The use of trypsin-like blood activity as a marker of pulmonary fibrosis severity.


  • V. V. Rodionova
  • O. V. Karaseva



pulmonary fibrosis (PF), biomarkers, trypsin-like activity of blood


Purpose – to determine changes in the trypsin-like blood activity and its relationship with acute phase indices of inflammation in patients with pulmonary fibrosis (PF) as a marker of course severity and prognosis of the disease. Materials and Methods: The study included 18 patients: 15 (83%) women and 3 (17%) men, mean age 53±2.5 years. The control group included 15 practically healthy persons. All the examined patients (n=18) were divided into two groups: with mild or moderately severe PF – 8 (44.4%) patients (group I), severe PF – 10 (55.6%) of patients (group II). Duration of the disease - from 1 month. up to 4 years. Patients underwent clinic-laboratory and anthropometric studies, a mMRC questionnaire was used, blood saturation was measured, lung radiography in 2 projections, echocardiography, and if necessary a high-resolution computer tomography etc were performed. Results and discussion: More than half of the patients were overweight (44,4%) or had obesity of І-ІІІ st. (27.8%). The severity of dyspnea according to mMRC scale was 3.0 (3.0-4.0) points in patients of group II and 2.5 (2.0-3.0) points in patients of group I. There was a decrease in C-reactive protein (CRP) in group I and a tendency to increase in patients of group II. When analyzing the indicator of trypsin-like blood activity (TLA), it was found that the median TLA at the beginning of the observation was twice as high as in healthy individuals, direct correlation was established between the level of TLA and the severity of the disease course. After treatment the level of TLA decreased in group I patients. In the severe course of PF, the average TLA level remained high. The progredient course of LF is characterized by severe clinical symptoms, a significant increase in TLA, CRP, reduced O2 saturation, a lack of response to treatment and an unfavorable prognosis. The TLA index can be used as a biochemical marker of the severity of PF along with the CRPindex, O2 saturation and the degree of dyspnoea.

Author Biographies

V. V. Rodionova

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Occupational Diseases and Clinical Immunology
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

O. V. Karaseva

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Occupational Diseases and Clinical Immunology
V. Vernadsky str., 9, Dnipro, 49044, Ukraine


Feshchenko YI, Gavrysyuk VK, Merenkova EO, et al. [Idiopathic pulmonary fibrosis: clinical picture, diagnosis, treatment (draft of the national agreement)]. Ukrainskyi pulmonologіchnyi zhurnal. 2013;3:26-30.

Karaseva OV, Rodionova VV. [Gastrophase para­meters of blood in patients with idiopathic pulmonary fibrosis during treatment]. Conference. Zaporizhzhia, September 22-23, 2016;26-27.

Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho C, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TEJr, Kondoh Y, Myers J, Mül­ler NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, Griss BS, Protzko SL, Schünemann HJ. ATS/ERS/JRS/ ALAT Committee on Idiopathic Pul­mo­nary Fibrosis. An official ATS/ERS/JRS/ALAT sta­tement: idiopathic pulmo­na­ry fibrosis: evidence-based guidelines for diagnosis and ma­nagement. J Res­pir Crit Care Med. 2011;183:788-824.

Kreider ME, Hansen-Flaschen J, Ahmad NN, Ros­sman MD, Kaiser LR, Kucharczuk JC, Shrager JB. Complications of video-assisted thoracoscopic lung bio­psy in patients with interstitial lung disease. Ann Thorac Surg. 2007;83:1140-4.

Danoff SK. Toward understanding patient expe­rience in idiopathic pulmonary fibrosis. European Respi­ratory Journal. [Internet]. 2017;49:1602202. Available from:

Raghu G, et al. Effect of Nintedanib in Subgroups of Idiopathic Pulmonary Fibrosis by Diagnostic Criteria // American journal of respiratory and critical care medi­cine. 2017;195(1):78-85.

Hopkins RB, Burke N, Fell C, et al. Epide­miology and survival of idiopathic pulmonary fibrosis from national data in Canada. Eur. Respir. J. 2016;48:187-95.

Hutchinson J, Fogarty A, Hubbard R, et al. Global incidence and mortality of idiopathic pulmonary fibrosis: a systematic review. Eur Respir J. 2015;46:795-806.

Menou A, et al. Human airway trypsin-like pro­tease, a serine protease involved in respiratory diseases. American Journal of Physiology-Lung Cellular and Mo­lecular Physiology. 2017;312(5):L657-68.

Raghu G, Chen SY, Hou Q, et al. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old. Eur. Respir. J. 2016;48:179-86.

Kryczka J, Boncela J. Leukocytes: the double-edged sword in fibrosis, Mediators of Inflammation, vol. 2015, Article ID 652035. Mediators of Inflammation. 2015;4:1-10.

Kryczka J, Boncela J. Proteases Revisited: Roles and Therapeutic Implicationsin Fibrosis. Mediators of Inflammation. 2017;2017.

Ley B, Collard HR, King TE. Clinical course and prediction of survival in idiopathic pulmonary fibrosis. Am. J. Respir. Crit. Care Med. 2011;183:431-40.

Linder S. “The matrix corroded: podosomes and invadopodia in extracellular matrix degradation,” Trends in Cell Biology” Trends in Cell Biology. 2007;3:107-17.

Ryerson CJ, Urbania TH, Richeldi L, Mooney JJ, Lee JS, Jones KD, Elicker BM, Koth LL, King TEJr, Wolters PJ, Collard HR. Prevalence and prognosis of unclassifiable interstitial lung disease. Eur Respir. J. 2013;42:750-7.

How to Cite

Rodionova VV, Karaseva OV. The use of trypsin-like blood activity as a marker of pulmonary fibrosis severity. Med. perspekt. [Internet]. 2018May24 [cited 2024Mar.3];23(2(part1):50-6. Available from: