Trypsinogen in urine

Trypsinogen, trypsinogen activating peptide (TAP) and carboxypeptidase activating peptide (CAPAP)
Trypsinogen (inactive form, proenzyme of trypsin) is produced by the acinous cells of the pancreas in two isoforms – trypsinogen-1 (cathodic isoenzyme, CT) and trypsinogen-2 (anodic isoenzyme, AT ). The inflammatory process in acute pancreatitis leads to increased circulating levels, and trypsinogen-2 can be detected in both serum and urinei. Premature activation of trypsinogen in the pancreatic tissue leads to the initiation of the activation cascade, autodigestion and is an important pathogenetic factor acute pancreatitis. Immunoreactive, both forms of trypsinogen (irAT, irCT) and their ratio in serum S-irAT/S-irCT or in urine U-irAT/U-irCT can be determined in the laboratory.

Clinic
Clinically, the level of trypsinogen-2 in the urine is most often used, values ​​of 5600–10,000 µg/l correspond to a severe, severe form of acute pancreatitis, values ​​of 130–890 µg/l then a moderate to mild form of AP. In the urine, we also determine the product of conversion of trypsinogen to active trypsin - trypsinogen activation peptide - TAP. An elevated TAP level is clinically significant for assessing the severity of acute pancreatitis, when TAP values ​​in the urine above 15 nmol/l detect moderate pancreatitis, values ​​above 40 nmol/l a severe form of the disease. The most recent studies are devoted to the determination of procarboxypeptidase B activation peptide in serum or urine. The activation peptide CAPAP is longer than other peptides released during the activation of pancreatic proenzymes, therefore it is more stable and more suitable for laboratory diagnostics. The normal serum CAPAP level by RIA is 0.8 nmol/L.