Role of phospholipase A2 in human acute pancreatitis.
In a prospective clinical trial, 85 patients with acute pancreatitis, including 50 with acute interstitial-edematous pancreatitis and 35 with necrotizing pancreatitis, were recruited. Serum pancreatic immunoreactive phospholipase A2 (IR-PLA2), serum phospholipase A catalytic activity (CA-PLA), and serum phospholipase A2 catalytic activity (CA-PLA2) were determined daily between day 1 and day 10 after the onset of the disease. The serum course of IR-PLA2 values for patients with acute interstitial-edematous pancreatitis was comparable to that for patients with necrotizing pancreatitis. In contrast, the determination of CA-PLA and of CA-PLA2 specific activity in the serum revealed a high differentiation between patients with interstitial edematous and those with necrotizing pancreatitis. The overall accuracy for differentiating patients with necrotizing pancreatitis from those with the interstitial-edematous type was 79% for CA-PLA and 77% for CA-PLA2 (cut-off level: CA-PLA, 15 U/L, day 1-5; CA-PLA2, 3.5 U/L, day 1-5). Patients with pancreatitis-associated pulmonary complications showed significantly higher CA-PLA and CA-PLA2 values in the serum. This study demonstrates the role of serum catalytic phospholipase A2 in human acute pancreatitis where the development of pancreatic necrosis and pulmonary failure is concerned.
Büchler
M
M
Department of Surgery, University of Ulm, Federal Republic of Germany.
Malfertheiner
P
P
Schädlich
H
H
Nevalainen
T J
TJ
Friess
H
H
Beger
H G
HG
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000201:enzymology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis / Q000201:enzymology*; D010740:Phospholipases / Q000502:physiology*; D010741:Phospholipases A / Q000502:physiology*; D054467:Phospholipases A2; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D010740:Phospholipases; D010741:Phospholipases A; D054467:Phospholipases A2