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Secretory phospholipase A2 activity correlates with postinjury multiple organ failure
D A Partrick1, E E Moore, C C Silliman
1Department of Surgery, Denver Health Medical Center, University of Colorado Health Sciences Center, Denver, CO, USA.
Unlabelled:
Postinjury multiple organ failure (MOF) may result from overwhelming systemic hyperinflammation. Secretory phospholipase A2 (sPLA2) produces many inflammatory lipid mediators, and levels have been correlated with both the severity of patient injury and postinjury mortality. The objective of this study was to characterize the plasma activity of sPLA2 type IIa in severely injured patients and to determine whether the activity of this enzyme correlates with the subsequent development of MOF.
Patients:
Seventeen severely injured patients at known risk for MOF had blood sampled on postinjury days 0, 1, 2, 3, and 5.
Design:
sPLA2 activity was sequentially measured and correlated with MOF scores.
Results:
Six patients (35%) developed MOF. In comparison with non-MOF patients, MOF patients had elevated sPLA2 activity beginning 36 hrs postinjury (MOF sPLA2, 2.4 +/- 0.97, vs. non-MOF sPLA2, 0.86 +/- 0.16 active units (AU); p < .05) and continuing over the ensuing 5 days. To rule out the possibility that stored blood components required for patient resuscitation was the source of sPLA2, the sPLA2 was measured in packed red blood cells, platelet concentrates, and fresh frozen plasma over the routine storage time. None of the products tested had elevated levels of sPLA2 compared with fresh plasma from healthy adult volunteers.
Conclusions:
We conclude that increased sPLA2 activity is associated with the development of postinjury MOF.
Insights
Elevated secretory phospholipase A2 (sPLA2) activity in severely injured patients is linked to the development of multiple organ failure (MOF). This finding may help predict MOF risk and guide treatment strategies.
Area of Science:
- Biochemistry
- Immunology
- Trauma Surgery
Background:
- Postinjury multiple organ failure (MOF) is a critical complication often driven by systemic hyperinflammation.
- Secretory phospholipase A2 (sPLA2) generates inflammatory lipid mediators, with its levels correlating to injury severity and mortality.
Purpose of the Study:
- To characterize plasma secretory phospholipase A2 type IIa (sPLA2) activity in severely injured patients.
- To determine if sPLA2 activity correlates with the development of MOF.
Main Methods:
- Seventeen severely injured patients at risk for MOF were monitored.
- Plasma sPLA2 activity was measured on postinjury days 0, 1, 2, 3, and 5.
- sPLA2 activity was correlated with MOF scores.
Main Results:
- Six patients (35%) developed MOF.
- MOF patients exhibited significantly elevated sPLA2 activity from 36 hours postinjury onwards compared to non-MOF patients (p < .05).
- sPLA2 levels in stored blood products were not elevated, ruling them out as a source.
Conclusions:
- Increased plasma sPLA2 activity is associated with the development of postinjury MOF.
- sPLA2 may serve as a biomarker for MOF risk in severely injured patients.