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Two neutral proteases (elastase-1ike = ELP, and chymotrypsin-like = CLP) derived from human PMN in highly purified form inactivate in vitro humanisolated coagulation factors (Thromb. Res. 6, 315, 1975). These effects can be observed also in human plasma, despite its high antiprotease capacity. (Blood February 1977).  ELP and CLP (both free of endotoxin) were infused into green monkeys either separate or in combination to investigate a possible role of these proteolytic enzymes also in vivo. Activity of coagulation factors I - XIII and antiprotease potential has been followed for a 24 hour period in short intervals.  A loss of activity of coagulation factor II, V, VIII, IX, X and XIII could be demonstrated. Fibrinogen concentration decreased and fibrinogen split products could be detected. In two-dimensional immunelectrophoresis α1-antitrypsin-ELP and α2-macroglobulin-ELP-complexes were demonstrable for about 6 hours after protease infusion. Bleeding complication occurred after injection of both enzymes.  The results indicate a direct proteolysis of coagulation factors by PMN neutral proteases in vivo.  We suggest that similar conditions are present in patients with acute leukemia or septicemia.

In vivo effects of human granulocyte neutral proteases on blood coagulation in green monkeys (cercopithecus aetiops)