Objective

To aid the clinician in correctly interpreting serum tryptase levels.

Data Sources

Primary peer-reviewed literature.

Study Selections

Clinical and basic science peer-reviewed studies characterizing the genetic and physiological bases for tryptase generation, secretion, and elevation, including those describing serum tryptase levels in population-based cohort studies.

Results

Clinically measured basal serum tryptase (BST) consists of ostensibly inactive alpha- and beta-tryptase precursors. The autosomal dominant genetic trait hereditary alpha-tryptasemia is the most often cause for elevated BST levels, with other acquired causes, such as renal failure and clonal myeloid diseases being far less common. Acute increases in serum tryptase levels resulting from release of mature tryptase from secretory granules is specific to mast cell degranulation but is not detected in all cases of systemic anaphylaxis.

Conclusion

Understanding the differences and distinguishing between acute increases in serum tryptase and chronic elevations in BST owing to inherited or acquired conditions is critical in the correct interpretation of this useful clinical biomarker.

中文翻译：

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人类血清类胰蛋白酶水平的遗传和获得性决定因素

客观的

帮助临床医生正确解释血清类胰蛋白酶水平。

数据源

主要的同行评审文献。

研究选择

临床和基础科学同行评审研究，描述了类胰蛋白酶产生、分泌和升高的遗传和生理基础，包括那些在基于人群的队列研究中描述血清类胰蛋白酶水平的研究。

结果

临床测量的基础血清类胰蛋白酶 (BST) 由表面上无活性的 α 和 β 类胰蛋白酶前体组成。常染色体显性遗传性状遗传性α-色氨酸血症是导致 BST 水平升高的最常见原因，而其他获得性原因，如肾功能衰竭和克隆性骨髓疾病则不太常见。由分泌颗粒释放成熟的类胰蛋白酶导致血清类胰蛋白酶水平的急性升高是肥大细胞脱颗粒的特异性，但并非在所有全身性过敏反应病例中都检测到。

结论

了解和区分血清类胰蛋白酶急性升高和 BST 慢性升高之间的差异是由于遗传或获得性条件，对于正确解释这一有用的临床生物标志物至关重要。