Antiprotease shield

The tissue-destructive potential of neutrophil-derived enzymes are countered by powerful plasma antiproteinases. These include ai-proteinase inhibitor, a2-macroglobulin, leukoproteinase inhibitor, plasminogen activator inhibitor (PAI-1), and tissue inhibitor of metalloproteinases (TIMPs) (4). Together, these inhibitors create an antiprotease shield in both plasma and in interstitial fluids. There is growing evidence that this antiprotease shield can be overwhelmed by the over exuberant neutrophil response in chronic wounds. 

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