Haapamäki M M, Grönroos J M, Pekkala E, Jokilammi-Siltanen A, Irjala K, Lertola K, Nevalainen T J
Department of Surgery, University of Turku, Finland.
Eur J Clin Chem Clin Biochem. 1997 Oct;35(10):749-54. doi: 10.1515/cclm.1997.35.10.749.
A major role has been proposed for group II phospholipase A2 in the pathogenesis of local and generalised inflammatory reactions. Elevated catalytic activity and mass concentrations of this enzyme have been found in serum and tissue samples of the colon in patients with active ulcerative colitis. The cellular source(s) of group II phospholipase A2 in the blood circulation is (are) unknown. In the current prospective study, we investigated the mass concentration of group II phospholipase A2 and the catalytic activity concentration of phospholipase A2 in serial serum samples of 15 consecutive patients who underwent a standard panproctocolectomy operation for severe ulcerative colitis. Both the catalytic activity concentrations of phospholipase A2 and the mass concentrations of group II phospholipase A2 increased rapidly in serum samples to maximum values on the first postoperative day and then decreased (p = 0.002 and p < 0.001, respectively) in patients who recovered uneventfully. Three patients had postoperative complications that further increased the enzyme concentrations at the time of respective complications. The pattern of group II phospholipase A2 mass concentration profiles was similar to the profiles of C-reactive protein. The results show that the removal of the large bowel does not eliminate the potential to secrete group II phospholipase A2 into the blood circulation in these patients. Secretion of group II phospholipase A2 into the circulation after surgery seems to be a normal host response to a major abdominal operation and postoperative complications. Consequently, we conclude that the large bowel is not an important source of group II phospholipase A2 in sera of patients with ulcerative colitis. The results also support the assumptions that the catalytic activity of phospholipase A2 in serum is attributable to group II phospholipase A2 and that this enzyme is an acute phase protein.
有人提出，II 型磷脂酶 A2 在局部和全身性炎症反应的发病机制中起主要作用。在活动性溃疡性结肠炎患者的结肠血清和组织样本中，已发现该酶的催化活性和质量浓度升高。血液循环中 II 型磷脂酶 A2 的细胞来源尚不清楚。在当前的前瞻性研究中，我们调查了 15 例因严重溃疡性结肠炎接受标准全直肠结肠切除术的连续患者的系列血清样本中 II 型磷脂酶 A2 的质量浓度和磷脂酶 A2 的催化活性浓度。在恢复顺利的患者中，磷脂酶 A2 的催化活性浓度和 II 型磷脂酶 A2 的质量浓度在血清样本中迅速升高至术后第一天的最大值，然后下降（分别为 p = 0.002 和 p < 0.001）。三名患者出现术后并发症，在各自并发症发生时进一步增加了酶浓度。II 型磷脂酶 A2 质量浓度曲线的模式与 C 反应蛋白的曲线相似。结果表明，切除大肠并不能消除这些患者向血液循环中分泌 II 型磷脂酶 A2 的可能性。术后 II 型磷脂酶 A2 分泌到循环中似乎是宿主对大型腹部手术和术后并发症的正常反应。因此，我们得出结论，大肠不是溃疡性结肠炎患者血清中 II 型磷脂酶 A2 的重要来源。结果还支持以下假设：血清中磷脂酶 A2 的催化活性归因于 II 型磷脂酶 A2，并且该酶是一种急性期蛋白。
