Pancreatic phospholipase A2 activity in acute pancreatitis: A prognostic marker for early identification of patients at risk

Remarkably elevated levels of phospholipase A(2) (PLA(2)) are
measurable in human blood samples in cases of acute pancreatitis.
The source of the enzyme was first thought to be exclusively the
pancreas, but now it is generally accepted that two isoenzymes the
pancreatic PLA(2), group I, and the extrapancreatic PLA(2), group
II contribute to the raised activity. In contrast to the group
II-PLA(2), the pancreatic PLA(2) is heatresistant for 1 hour at 60
degreesC. The catalytically inactive proenzyme of the pancreatic
PLA(2) can be activated by trypsin. The aim of our study was to
evaluate the diagnostic value of PLA(2) isoenzyme activity
measurements to identify patients with severe complications in
acute pancreatitis. Blood samples from patients suffering from
acute pancreatitis were analyzed for catalytically active
pancreatic PLA(2) on day 1 and 2 of hospitalization with a modified
radiometric Escherichia colibased PLA(2) assay. In 10 of 41
patients clearly elevated values of catalytically active,
heatresistant pancreatic PLA(2) (7.2 to 81.2 U/l) were observed.
This group of patients was characterized by severe complications
(necrotizing pancreatitis, shock, sepsis, respiratory problems) of
which two patients subsequently died. Patients with low or
undetectable activity (