The isolation of leukokinin-H and leukokininogen from human ascites fluid; their properties and role.

The leukokinin-leukokininogen system is a pathological kinin generating system which is catalyzed by acid proteases present in neoplastic cells, white cells and even normal tissues. The components of the human system including leukokinin-H and leukokininogen have now been isolated and characterized. Very specific protease inhibitors of the system such as pepstatin have been found and are now known to prevent "in vivo" the formation of pathological fluids such as neoplastic ascites. Strong evidence has been previously published and additional evidence has been presented here which indicates that pepstatin's actions are related to the inhibition of cathepsin-D in vivo and the inhibition of leukokinin formation. Both leukokinins and leukokininogens have been clearly defined and shown to differ from bradykinin and human bradykininogens. This clearly demonstrates the presence in pathological systems of a kinin-generating system which is separate and distinct from the bradykinin generating system. The importance of the leukokinin-leukokininogen system in disease would seem to be very great. The finding that pepstatin can inhibit the system in vivo opens the way for studies of pepstatin and related protease inhibitors as therapeutic agents in neoplastic disease and protease mediated inflammatory disorders.

Pepstatin, an ascites retardant of L1210 tumor-bearing mice.

The effect of pepstatin on the kinetics of ascitic fluid accumulation in L1210 tumor-bearing mice (DBA/2) was observed. Following inoculation of 1.5x10(6) tumor cells, untreated mice reached a peak of fluid accumulation on day 6 and remained at this level until death on day 9. A "lag" phase of 4 days occurred before fluid accumulation was seen. Pepstatin administered SC in a single dose of 80 mg/kg during the lag phase, significantly retarded fluid accumulation as compared to untreated animals. Pepstatin administered following fluid accumulation was much less effective. We concluded that pepstatin prevents fluid accumulation rather than acts as a diuretic agent. The term "ascites retardant" is suggested for the pharmacologic actions of pepstatin, since it prevents fluid accumulation without diminishing the cell count.

Pepstatin, an inhibitor of leukokinin formation and ascitic fluid accumulation.

Ascites fluid accumulation accompanying a mastocytoma or L1210 murine tumor is significantly retarded following the i.p. or s.c. injection of moderate quantities of pepstatin, a known acid protease inhibitor. No effect on cell count was noted by pepstatin treatment. The probable mechanism by which pepstatin acts is by inhigiting the enzymatic formation of chemical mediators known as leukokinins. These are pharmoacologically active peptiedes having potent permeability characteristics previously described by this laboratory. Leukokinins are formed by cathepsin D-like enzymes present in the invading cells and in the ascites fluid acting on a protein substrate, leukokininogen. present in the ascites fluid. Pestatin inhibits the action of these leukokinin-forming enzymes invitro but has no effect on kallikreins (bradykinin-forming enzymes) in vitro. Human ascites fluid from a patient with ovarian carcioma was found to have a paepstatin-inhibited, leukokinin-generating system, as does the mouse. A 'chemical mediator' theory is proposed for ascites fromation which broadens the previously held theory of lymphatic blockage (Holm-Nielsen) and may explain the recent findings of Hirabayashi and Graham of increased plasma-ascites exchange in peritoneal carcionmatosis. Pepstatin inhibition of chemical mediator formation may represent a new therapeutic approach to ascites fluid accumulation in neoplastic disease.

PMN-kinin and kinin metabolizing enzymes in normal and malignant leucocytes.

1. Studies have been carried out on the kinin-forming and kinin destroying activity of rabbit macrophages obtained from the lung before and after BCG injection and from the peritoneal cavity following mineral oil injection. A similar study was carried out with L-1210 leukaemic cells obtained from the peritoneal cavity of mice.2. The macrophages and leukaemic cells contain enzymes that form kinins from purified kininogen substrates at acid pH. The kinin-forming activity is not limited to the lysosomal fraction of the cell since it is found in extralysosomal compartments. Delta-guanidovaleryl benzyl ester partially inhibits the kinin-forming activity. Trasylol does not inhibit the kinin-forming activity of these cells, but does inhibit the kininases of these cells. The lack of effectiveness of this agent as a general anti-inflammatory agent is thus explained.3. The kininases of the normal and malignant cells are also inhibited by chloromethyl ketones such as tosyl-lysine chloromethyl ketone (TLCK) and tosyl-phenylalanine-chloromethyl ketone (TPCK) as well as by copper salts. Hydroxyquinoline has no inhibitory action on these cells, indicating that they differ from the plasma kininases.4. Investigation of the kinins produced by enzymes in rabbit and human polymorphonuclear (PMN) cells has demonstrated the formation of a kinin that differs from bradykinin and other known mammalian kinins in its pharmacological properties, molecular weight, and amino-terminal end group. This peptide has been named PMN-kinin.5. Overall, the investigation has demonstrated the importance of white cells in contributing to the formation and destruction of "extra-plasma" sources of kinins by enzymes which differ from plasma enzymes. Anti-inflammatory agents may have different actions on these cell enzymes from those on plasma enzymes.