Phospholipase A2 in acute pancreatitis: New biochemical and pathological aspects

Phospholipase A2 has been implicated in the pathogenesis and pathophysiolog y of acute pancreatitis. The initial enthusiasm concerning pancreatic group I phospholipase A2 as an enzyme responsible for pancreatic necrosis and sy stemic manifestations of acute pancreatitis has gradually waned, as the mec hanisms of the pathogenesis and the pathophysiology of acute pancreatitis h ave been revealed. The overactive systemic inflammatory response associated with the activation of different cascade systems and increased levels of i nflammatory mediators as seen in severe acute pancreatitis, closely resembl es that associated with other severe inflammatory diseases such as septic s hock. The critical role of the non-pancreatic secretory group II phospholip ase A2 in the chain of inflammatory mediators has been emphasized recently, as new detection methods for the enzyme have become available.