The diagnostic value of serum pancreatic phospholipase A2 (PLA2) in pancreatic diseases

Phospholipase A2 superfamily in cancer

Phospholipase A2 enzymes (PLA₂s) comprise a superfamily that is generally divided into six subfamilies known as cytosolic PLA₂s (cPLA₂s), calcium-independent PLA₂s (iPLA₂s), secreted PLA₂s (sPLA₂s), lysosomal PLA₂s, platelet-activating factor (PAF) acetylhydrolases, and adipose specific PLA₂s. Each subfamily consists of several isozymes that possess PLA₂ activity. The first three PLA₂ subfamilies play important roles in inflammation-related diseases and cancer. In this review, the roles of well-studied enzymes sPLA₂-IIA, cPLA₂α and iPLA₂β in carcinogenesis and cancer development were discussed. sPLA₂-IIA seems to play conflicting roles and can act as a tumor suppressor or a tumor promoter according to the cancer type, but cPLA₂α and iPLA₂β play protumorigenic role in most cancers. The mechanisms of PLA₂-mediated signal transduction and crosstalk between cancer cells and endothelial cells in the tumor microenvironment are described. Moreover, the mechanisms by which PLA₂s mediate lipid reprogramming and glycerophospholipid remodeling in cancer cells are illustrated. PLA₂s as the upstream regulators of the arachidonic acid cascade are generally high expressed and activated in various cancers. Therefore, they can be considered as potential pharmacological targets and biomarkers in cancer. The detailed information summarized in this review may aid in understanding the roles of PLA₂s in cancer, and provide new clues for the development of novel agents and strategies for tumor prevention and treatment.

Phospholipase A2 as a point of care alternative to serum amylase and pancreatic lipase

Acute pancreatitis is a relatively common and potentially fatal condition, but the presenting symptoms are non-specific and diagnosis relies largely on the measurement of amylase activity by the hospital clinical laboratory. In this work we develop a point of care test for pancreatitis measuring concentration of secretory phospholipase A2 group IB (sPLA2-IB). Novel antibodies for sPLA2-IB were raised and used to design an ELISA and a lateral flow device (LFD) for the point of care measurement of sPLA2-IB concentration, which was compared to pancreatic amylase activity, lipase activity, and sPLA2-IB activity in 153 serum samples. 98 of these samples were obtained from the pathology unit of a major hospital and classified retrospectively according to presence or absence of pancreatitis, and the remaining 55 were obtained from commercial sources to serve as high lipase (n = 20), CA19-9 positive (n = 15), and healthy (n = 20) controls. sPLA2-IB concentration correlated well with the serum activity of both amylase and lipase, and performed at least as well as either markers in the differentiation of pancreatitis from controls.

Quantitative proteomics investigation of pancreatic intraepithelial neoplasia

Patients with pancreatic cancer are usually diagnosed at late stages, when the disease is incurable. Pancreatic intraepithelial neoplasia (PanIN) 3 is believed to be the immediate precursor lesion of pancreatic adenocarcinoma, and would be an ideal stage to diagnose patients, when intervention and cure are possible and patients are curable. In this study, we used quantitative proteomics to identify dysregulated proteins in PanIN 3 lesions. Altogether, over 200 dysregulated proteins were identified in the PanIN 3 tissues, with a minimum of a 1.75-fold change compared with the proteins in normal pancreas. These dysregulated PanIN 3 proteins play roles in cell motility, the inflammatory response, the blood clotting cascade, the cell cycle and its regulation, and protein degradation. Further network analysis of the proteins identified c-MYC as an important regulatory protein in PanIN 3 lesions. Finally, three of the overexpressed proteins, laminin beta-1, galectin-1, and actinin-4 were validated by immunohistochemistry analysis. All three of these proteins were overexpressed in the stroma or ductal epithelial cells of advanced PanIN lesions as well as in pancreatic cancer tissue. Our findings suggest that these three proteins may be useful as biomarkers for advanced PanIN and pancreatic cancer if further validated. The dysregulated proteins identified in this study may assist in the selection of candidates for future development of biomarkers for detecting early and curable pancreatic neoplasia.

