Effect of Trypsin Inhibitors on Shwartzman Phenomenon.∗

Summary 1 Trypsin inhibitors injected intravenously at about the time of the provocative endotoxin injection, partially or completely inhibited the local Shwartzman phenomenon and prevented development of renal lesions (as seen in the generalized Shwartzman phenomenon). 2 Inhibitors administered intradermally mixed with the endotoxin skin preparatory dose, or intravenously at time of skin preparation, did not influence the reaction. 3 The data presented suggest that activated proteolytic enzymes are involved in the Shwartzman phenomenon. 4 The role of these enzymes in the pathogenesis of the phenomenon is discussed. Alterations of the clotting mechanism and vascular changes brought about by release of serotonin, histamine and activation of plasma kinins have been considered.