A preliminary report on the radiologic evaluation of trypsin in certain chronic chest diseases.

Abstract

The proteolytic enzyme, trypsin, is finding a broad range of uses in medicine. It has been found to increase permeability of tissues which are partially obstructed by inflammation or perhaps by cellular debris. Other observers have reported, and our findings lend confirmatory support to the thesis, that trypsin increases the liquefaction of thick mucus. Laboratory work has demonstrated1 that the enzyme decreases the degree of inflammatory change around an intentionally traumatized area and tends to resolve the viscid accumulations of edema fluid surrounding the injury. Microscopic examination of inflammatory masses demonstrated a diminution of the fibrin, platelet, and cellular substances, in trypsin-treated animals compared to controls.2 In our previous work,3 ‘ clinical changes have been reported following the administration of trypsin to patients with certain chronic chest diseases. In those conditions where tenacious, inspissated mucus had impaired breathing, daily intramuscular injections of the enzyme appeared to lessen the viscosity and tenacity of the sputum, facilitating the raising of this embarrassing and inconveniencing “gunk.” Subsequently, the volume of the expectorate decreased and breathing became easier. Subjective effects were noted uniformly. In addition, objective studies were undertaken in the patients and the results were confirmatory, but not as consistent as the subjective improvement. Methods and Materials Radiologic examinations were made on all patients before and after a course of trypsin treatment. Some measure of difference was seen in almost all patients, and in half of them the degree of improvement was classed as marked. The purpose of this paper is to present the x-ray findings, as offered by the consulting roentgenologist who took the x-ray films, and also to present the readings of a reviewing roentgenologist. It has been shown