Increased Concentrations of Synovial-Type Phospholipase A2 in Serum and Pulmonary and Renal Complications in Acute Pancreatitis

Abstract

The most important fatal complications of acute pancreatitis are respiratory dysfunction and anuria. Phospholipase A₂ has been postulated to be associated with pathologies of various diseases, such as acute pancreatitis, septic shock and multiple injuries. We have recently developed immunoassays for the measurement of pancreatic and nonpancreatic synovial-type phospholipase A₂. The present prospective study on 35 consecutive patients with acute pancreatitis indicated that the concentration of synovial-type phospholipase A₂, the catalytic activity of phospholipase A₂ and the concentration of C-reactive protein in serum were significantly higher in those patients suffering from acute pancreatitis who needed respirator treatment than in those who managed with spontaneous breathing, while there was no difference between these groups in the concentration of pancreatic phospholipase A₂. The only significant difference between patients whose highest creatinine concentration rose up to 140 μmol/l and those whose highest creatinine concentration remained below this cutoff value was in their synovial-type phospholipase A₂ values. The increased concentration of nonpancreatic synovial-type phospholipase A₂ in serum was associated with pulmonary and renal complications. These results emphasize the role of synovial-type phospholipase A₂ in the pathophysiology of acute pancreatitis.