Skip to main content
Gut logoLink to Gut
. 1991 Apr;32(4):430–434. doi: 10.1136/gut.32.4.430

Alpha 2 macroglobulin state in acute pancreatitis. Raised values of alpha 2 macroglobulin-protease complexes in severe and mild attacks.

R E Banks 1, S W Evans 1, D Alexander 1, F Van Leuven 1, J T Whicher 1, M J McMahon 1
PMCID: PMC1379085  PMID: 1709131

Abstract

Plasma values of C reactive protein, alpha 1 proteinase inhibitor, alpha 2 macroglobulin, and complexed alpha 2 macroglobulin have been determined in serial samples from 27 patients with acute pancreatitis. Complexed alpha 2 macroglobulin was measured by a novel enzyme linked immunosorbent assay with a monoclonal antibody specific for the complexed form. Patients with severe illness had lower concentrations of total alpha 2 macroglobulin and higher concentrations of complexed alpha 2 macroglobulin than those with mild illness, and in the majority of severe attacks the abnormal amounts of complexed alpha 2 macroglobulin were present throughout the eight days of the study. The proportion of total alpha 2 macroglobulin in the uncomplexed form, however, was generally greater than 90%, and in 26% of the mild cases completely normal concentrations of uncomplexed alpha 2 macroglobulin (greater than 99% of total) were found throughout the eight days of the study. This suggests that exhaustion of alpha 2 macroglobulin in plasma is unlikely to be a major factor in the pathogenesis of acute pancreatitis.

