Nevalainen Timo J, Eerola Leena I, Rintala Esa, Laine V Jukka O, Lambeau Gérard, Gelb Michael H
Department of Pathology, University of Turku, Finland.
Biochim Biophys Acta. 2005 Apr 15;1733(2-3):210-23. doi: 10.1016/j.bbalip.2004.12.012. Epub 2005 Jan 7.
Time-resolved fluoroimmunoassays (TR-FIA) were developed for all human secreted phospholipases A(2) (PLA(2)), viz. group (G) IB, GIIA, GIID, GIIE, GIIF, GIII, GV, GX and GXIIA PLA(2) and the GXIIB PLA(2)-like protein. Antibodies were raised in rabbits against recombinant human PLA(2) proteins and used in sandwich-type TR-FIAs as both catching and detecting antibodies, the latter after labeling with Europium. The antibodies were non-cross-reactive. The analytical sensitivities were 1 microg/L for the TR-FIA for GIB PLA(2), 1 microg/L (GIIA), 35 microg/L (GIID), 3 microg/L (GIIE), 4 microg/L (GIIF), 14 microg/L (GIII), 11 microg/L (GV), 2 microg/L (GX), 92 microg/L (GXIIA) and 242 microg/L (GXIIB). All secreted PLA(2)s were assayed by these TR-FIAs in serum samples from 34 patients (23 men and 11 women, mean age 53.2 years) treated in an intensive care unit for septic infections, and in control samples from 28 volunteer blood donors (14 men and 14 women, mean age 57.0 years). Five serum samples (3 in the sepsis group and 2 in the blood donor group) gave high TR-FIA signals that were reduced to background (blank) levels by the addition of non-immune rabbit IgG to the sera. This reactivity was assumed to be due to the presence of heterophilic antibodies in these subjects. In all other subjects, including septic patients and healthy blood donors, the TR-FIA signals for GIID, GIIE, GIIF, GIII, GV, GX and GXIIA PLA(2) and the GXIIB PLA(2)-like protein were at background (blank) levels. Four patients in the sepsis group had pancreatic involvement and elevated concentration of GIB PLA(2) in serum (median 19.0 microg/L, range 13.1-33.7 microg/L, n = 4) as compared to the healthy blood donors (median 1.8 microg/L, range 0.8-3.4 microg/L, n = 28, P < 0.0001). The concentration of GIIA PLA(2) in the sera of septic patients (median 315.7 microg/L, range 15.9-979.6 microg/L, n = 34) was highly elevated as compared to that of the blood donors (median 1.8 microg/L, range 0.8-5.8 microg/L, n = 28, P < 0.0001). Our current results confirmed elevated concentrations of GIB and GIIA PLA(2) in the sera of patients suffering from acute pancreatitis or septic infections, respectively, as compared to healthy subjects. However, in the same serum samples, the concentrations of the other secreted PLA(2)s, viz. GIID, GIIE, GIIF, GIII, GV, GX and GXIIA PLA(2) and the GXIIB PLA(2)-like protein were below the respective analytical sensitivities of the TR-FIAs. It is concluded that generalized bacterial infections do not lead to elevated serum levels of GIIE, GIIF, GIII, GV and GX PLA(2)s above the detection limits of the current TR-FIAs.
已针对所有人类分泌型磷脂酶A(2)(PLA(2))开发了时间分辨荧光免疫分析(TR-FIA),即IB组、IIA组、IID组、IIE组、IIF组、III组、V组、X组和XIIA组PLA(2)以及XIIB组PLA(2)样蛋白。用重组人PLA(2)蛋白对兔进行免疫以产生抗体,并将其用作夹心型TR-FIA中的捕获抗体和检测抗体,后者用铕标记。这些抗体无交叉反应性。GIB组PLA(2)的TR-FIA分析灵敏度为1微克/升,IIA组为1微克/升,IID组为35微克/升,IIE组为3微克/升,IIF组为4微克/升,III组为14微克/升,V组为11微克/升,X组为2微克/升,XIIA组为92微克/升,XIIB组为242微克/升。通过这些TR-FIA对34例在重症监护病房接受脓毒症感染治疗的患者(23名男性和11名女性;平均年龄53.2岁)的血清样本以及28名志愿献血者(14名男性和14名女性;平均年龄57.0岁)的对照样本中的所有分泌型PLA(2)进行了检测。5份血清样本(脓毒症组3份,献血者组2份)给出了较高的TR-FIA信号,在血清中加入非免疫兔IgG后,这些信号降至背景(空白)水平。推测这种反应性是由于这些受试者中存在嗜异性抗体。在所有其他受试者中,包括脓毒症患者和健康献血者,IID组、IIE组、IIF组、III组、V组、X组和XIIA组PLA(2)以及XIIB组PLA(2)样蛋白的TR-FIA信号均处于背景(空白)水平。脓毒症组中有4例患者有胰腺受累,与健康献血者相比,其血清中GIB组PLA(2)浓度升高(中位数19.0微克/升,范围13.1 - 33.7微克/升,n = 4)(健康献血者中位数1.8微克/升,范围0.8 - 3.4微克/升,n = 28,P < 0.0001)。脓毒症患者血清中IIA组PLA(2)浓度(中位数315.7微克/升,范围15.9 - 979.6微克/升,n = 34)与献血者相比显著升高(中位数1.8微克/升,范围0.8 - 5.8微克/升,n = 28,P < 0.0001)。我们目前的结果证实,与健康受试者相比,急性胰腺炎患者或脓毒症感染患者血清中GIB组和IIA组PLA(2)浓度分别升高。然而,在相同的血清样本中,其他分泌型PLA(2),即IID组、IIE组、IIF组、III组、V组、X组和XIIA组PLA(2)以及XIIB组PLA(2)样蛋白的浓度低于TR-FIA各自的分析灵敏度。结论是,全身性细菌感染不会导致血清中IIE组、IIF组、III组、V组和X组PLA(2)水平升高至超过当前TR-FIA的检测限。