Time course of changes in pancreatic enzymes, isoenzymes and, isoforms in serum after endoscopic retrograde cholangiopancreatography.
Kinetics of the catalytic activities of total amylase (AMY; EC 3.2.1.1), pancreatic (P)-AMY isoenzyme, P2 and P3 isoforms, and pancreatic lipase (LPS; EC 3.1.1.3), and of the mass concentration of LPS in serum were studied in 10 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) and showed a distinct pancreatic injury. The temporal characteristics of enzyme changes described were (a) the maximal rate (Ka) at which enzymes are released into blood, (b) the time lag from ERCP until maximum concentration value, (c) the peak value of each serum enzyme, and (d) the rate (Kd) at which each enzyme is cleared from serum. LPS activity and mass concentrations increased and decreased faster than AMY and isoamylases, and the time of the LPS peak tended to be earlier than that of the other enzymes, but not significantly. The average peak increase of LPS values was higher than that of total AMY, P-AMY, and P2 isoform (P less than 0.001). The P-AMY time-activity curve was a composite of curves attributable to its isoforms; the isoforms increased and peaked sequentially, with P3 returning to normal more slowly than did P2. LPS mass and activity concentrations showed excellent parallelism, with no important differences. At 50 h after ERCP, only LPS values still exceeded the upper reference limit, returning to normal 70 h after the examination.
Panteghini
M
M
Laboratorio Analisi Chimico-Cliniche, Spedali Civili, Brescia, Italy.
Pagani
F
F
Alebardi
O
O
Lancini
G
G
Cestari
R
R
D000681:Amylases / Q000378:metabolism*; D002384:Catalysis; D002760:Cholangiopancreatography, Endoscopic Retrograde; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism*; D008049:Lipase / Q000378:metabolism*; D010179:Pancreas / Q000201:enzymology*
D007527:Isoenzymes; D008049:Lipase; D000681:Amylases