| Local and systemic zymogen activation in human acute pancreatitis. | |
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MedLine Citation:
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PMID: 11025364 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Activation of trypsinogen and phospholipase A(2) is an early event in pancreatic inflammation, but little is known about zymogen activation and the severity of human pancreatitis. METHODS: Using a new fluoroimmunoassay we measured trypsinogen activation peptide (TAP) and phospholipase A(2) activation peptide (PROP) in plasma and ascites in 25 patients with acute pancreatitis. TAP, PROP, Pro-PROP and pancreatic PLA(2)-I were measured in plasma for 14 days and in pancreatic necroses, ascitic fluid and pleural effusions. RESULTS: All 16 patients with severe acute pancreatitis (SAP) had pancreatic necrosis, 10 developed systemic complications like sepsis, pulmonary or renal failure, 6 had infected necrosis, and 4 died. All 9 patients with mild pancreatitis (MAP) survived. Plasma TAP on admission was higher in patients with SAP than in those with MAP and increased in infected necroses. It did not correlate with systemic complications. Systemic PROP was not increased in complicated courses but was significantly higher in patients with MAP than in those with SAP on admission. Pro-PROP was higher in patients with SAP than in those with MAP but was not correlated with systemic complications. Plasma pancreatic PLA(2)-I was increased but not different in patients with SAP and those with MAP. In patients with pancreatic necrosis, TAP and PROP were highest, while in those with post-acute pancreatic abscess, only PROP and Pro-PROP were high. In patients with pleural effusion, TAP was low and PROP/ Pro-PROP were high. CONCLUSION: Trypsinogen and PLA(2)-I activation are early events in acute pancreatitis and the activation peptides can be detected in plasma. In the pancreas, trypsinogen activation is accompanied by PLA(2)-I activation in patients with pancreatic necrosis. However, in our study, organ complications in SAP patients was not associated with increased plasma PROP. |
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Authors:
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J M Mayer; B Rau; M Siech; H G Beger |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Digestion Volume: 62 ISSN: 0012-2823 ISO Abbreviation: Digestion Publication Date: 2000 |
Date Detail:
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Created Date: 2000-11-13 Completed Date: 2001-01-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0150472 Medline TA: Digestion Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 164-70 Citation Subset: IM |
Copyright Information:
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Copyright 2000 S. Karger AG, Basel. |
Affiliation:
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Department of General Surgery, University Hospital of Ulm, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Aged, 80 and over Ascites Enzyme Induction Female Humans Male Middle Aged Necrosis Oligopeptides / analysis, pharmacology Pancreatitis / enzymology* Phospholipases A / metabolism* Pleural Effusion Proteins / analysis, pharmacology Trypsinogen / metabolism* |
| Chemical | |
Reg. No./Substance:
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0/Oligopeptides; 0/Proteins; 0/phospholipase A2-activating protein; 0/trypsinogen activation peptide; 9002-08-8/Trypsinogen; EC 3.1.1.-/Phospholipases A |
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