An experimental study in etiologic effect of pancreas divisum on chronic pancreatitis and its pathogenesis

AIM: To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis.

METHODS: A PD canine model was established in 32 dogs. The dogs were randomly divvided into 4 groups (n = 8). Group I: The communicating branch between the dorsal and ventral pancreatic ducts was partly ligated Group IIa: The communicating branch was amputated and completely ligated Group IIb: The dorsal duct was amputated and ligated at 2 mm distance to the minor papilla. Group III: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipase A2 (PLA2) and amylase (Ams) were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductograhpy and the pathologic examination were made.

RESULTS: The activities of serum PLA2 and ams in Group I, IIa, and IIb were sigificantly increased 5-80 d after operation. At sacrifice, the basal pressures of the ventral duct were significantly wiaher 30 min-60 min after provocation in Group I, IIa and IIb. The pressures of the dorsal duct were significantly increased in Group IIb but no difference in Group I and IIa. Under light microscopy the fibrosis of interlobus and periducts, the destruction of acini and infiltratiob of inflammatory cell in dorsal and ventral pancreas were found in Group IIb. But in Group I and IIa, this findings were pesent only in ventral pancreas. The electron microscopy showed that in ventral pancreas of Group I and IIa and the dorsal and ventral pancreas of Group IIb, the rough endoplasmic reticulum of the acinar cells showed granules-scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen.

CONCLUSION: PD is one of etiologic factors in chronic pancreatitis. The pathogenesis is the functional obstruction of the minor papilla at the peak stage of secretion.

Human pancreatic phospholipase A2 stimulates the growth of human pancreatic cancer cell line

Phospholipase A2 (PLA2) from human pancreas, designated hPLA2-I, functions as a digestive enzyme. Interestingly, the present study demonstrated that the mature form of hPLA2-I stimulated the growth of a human pancreatic cancer cell line MIAPaCa-2, whereas the pro-form was ineffective. PLA2s from Laticauda semifasciata fraction I, Crotalus adamanteus venom, Streptomyces violaceoruber and bee venom, showed no proliferative effect to the growth of MIAPaCa-2. The Scatchard plot analysis revealed that the MIAPaCa-2 cell had a specific binding site for the mature hPLA2-I. The equilibrium binding constant (Kd) and the maximum binding capacity (Bmax) were 2.6 nM and 0.4 fmol/10(6) cells, respectively. These results suggest that the mature hPLA2-I, but not the pro-form, may function as a growth factor of pancreas carcinoma via the specific binding site.

Elevation of serum phospholipase A2 in patients at an intensive care unit

To evaluate the organ specificity of pancreatic phospholipase A2 (PLA2) and the diagnostic value of the elevation of serum PLA2 levels in patients with serious diseases not involving the pancreas, we studied the organ distribution of PLA2 in autopsy specimens and serum level of PLA2 in patients who required admission to an intensive care unit (ICU). PLA2 was measured by a specific radioimmunoassay (RIA), using monoclonal antibody against human pancreatic PLA2. Organ distribution of PLA2 revealed that the pancreas showed a much higher content of pancreatic PLA2 immunoreactivity than any other organ. An abnormally high value of serum PLA2 was observed in 18 of 30 patients (60%) at ICU. Both serum PLA2 and pancreatic isoamylase were elevated in 11 patients (37%). Of 11 patients with hyperphospholipasemia and hyperamylasemia, serum creatinine was elevated in five patients and blood urea nitrogen in nine patients. Serum PLA2 levels did not always rise comparably to serum creatinine and blood urea nitrogen levels. Serum PLA2 values showed the best correlation with serum lactate dehydrogenase levels among routine blood-chemistry tests. The elevation of serum PLA2 was ascribable to renal dysfunction or ischemic pancreatic damage secondary to circulatory collapse with multiple organ failure.