Prognostic value of serum phospholipase A in acute pancreatitis

Abstract

Serum from 48 patients with acute pancreatitis (21 with interstitial-edematous and 27 with necrotizing pancreatitis) was monitored for immunoreactive (IR) phospholipase A2 (PLA2) protein concentration and PLA catalytic activity. In both groups within 48 h after start of acute pancreatitis an up to tenfold increase of IR-PLA2 was demonstrable. Determination of IR-PLA2 revealed no differences between the groups. In contrast, determination of PLA catalytic activity allowed us to differentiate between patients with interstitial-edematous and necrotizing pancreatitis.

Useful Markers for Predicting Severity and Monitoring Progression of Acute Pancreatitis

“…A differentiation between mild and severe pancreatitis can be performed as early as 24 h after onset of symptoms. While type I PLA 2 is of pancreatic origin and does not differentiate between mild and severe acute pancreatitis, type II PLA 2 , measured as catalytic PLA 2 activity in serum, has been shown to be a good prognostic marker for disease severity and pulmonary dysfunction [100][101][102][103]. However, the limiting factor for type II PLA 2 is that no assay for routine clinical use is available at this time.…”

“…It induces cell necrosis and may play a role in the pulmonary dysfunction associated with acute pancreatitis [99]. Several studies have shown a correlation between the plasma concentration of PLA 2 and the severity of the attack [100][101][102][103]. Circulating immunoreactive PLA 2 appears to parallel clinical severity [104,105], but measurement of the catalytic activity of PLA 2 provides better discrimination [100-103, 106, 107].…”

Application of a New Monoclonal Antibody for Time-resolved Fluoroimmunoassay of Human Pancreatic Phospholipase A2

“…Therefore immunoassays do not give any Information äs to the catalytic activity of the phospholipase A 2 enzyme molecule being measured. Since the catalytic activity of phospholipase A 2 correlates with the severity of the disease in acute pancratitis (6), it is advisible to measure both the catalytic activity of phospholipase A 2 and the concentration of immunoreactive pancreatic phospholipase A 2 in the same serum samples in order to specifically detect pancreatic acinar cell injury (by the latter method) and to assess the severity of the disease process (by the former method). There is an ample selection of methods available for the determination of phospholipase A 2 catalytic activity (23).…”

“…values of immunoreactive pancreatic phospholipase Time-resolved fluorescence was used äs a detecting A 2 have been found in sera of patients suffering from method in a solid-phase sandwich assay. The monoacute pancreatitis (5,6), pancreatic qancer (5) and donal antibod y was used as the catchin S antibod y and polyclonal anti-phospholipase A 2 antibody la-! ) Enzymes· belled with an europium (Eu) chelate was used as the Phospholipase A 2 , phosphatide 2-acylhydrolase (EC 3.1.1.4) detecting antibody.…”

Effect of Procainhydrochloride on Phospholipase A2 Catalytic Activity in Sodium Taurocholate-Induced Acute Experimental Pancreatitis in Rats

“…In acute pancreatitis (AP) two types of PLA2 have been described as playing important pathophysiological roles: (1) pancreatic group I PLA2, secreted by acinar cells, and (2) nonpancreatic group II PLA2 [1][2][3][4][5][6][7][8] . Group II PLA2 seems to be the major enzyme in AP responsible for the systemic inflammatory process [4] .…”