SERUM PHOSPHOLIPASES A(2) IN PATIENTS UNDERGOING PANPROCTOCOLECTOMY BECAUSE OF SEVERE ULCERATIVE-COLITIS

A major role has been proposed for group II phospholipase A(2) in the pathogenesis of local and generalised inflammatory reactions. Elevated catalytic activity and mass concentrations of this enzyme have been f ound in serum and tissue samples of the colon in patients with active ulcerative colitis. The cellular source(s) of group II phospholipase A (2) in the blood circulation is (are) unknown. In the current prospect ive study, we investigated the mass concentration of group II phosphol ipase A(2) and the catalytic activity concentration of phospholipase A (2) in serial serum samples of 15 consecutive patients who underwent a standard panproctocolectomy operation for severe ulcerative colitis. Both the catalytic activity concentrations of phospholipase A(2) and t he mass concentrations of group II phospholipase A(2) increased rapidl y in serum samples to maximum values on the first postoperative day an d then decreased (p = 0.002 and p < 0.001, respectively) in patients w ho recovered uneventfully. Three patients had postoperative complicati ons that further increased the enzyme concentrations at the time of re spective complications. The pattern of group II phospholipase A(2) mas s concentration profiles was similar to the profiles of C-reactive pro tein. The results show that the removal of the large bowel does not el iminate the potential to secrete group II phospholipase A(2) into the blood circulation in these patients. Secretion of group II phospholipa se A(2) into the circulation after surgery seems to be a normal host r esponse to a major abdominal operation and postoperative complications . Consequently, we conclude that the large bowel is not an important s ource of group II phospholipase A(2) in sera of patients with ulcerati ve colitis. The results also support the assumptions that the catalyti c activity of phospholipase A(2) in serum is attributable to group II phospholipase A(2) and that this enzyme is an acute phase protein.