Phospholipid changes in children with pancreatic sufficiency and insufficiency

The phospholipid secretion rates and phospholipase A1 and phospholipase A2 activities in biliary-pancreatic secretions of patients with pancreatic sufficiency and insufficiency were measured using 31P-NMR spectroscopy. It was possible to quantify conveniently the individual phospholipids without prior extraction of lipids or treatment of the samples with detergent. The reciprocal nature of the decrease in phosphatidylcholine concentration, compared with the increase in the concentration of 1-lysophosphatidylcholine and 2-lysophosphatidylcholine, suggested a substrate/product relationship consistent with the activities of phospholipase A1 and phospholipase A2, respectively. Although the secretion rates of total biliary phospholipids among the patients with pancreatic sufficiency were similar, the phospholipase A1 and phospholipase A2 activities varied considerably. The latter differences were similar to their pancreatic lipase and colipase secretion levels and hence their degree of pancreatic dysfunction. The biliary-pancreatic secretions from patients with pancreatic insufficiency showed no enzyme activities. Total biliary phospholipid secretions in patients with pancreatic insufficiency with common bile duct stenosis were significantly lower than those in patients with pancreatic sufficiency, and pancreatic insufficiency without common bile duct stenosis.