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Enzyme-linked immunosorbent assay has been used to measure elastase proteinase inhibitor complex (EPIC) and C-reactive protein (CRP) in the elderly, with and without infection. Median EPIC levels in the elderly with infection, hospital controls, healthy elderly residents in old people’s homes and healthy blood donors were 300, 104, 96 and 74 ng/ml respectively. Ninety-five per cent of the patients with infection had EPIC levels well above the normal range. The median EPIC level in the elderly with infection showed a statistically significant difference from that in the control groups (p< 0.0001, Mann U test). CRP showed similar results. Elevation of EPIC or CRP did not depend on the type of infection or bacteria isolated. We would conclude that neutrophil inhibitor-bound elastase could be used as a marker of inflammation in old people.

To assess lactoferrin as a marker of infection, plasma lactoferrin (LF) levels were determined in elderly in- patients with infection and compared with age- and sex- matched healthy and hospital controls and young healthy blood donors. The median LF level in infection (800 ng/mL) was significantly higher than in healthy elderly living in old people’s home (300 ng/mL) or elderly hospital controls (298 ng/mL) (p < 0.01 in each case). Plasma LF correlated significantly with elastase alpha- 1- proteinase inhibitor complex (EPIC) (Rs= 0.8, p < 0.01) and C- reactive protein (CRP) (Rs= 0.45, p < 0.02), but not with erythrocyte sedimentation rate (ESR) or white blood cell counts. We conclude that plasma LF, like CRP and EPIC, is a marker of infection in elderly individuals. (Aging Clin. Exp. Res. 4: 135–137, 1992)