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During intensive care, the severity of gut-derived systemic endotoxaemia in 16 patients with active Crohn's disease was characterized by the simultaneous determination of elastase/alpha 1-proteinase-inhibitor and Limulus-amoebocyte-lysate-reactivity. Using both assays in 15/16 patients the detectable endotoxic activity during the disease course was reflected by a parallelism between elastase/alpha 1-proteinase-inhibitor and Limulus-amoebocyte-lysate-reactivity. In 8 gut-irrigated patients, significantly lower elastase/alpha 1-proteinase-inhibitor concentrations and Limulus-amoebocyte-lysate-reactivities were measured compared with 8 gut-nonirrigated patients. The Crohn's disease activity index and the van Hees activity index as well as the inpatient time were significantly lower in lavage patients compared with gut-nonirrigated patients. It is concluded with that elastase/alpha 1-proteinase-inhibitor can be used as an alternative to the bioassayed Limulus-amoebocyte-lysate-reactivity in order to characterize systemic endotoxaemia.

Endotoxaemia in Patients with Crohn’s Disease: A Longitudinal Study of Elastase/α 1 -Proteinase Inhibitor and Limulus-Amoebocyte-Lysate Reactivity