Elastase, Pancreatic, Serum

Clinical Significance:
Serum Elastase, also called Pancreatopeptidase, is a protease present in pancreatic secretion with the unique ability to rapidly hydrolyze elastin.  Elastin is a fibrillar protein found in connective tissue.  Elastin forms the elastic fibers found mostly in lungs and skin.  Elastase is able to hydrolyze denatured hemoglobin, casein, fibrin, albumin and denatured but not native collagen.  Elastase has been implicated in the pathogenesis of pulmonary emphysema, atherosclerosis and in the vascular injury of acute pancreatic necrosis.  Elastase activity is inhibited by protease inhibitors including a1-anti-Trypsin, a1-anti-Chymotrypsin, anti-Thrombin III, a2-Macroglobulin and b1-anti-Collagenase.  Patients with thyroid dysfunction have decreased Elastase activity. Serum pancreatic levels quantify EL 1 for the diagnosis or exclusion of an acute pancreatitis or an inflammatory episode of chronic pancreatitis or gallstone induced pancreatitis.

Reference Range
Normal pancreatic exocrine function: Less than 3.5 ng/mL

Reference range is listed on individual patient test reports.
Elastase is measured by direct EIA/ELISA.

Patient Preparation
The patient should fast for 10 to 12 hours prior to collection of specimen. Medications
that affect pancreatic activity should be discontinued, if possible, for at least 48 hours
prior to collection of specimen.

Specimen Collection
Collect 3 mL serum and separate as soon as possible. Freeze serum immediately after
separation. Minimum specimen size is 1 mL.

Special Specimens
For tumor/tissue and various fluids (e.g., CSF, peritoneal fluid, synovial fluid), contact
ISI for requirements and special handling instructions.

Shipping Instructions
Specimens should be shipped frozen in dry ice.

1. Wortsman J, Matsuoka LY, Kueppers F. Elastase inhibitory activity in serum of patients with thyroid dysfunction. Clin Chem.
37:108-10, 1991.
2. Geokas MC, Brodrick JW, Johnson JH, et al. Pancreatic elastase in human serum. Determination by EIA/ELISA. J Biol
Chem. 10 Jan; 252(1):61-7, 1977.

CPT Code:
Pancreatic Elastase I