International Journal of Pancreatology

, Volume 25, Issue 1, pp 17–21 | Cite as

Molecular forms of serum pancreatic stone protein in acute pancreatitis

  • Yasuyuki Nakae
  • Satoru Naruse
  • Motoji Kitagawa
  • Hiroshi Ishiguro
  • Masanori Kato
  • Shinobu Hayakawa
  • Takaharu Kondo
  • Tetsuo Hayakawa


Conclusion: Elevation of serum pancreatic stone protein- (PSP) S1 suggests activation of trypsinogen in the pancreas. This information would prompt the start of intensive treatment and may improve prognosis of acute pancreatitis (AP).

Background: PSP exists in two molecular forms, PSP-S2–5 and PSP-S1. PSP-S1 is produced by enzyme cleavage of PSP-S2–5 by trypsin. Total serum PSP rose in AP, but little is known about its molecular forms. In this study, we characterized the molecular forms of serum PSP in AP.

Methods: Sera were taken from 8 patients with severe acute pancreatitis (sAP) and from 11 patients with mild acute pancreatitis (mAP). Serum PSP was characterized by high-performance liquid chromatography (HPLC) followed by the specific enzyme immunoassay (EIA).

Results: The total serum PSP in sAP was higher than in mAP, but the difference was not significant. The PSP-S1 was detected in serum in all (7/7) patients in sAP and in 72% (8/11) of patients in mAP. Serum level of PSP-S1 was significantly higher in sAP than that in mAP (p<0.05), and the cutoff value to distinguish the two groups was 30 ng/mL. Serum PSP-S1 did not show significant correlation with total PSP, immunoreactive trypsin, or C-reactive protein.

