1. Proteinase inhibitors have been studied in whole serum by using a kinetic method that avoids potentially damaging protein separation procedures.
2. The α2-macroglobulin of an individual can be allocated unambiguously into one of seven categories according to the binding of trypsin to inhibitor in two kinetically apparent binding modes (β- and α-modes).
3. The distribution of α2-macroglobulin β:α ratios in a healthy adult population is defined, and shown to be independent of sex and age.
4. The distribution of β: α ratios in a group of patients with cryptogenic fibrosing alveolitis was found to be significantly different (P < 0.005) from the normal distribution.
5. Changes in the β: α ratio were noted in five of six patients with cryptogenic fibrosing alveolitis after treatment, but on no occasion when two healthy subjects were assessed a total of nine times.
6. The molecular interpretation and the possible importance of altered proteinase inhibition in inflammation and fibrosis are discussed.
Clinical usefulness of high resolution computed tomography in cryptogenic fibrosing alveolitis
