Figure 5. Potential direct and organism-wide pathogenic mechanism of sPLA₂-IIA.

Mechanisms include: (a) hydrolysis of cellular membranes that broadly invoke tissue damage and organ dysfunction; (b) hydrolysis of mitochondrial membranes leading to the release of mtDNA, acetylcarnitine, and DAMPs; (c) internalization of damaged mitochondria by bystander leukocytes to increase inflammatory mediators including lyso-PLs, UFAs, eicosanoids, and cytokines; and (d) hydrolysis of platelet-derived EVs to release eicosanoids, platelet-activating factor, and lyso-PLs.