The potential role of Clostridium perfringens alpha toxin in the pathogenesis of acute pancreatitis.
BACKGROUND
Clostridium perfringens is a bowel commensal that can colonise the biliary tract. It produces the alpha toxin (phospholipase C), which can induce spontaneous tissue necrosis.


OBJECTIVE
To investigate whether there is any evidence that Clostridium perfringens alpha toxin can be detected in acute pancreatitis.


METHODS
Serum samples from 21 patients with acute pancreatitis and 22 controls were assayed for C perfringens phospholipase C as well as anti-phospholipase C IgG and IgM; IgG and IgM anti-toxins were measured by enzyme linked immunosorbent assay.


RESULTS
In normal healthy controls there is a very high level of natural anti-toxin of both the IgG and IgM class. Of the 21 patients with acute pancreatitis alpha toxin was detected in five (23.8%). Levels of both IgG and IgM anti-toxin were significantly reduced in acute pancreatitis.


CONCLUSIONS
The results suggest that there is an abnormality of the immune status to C perfringens alpha toxin in patients with acute pancreatitis. This may be the result of a release of alpha toxin, although it is difficult to state whether this is a primary or secondary phenomenon in these patients. These preliminary results merit further investigation.
Holdsworth
R J
RJ
Department of Surgery, Ninewells Hospital and Medical School, Dundee.
Parratt
D
D
D000208:Acute Disease; D000992:Antitoxins / Q000032:analysis; D001427:Bacterial Toxins / Q000097:blood*; D002135:Calcium-Binding Proteins; D003016:Clostridium perfringens; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D010195:Pancreatitis / Q000209:etiology* / Q000276:immunology; D010738:Type C Phospholipases / Q000097:blood / Q000276:immunology
D000992:Antitoxins; D001427:Bacterial Toxins; D002135:Calcium-Binding Proteins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010738:Type C Phospholipases; C040649:alpha toxin, Clostridium perfringens