Structural evaluation of plasma alpha-2-macroglobulin in acute acute pancreatitis

BISARO LYDA,; RAMOS ADRIAN,; SÁNCHEZ CECILIA,; MONTENEGRO RICARDO,; CHIABRANDO, GUSTAVO A

CLINICAL CHEMISTRY AND LABORATORY MEDICINE

Walter de Gruyter

Año: 2005 vol. 43 p. 1183 - 1189

1434-6621

In this work we evaluate the proteolytic state of plasma alpha-2-Macroglobulin in acute pancreatitis. In addition, the plasma activity of matrix metalloproteinase-2 (MMP-2), MMP-9 and serine proteinases were analyzed. Thirty-three patients with acute pancreatitis were studied, of whom 16 were diagnosed as mild and 17 as severe acute pancreatitis. In this last patient group, three of them coursed multi-organ failure and died as consequence of these complications. The proteolytic fragmentation of alpha-2-Macroglobulin was evaluated by Western blotting whereas the plasma activity of MMP-2, MMP-9 and serine proteinases was evaluated by gelatin zymography. An enhanced fragmentation of alpha-2-Macroglobulin was detected in severe acute pancreatitis patients with multiple organ and lethal complications. In this same patient group an increased plasma activity of active forms of MMP-2 and MMP-9, as well as serine proteinases was shown. In addition, we demonstrate that chymotrypsin-like proteinases could be the principal cause of alpha-2-Macroglobulin degradation in this group of patients. Our results indicate that the secondary proteolysis of alpha-2-Macroglobulin promotes an impaired control on extracellular proteolytic activity, deriving in local and distant tissue injuries during severe acute pancreatitis. Finally, the structural evaluation of plasma alpha-2-Macroglobulin could be used as a prognostic marker of the severity in acute pancreatitis.