Full text

PDF
430

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adham N. F., Song M. K., Haberfelde G. C. Relationship between the functional status of the reticuloendothelial system and the outcome of experimentally induced pancreatitis in young mice. Gastroenterology. 1983 Mar;84(3):461–469. [PubMed] [Google Scholar]
  2. Balldin G., Eddeland A., Ohlsson K. Studies on the role of the plasma protease inhibitors on in vitro C3 activation and in acute pancreatitis. Scand J Gastroenterol. 1981;16(5):603–609. doi: 10.3109/00365528109182018. [DOI] [PubMed] [Google Scholar]
  3. Banks R. E., Evans S. W., Van Leuven F., Alexander D., McMahon M. J., Whicher J. T. Measurement of the 'fast' or complexed form of alpha 2 macroglobulin in biological fluids using a sandwich enzyme immunoassay. J Immunol Methods. 1990 Jan 24;126(1):13–20. doi: 10.1016/0022-1759(90)90006-h. [DOI] [PubMed] [Google Scholar]
  4. Barrett A. J., Brown M. A., Sayers C. A. The electrophoretically 'slow' and 'fast' forms of the alpha 2-macroglobulin molecule. Biochem J. 1979 Aug 1;181(2):401–418. doi: 10.1042/bj1810401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Barrett A. J., Starkey P. M. The interaction of alpha 2-macroglobulin with proteinases. Characteristics and specificity of the reaction, and a hypothesis concerning its molecular mechanism. Biochem J. 1973 Aug;133(4):709–724. doi: 10.1042/bj1330709. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Borgström A., Ohlsson K. Radioimmunological determination and characterization of cathodal trypsin-like immunoreactivity in normal human plasma. Scand J Clin Lab Invest. 1976 Dec;36(8):809–814. doi: 10.3109/00365517609081942. [DOI] [PubMed] [Google Scholar]
  7. Brodrick J. W., Geokas M. C., Largman C., Fassett M., Johnson J. H. Molecular forms of immunoreactive pancreatic cationic trypsin in pancreatitis patient sera. Am J Physiol. 1979 Nov;237(5):E474–E480. doi: 10.1152/ajpendo.1979.237.5.E474. [DOI] [PubMed] [Google Scholar]
  8. Büchler M., Malfertheiner P., Schoetensack C., Uhl W., Beger H. G. Sensitivity of antiproteases, complement factors and C-reactive protein in detecting pancreatic necrosis. Results of a prospective clinical study. Int J Pancreatol. 1986 Oct;1(3-4):227–235. doi: 10.1007/BF02795248. [DOI] [PubMed] [Google Scholar]
  9. Geokas M. C., Brodrick J. W., Johnson J. H., Largman C. Pancreatic elastase in human serum. Determination by radioimmunoassay. J Biol Chem. 1977 Jan 10;252(1):61–67. [PubMed] [Google Scholar]
  10. Geokas M. C., Largman C., Brodrick J. W., Johnson J. H., Fassett M. Immunoreactive forms of human pancreatic chymotrypsin in normal plasma. J Biol Chem. 1979 Apr 25;254(8):2775–2781. [PubMed] [Google Scholar]
  11. Goodman A. J., Bird N. C., Johnson A. G. Antiprotease capacity in acute pancreatitis. Br J Surg. 1986 Oct;73(10):796–798. doi: 10.1002/bjs.1800731012. [DOI] [PubMed] [Google Scholar]
  12. Gressner A. M., Peltzer B. Amidolytic and immuno-nephelometric determination of alpha 1-proteinase inhibitor and alpha 2-macroglobulin in serum with calculation of specific inhibitor activities in health and disease. J Clin Chem Clin Biochem. 1984 Oct;22(10):633–640. doi: 10.1515/cclm.1984.22.10.633. [DOI] [PubMed] [Google Scholar]
  13. Hermon-Taylor J., Magee A. I., Grant D. A., Jones P. A., Marshall C. E., Dunham J. Cleavage of peptide hormones by alpha 2-macroglobulin-trypsin complex and its relation to the pathogenesis and chemotherapy of acute pancreatitis. Clin Chim Acta. 1981 Jan 22;109(2):203–209. doi: 10.1016/0009-8981(81)90335-1. [DOI] [PubMed] [Google Scholar]
  14. Largman C., Johnson J. H., Brodrick J. W., Geokas M. C. Proinsulin conversion to desalanyl insulin by alpha2-macroglobin-bound trypsin. Nature. 1977 Sep 8;269(5624):168–170. doi: 10.1038/269168a0. [DOI] [PubMed] [Google Scholar]
  15. Lasson A., Ohlsson K. Protease inhibitors in acute human pancreatitis. Correlation between biochemical changes and clinical course. Scand J Gastroenterol. 1984 Sep;19(6):779–786. [PubMed] [Google Scholar]
  16. Leese T., Holliday M., Heath D., Hall A. W., Bell P. R. Multicentre clinical trial of low volume fresh frozen plasma therapy in acute pancreatitis. Br J Surg. 1987 Oct;74(10):907–911. doi: 10.1002/bjs.1800741012. [DOI] [PubMed] [Google Scholar]
  17. Leese T., Shaw D., Holliday M. Prognostic markers in acute pancreatitis: can pancreatic necrosis be predicted? Ann R Coll Surg Engl. 1988 Jul;70(4):227–232. [PMC free article] [PubMed] [Google Scholar]
  18. Mayer A. D., Airey M., Hodgson J., McMahon M. J. Enzyme transfer from pancreas to plasma during acute pancreatitis. The contribution of ascitic fluid and lymphatic drainage of the pancreas. Gut. 1985 Sep;26(9):876–881. doi: 10.1136/gut.26.9.876. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. McMahon M. J., Bowen M., Mayer A. D., Cooper E. H. Relation of alpha 2-macroglobulin and other antiproteases to the clinical features of acute pancreatitis. Am J Surg. 1984 Jan;147(1):164–170. doi: 10.1016/0002-9610(84)90052-7. [DOI] [PubMed] [Google Scholar]
  20. Ohlsson K. Experimental pancreatitis in the dog. Appearance of complexes between proteases and trypsin inhibitors in ascitic fluid, lymph, and plasma. Scand J Gastroenterol. 1971;6(7):645–652. doi: 10.3109/00365527109181147. [DOI] [PubMed] [Google Scholar]
  21. Ohlsson K., Laurell C. B. The disappearance of enzyme-inhibitor complexes from the circulation of man. Clin Sci Mol Med. 1976 Jul;51(1):87–92. doi: 10.1042/cs0510087. [DOI] [PubMed] [Google Scholar]
  22. Roberts R. C. Protease inhibitors of human plasma. Alpha-2-macroglobulin. J Med. 1985;16(1-3):129–224. [PubMed] [Google Scholar]
  23. Toki N., Takasugi S., Sumi H. Isolation and characterization of a pancreatic elastase from plasma of patients with acute pancreatitis. Clin Sci (Lond) 1982 Mar;62(3):321–328. doi: 10.1042/cs0620321. [DOI] [PubMed] [Google Scholar]
  24. Travis J., Salvesen G. S. Human plasma proteinase inhibitors. Annu Rev Biochem. 1983;52:655–709. doi: 10.1146/annurev.bi.52.070183.003255. [DOI] [PubMed] [Google Scholar]
  25. Van Leuven F., Marynen P., Cassiman J. J., Van den Berghe H. Mapping of structure-function relationships in proteins with a panel of monoclonal antibodies. A study on human alpha 2 macroglobulin. J Immunol Methods. 1988 Jun 28;111(1):39–49. doi: 10.1016/0022-1759(88)90057-9. [DOI] [PubMed] [Google Scholar]
  26. Wendt P., Fritsch A., Schulz F., Wunderlich G., Blümel G. Proteinases and inhibitors in plasma and peritoneal exudate in acute pancreatitis. Hepatogastroenterology. 1984 Dec;31(6):277–281. [PubMed] [Google Scholar]
  27. Wilson C., Heads A., Shenkin A., Imrie C. W. C-reactive protein, antiproteases and complement factors as objective markers of severity in acute pancreatitis. Br J Surg. 1989 Feb;76(2):177–181. doi: 10.1002/bjs.1800760224. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES