The Possible Role of Phospholipase a in the Pathogenesis of Acute Pancreatitis

Abstract

The injection of lysolecithin into the rat pancreas is followed by severe pancreatic necrosis and extensive fat necrosis throughout the abdominal cavity. Phospholipase A, dissolved in a low-concentrated solution of bile acids and injected into the rat pancreas, has the same necrotizing effect. The injected phospholipase A splits the lecithin and the cephalin of the pancreatic tissue into their lysocompounds. The phospholipase A activity of the human pancreas is 10–30 times higher than that found in the pig, ox, or rat pancreas. The lecithin of bile is split into lysolecithin, in mixtures of human bile and human pancreatic juice. Normal human pancreatic tissue has only a low content of lysolecithin. In the necrotic pancreatic tissue of three patients who died of acute pancreatitis, there was a reversal of the normal phospholipid spectrum. Lysolecithin was the main phospholipid fraction in all cases, whereas the lecithin and cephalin were markedly reduced. It is concluded from these results that the intrapancreatic activation of phospholipase A may be an important factor in the pathogenesis of acute pancreatic necrosis.

Key-words:

• Pancreatitis
• bile
• phospholipase A
• lysolecithin
• phospholipids