolysis increased as a direct function of both trypsin concentration and duration of substrate exposure (P < 0.0001). Fibrin lysis resulting from the urine of the transplant patient was 4.6 times greater than that predicted based upon assays of total trypsin content in the sample. Fibrinolytic activity in control urine specimens was 0.16% of that observed in transplant urine specimens. Exposure of the rat urinary bladder to 200 micrograms/ml trypsin concentrations, or transplant urine, resulted in a significant increase in bacterial adherence over that seen in control urine from treated animals (P < 0.05). These findings demonstrate a significant effect of urinary trypsin on physiologic processes involved in hemostasis and the prevention of urinary tract infection. Active urinary trypsin may play an etiologic role in hemorrhagic and infectious lower urinary tract complications observed in patients with a PDC.

Author List

See WA, Smith JL

Author

William See MD Emeritus Professor in the Urology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Animals
Bacterial Adhesion
Cystostomy
Duodenostomy
Enzyme Activation
Fibrinolysis
Hemorrhage
Humans
In Vitro Techniques
Pancreas Transplantation
Rats
Trypsin
Urinary Bladder
Urinary Tract Infections
Urologic Diseases