Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Pancreas. 2012 May;41(4):518-22. doi: 10.1097/MPA.0b013e31823ca306.
Oxidative stress is intimately involved in the pathogenesis of chronic pancreatitis (CP), and its quantification may represent a useful biomarker. The aim was to determine whether oxidized fatty acid (OxFA) levels in serum and/or pancreatic fluid are elevated in CP.
Patients evaluated for abdominal pain were classified into 3 groups (controls, mild CP, and severe CP). Serum and secretin-stimulated pancreatic fluid samples were stored under conditions to minimize artificial oxidation. Ten arachidonic and linoleic acid oxidation products were simultaneously measured using liquid chromatography-electrospray ionization-tandem mass spectrometry.
Most OxFAs were significantly elevated in the serum of patients with mild and severe CP compared to controls and correlated with structural features on endoscopic ultrasound. For example, the mean (SD) ratio of serum 13-HODE to its precursor linoleic acid was 0.03 (0.004) in controls, 0.06 (0.02) in mild CP, and 0.10 (0.04) in severe CP (analysis of variance, P = 0.004) and had a strong correlation with endoscopic ultrasound features (Spearman r = 0.84, P < 0.001). In the pancreatic fluid, statistically significant increases of OxFA products were observed in mild CP compared to controls.
Oxidized fatty acid products are increased in the serum and pancreatic fluid of patients with CP, suggesting a potential role as biomarkers.
AA - arachidonic acidANOVA - analysis of varianceAP - acute pancreatitisCP - chronic pancreatitisePFT - endoscopic pancreatic function testEUS - endoscopic ultrasoundHPLC - high-pressure liquid chromatographyHETE - hydroxy-eicosatetranoic acidHODE - hydroxy-octadecadienoic acidLA - linoleic acidLC-ESI-MS/MS - liquid chromatography-electrospray ionization-tandem mass spectrometryM - molarOxFA - oxidized fatty acidsPFT - pancreatic function test.
氧化应激与慢性胰腺炎（CP）的发病机制密切相关，其定量检测可能是一种有用的生物标志物。本研究旨在确定血清和/或胰液中氧化脂肪酸（OxFA）水平是否在 CP 中升高。
评估腹痛的患者被分为 3 组（对照组、轻度 CP 和重度 CP）。血清和促胰液素刺激的胰液样本在尽量减少人为氧化的条件下储存。使用液相色谱-电喷雾电离-串联质谱法同时测定 10 种花生四烯酸和亚油酸氧化产物。
与对照组相比，轻度和重度 CP 患者的血清中大多数 OxFA 显著升高，并与内镜超声的结构特征相关。例如，对照组血清 13-HODE 与其前体亚油酸的平均（SD）比值为 0.03（0.004），轻度 CP 为 0.06（0.02），重度 CP 为 0.10（0.04）（方差分析，P=0.004），与内镜超声特征有很强的相关性（Spearman r=0.84，P<0.001）。在胰液中，与对照组相比，轻度 CP 患者 OxFA 产物的增加有统计学意义。
CP 患者血清和胰液中氧化脂肪酸产物增加，提示其可能作为生物标志物。
AA-花生四烯酸；ANOVA-方差分析；AP-急性胰腺炎；CP-慢性胰腺炎；ePFT-内镜下胰腺功能试验；EUS-内镜超声；HPLC-高压液相色谱；HETE-羟基二十碳四烯酸；HODE-羟基十八碳二烯酸；LA-亚油酸；LC-ESI-MS/MS-液相色谱-电喷雾电离-串联质谱；OxFA-氧化脂肪酸；PFT-胰腺功能试验。
