The role of phospholipase A2 in human acute pancreatitis.

Several studies suggest that the activation of pancreatic phospholipase A2 (PLA2) and its release from injured acinar cells play an important role in the pathogenesis of acute pancreatitis. Elevated catalytic activity of PLA2 in serum is associated especially with severe forms of the disease. PLA2 has been purified from human cadaver pancreas and an antiserum raised against the enzyme in rabbits. Immuno-histochemical localization of PLA2 in pancreatic tissue was abnormal in acute pancreatitis. A time-resolved fluoroimmunoassay for human pancreatic PLA2 has been developed. Increased serum concentrations of immunoreactive PLA2 were found in acute pancreatitis during the first week after hospital admission. The values returned to normal somewhat more slowly than corresponding serum amylase values. The immunochemical determination of PLA2 in serum provides a fast and specific detection of injury to pancreatic acinar cells. The pancreas is not the only source of PLA2 in acute pancreatitis. The nonpancreatic PLA2 may originate from various inflammatory cells, but this hypothesis remains to be proven.