Simultaneous determinations of pancreatic phospholipase A₂ and prophospholipase A₂ in various pancreatic diseases

Abstract

Pancreatic phospholipase A₂ (PLA₂) is secreted into the pancreatic juice by pancreatic acinar cells as a proenzyme (proPLA₂), which is activated by trypsin. Radioimmunoassays with monoclonal antibodies to PLA₂ and proPLA₂ were used to examine the serum PLA₂ and proPLA₂ levels simultaneously in patients with various pancreatic diseases. In healthy subjects, proPLA₂ proved to be the major form of the enzyme. The serum PLA₂ level were found to be significantly increased in patients with acute pancreatitis, the active phase of chronic relapsing pancreatitis, and the early stage of pancreatic cancer. In the terminal stage of pancreatic cancer the serum PLA₂ level became low. In patients with chronic pancreatitis, significant correlations were observed between the levels of factors evaluated by the secretin test and the serum total PLA₂ and proPLA₂ level, but not the PLA₂ level. The serum PLA₂ and proPLA₂ concentrations, and the proportion of proPLA₂ in the total, were within normal ranges in patients with liver cirrhosis, hepatocellular carcinoma, and chronic renal failure. These results suggest that simultaneous measurements of serum PLA₂ and proPLA₂ are clinically useful for diagnosis and monitoring of the active phase of pancreatitis.