TY - JOUR
T1 - Clinical and biological role of secretory phospholipase A2 in acute respiratory distress syndrome infants
AU - De Luca, Daniele
AU - Lopez-Rodriguez, Elena
AU - Minucci, Angelo
AU - Vendittelli, Francesca
AU - Gentile, Leonarda
AU - Stival, Eleonora
AU - Conti, Giorgio
AU - Piastra, Marco
AU - Antonelli, Massimo
AU - Echaide, Mercedes
AU - Perez-Gil, Jesus
AU - Capoluongo, Ettore Domenico
PY - 2013
Y1 - 2013
N2 - Introduction: Secretory phospholipase A2 is supposed to play a role in
acute lung injury but no data are available for pediatric acute
respiratory distress syndrome (ARDS). It is not clear which enzyme
subtypes are secreted and what the relationships are between enzyme
activity, biophysical and biochemical parameters, and clinical outcomes.
We aimed to measure the enzyme and identify its subtypes and to study
its biochemical and biophysical effect. The secondary aim was to
correlate enzyme activity with clinical outcome.
Methods: Bronchoalveolar lavage was performed in 24 infants with ARDS
and 14 controls with no lung disease. Samples were assayed for secretory
phospholipase A2 and molecules related to its activity and expression.
Western blotting and captive bubble surfactometry were also performed.
Clinical data were real time downloaded.
Results: Tumor necrosis factor-alpha (814 (506-2,499) vs. 287
(111-1,315) pg/mL; P = 0.04), enzyme activity (430 (253600) vs. 149
(61-387) IU/mL; P = 0.01), free fatty acids (4.3 (2.8-8.6) vs. 2
(0.8-4.6) mM; P = 0.026), and minimum surface tension (25.6 +/- 6.1 vs.
18 +/- 1.8 mN/m; P = 0.006) were higher in ARDS than in controls.
Phospholipids are lower in ARDS than in controls (76.5 (54-100) vs.
1,094 (536-2,907) mu g/mL; P = 0.0001). Three enzyme subtypes were
identified (-IIA, -V, -X), although in lower quantities in controls;
another subtype (-IB) was mainly detected in ARDS. Significant
correlations exist between enzyme activity, free fatty acids (rho =
0.823; P < 0.001), and surface tension (rho = 0.55; P < 0.028).
Correlations also exist with intensive care stay (rho = 0.54; P =
0.001), PRISM-III24 (rho = 0.79; P < 0.001), duration of ventilation
(rho = 0.53; P = 0.002), and oxygen therapy (rho = 0.54; P = 0.001).
Conclusions: Secretory phospholipase A2 activity is raised in pediatric
ARDS and constituted of four subtypes. Enzyme correlates with some
inflammatory mediators, surface tension, and major clinical outcomes.
Secretory phospholipase A2 may be a clinically relevant target in
pediatric ARDS.
AB - Introduction: Secretory phospholipase A2 is supposed to play a role in
acute lung injury but no data are available for pediatric acute
respiratory distress syndrome (ARDS). It is not clear which enzyme
subtypes are secreted and what the relationships are between enzyme
activity, biophysical and biochemical parameters, and clinical outcomes.
We aimed to measure the enzyme and identify its subtypes and to study
its biochemical and biophysical effect. The secondary aim was to
correlate enzyme activity with clinical outcome.
Methods: Bronchoalveolar lavage was performed in 24 infants with ARDS
and 14 controls with no lung disease. Samples were assayed for secretory
phospholipase A2 and molecules related to its activity and expression.
Western blotting and captive bubble surfactometry were also performed.
Clinical data were real time downloaded.
Results: Tumor necrosis factor-alpha (814 (506-2,499) vs. 287
(111-1,315) pg/mL; P = 0.04), enzyme activity (430 (253600) vs. 149
(61-387) IU/mL; P = 0.01), free fatty acids (4.3 (2.8-8.6) vs. 2
(0.8-4.6) mM; P = 0.026), and minimum surface tension (25.6 +/- 6.1 vs.
18 +/- 1.8 mN/m; P = 0.006) were higher in ARDS than in controls.
Phospholipids are lower in ARDS than in controls (76.5 (54-100) vs.
1,094 (536-2,907) mu g/mL; P = 0.0001). Three enzyme subtypes were
identified (-IIA, -V, -X), although in lower quantities in controls;
another subtype (-IB) was mainly detected in ARDS. Significant
correlations exist between enzyme activity, free fatty acids (rho =
0.823; P < 0.001), and surface tension (rho = 0.55; P < 0.028).
Correlations also exist with intensive care stay (rho = 0.54; P =
0.001), PRISM-III24 (rho = 0.79; P < 0.001), duration of ventilation
(rho = 0.53; P = 0.002), and oxygen therapy (rho = 0.54; P = 0.001).
Conclusions: Secretory phospholipase A2 activity is raised in pediatric
ARDS and constituted of four subtypes. Enzyme correlates with some
inflammatory mediators, surface tension, and major clinical outcomes.
Secretory phospholipase A2 may be a clinically relevant target in
pediatric ARDS.
KW - BRONCHOALVEOLAR LAVAGE
KW - LUNG INJURY
KW - BRONCHOALVEOLAR LAVAGE
KW - LUNG INJURY
UR - http://hdl.handle.net/10807/57416
U2 - 10.1186/cc12842
DO - 10.1186/cc12842
M3 - Article
SN - 1466-609X
VL - 17
SP - N/A-N/A
JO - Critical Care
JF - Critical Care
ER -