Key Words

Pancreatic stone protein acute pancreatitis trypsin molecular form 


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  1. 1.
    Creuzfeldt W, Schmidt H. Aetiology and pathogenesis of pancreatitis (current concept). Scand J Gastroenterol Suppl 1970; 6: 47–62.Google Scholar
  2. 2.
    Nakae Y, Naruse S, Kitagawa M, Hirao S, Yamamoto R, Hayakawa T. Activation of trypsinogen in experimental models of acute pancreatitis in rats. Pancreas 1995; 10: 306–313.PubMedCrossRefGoogle Scholar
  3. 3.
    Rinderknecht H. Activation of pancreatic zymogens. Dig Dis Sci 1986; 31: 314–321.PubMedCrossRefGoogle Scholar
  4. 4.
    Steer ML, Meldolesi J. Pathogenesis of acute pancreatitis. Annu Rev Med 1988; 39: 95–105.PubMedCrossRefGoogle Scholar
  5. 5.
    Ohlsson K, Ganrot PO, Laurell CB. In vivo interaction between trypsin and some plasma proteins in relation to tolerance to intravenous infusion of trypsin in dog. Acta Chir Scand 1971; 137: 113–121.PubMedGoogle Scholar
  6. 6.
    Brodrick JW, Geokas MC, Largman C, Fassett M, Johnson JH. Molecular forms of immunoreactive pancreatic cationic trypsin in pancreatitis patients sera. Am J Physiol 1979; 237: E478–480.Google Scholar
  7. 7.
    Gudgeon AM, Heath DI, Hurley P, Jahanli A, Patel G, Wilson C, et al. Trypsinogen activation peptides assay in the early prediction of severity of acute pancreatitis. Lancet 1990; 335: 4–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Karanjia ND, Widdison AL, Jehanli A, Hermon-Taylor J, Reber HA. Assay of tryps inogen activation in the cat experimental models of acute pancreatitis. Pancreas 1993; 8: 189–195.PubMedCrossRefGoogle Scholar
  9. 9.
    Banks RE, Evans SW, Alexander D, Van Leuven F, Whicher JT, McMahon MJ. Alpha2 macroglobulin state in acute pancreatitis. Raised values of α2 macroglobulin-protease complexes in severe and mild attacks. Gut 1991; 32: 430–434.PubMedCrossRefGoogle Scholar
  10. 10.
    Nakae Y, Hayakawa T, Kondo T, Shibata T, Kitagawa M, Sakai Y, et al. Diagnostic value of serum α2-macroglobulin-tryspin complex in pancreatic diseases using a colorimetric assay with a synthetic chromogenic substrate. Jpn J Gastroenterol 1991; 88: 2853–2860.Google Scholar
  11. 11.
    Sobajima H, Hayakawa T, Kondo T, Shibata T, Kitagawa M, Sakai Y, et al. Monitoring serum tryptic activity and effect of trypsin inhibitor on rat acute pancreatitis. Digestion 1994; 55: 90–96.PubMedCrossRefGoogle Scholar
  12. 12.
    Nakae Y, Hayakawa T, Kondo T, Shibata T, Kitagawa M, Sakai Y, et al. Serum α2-macroglobulin-trypsin complex and early recognition of severe acute pancreatitis after endoscopic retrograde pancreatography. J Gastroenterol Hepatol 1994; 9: 272–276.PubMedCrossRefGoogle Scholar
  13. 13.
    Hedström J, Sainio V, Kemppainen E, Haapianen R, Kivilaakso E, Schröder T, et al. Serum complex of trypsin 2 and a1 antitrypsin as diagnostic and prognostic marker of acute pancreatitis: clinical study in consecutive patients. Br Med S 1996; 313: 333–337.Google Scholar
  14. 14.
    Multigner L, De Caro A, Lombardo D, Campese D, Sahles H. Pancreatic stone protein, a phosphoprotein which inhibits calcium carbonate precipitation from pancreatic juice. Biochem Biophys Res Commun 1983; 110: 69–74.PubMedCrossRefGoogle Scholar
  15. 15.
    De Caro A, Multigner L, Dagorn JC, Sarles H. The human pancreatic stone protein. Biochemie 1988; 70: 1209–1214.CrossRefGoogle Scholar
  16. 16.
    Katsuzaki T, Tatemichi N, Takeichi C, Hayakawa S, Hayakawa T, Shibata T, et al. Enzyme immunoassay for specific analysis of pancreatic stone protein in human pancreatic juice. J Clin Lab Anal 1992; 6: 375–378.PubMedCrossRefGoogle Scholar
  17. 17.
    Katsuzaki T, Tatemichi N, Takeichi C, Hayakawa S, Hayakawa T, Shibata T, et al. Enzyme immunoassay and immunochemical characterization of pancreatic stone protein in human serum. J Clin Lab Anal 1992; 6: 143–147.PubMedCrossRefGoogle Scholar
  18. 18.
    Kato M, Hayakawa S, Naruse S, Kitagawa M, Ishiguro H, Nakae Y, et al. Change of pancreatic enzymes, pancreatic stone protein (PSP), and plasma α2-macroglobulin-trypsin complex-like substance (MTLS) in the activation of pancreatic juice. Pancreas 1997; 15: 345–349.PubMedCrossRefGoogle Scholar
  19. 19.
    Hayakawa T, Kondo T, Shibata T, Kitagawa M, Sakai Y, Sobajima H, et al. Serum pancreatic stone protein in pancreatic diseases. Int J Pancreatol 1993; 13: 97–103.PubMedGoogle Scholar
  20. 20.
    Knaus A, Zimmerman JE, Wargner DP, Draper EA, Lawrence DE. APACHE acute physiology and chronic health evaluation: a severity of disease classification system. Crit Care Med 1984; 12: 975–977.CrossRefGoogle Scholar
  21. 21.
    Saito Y, Yamamoto M. Severe acute pancreatitis in Japan, in Acute Pancreatitis: Diagnosis and Therapy, Edward L, Bradley III, eds. Raven, New York 1994; pp. 139–144.Google Scholar
  22. 22.
    Schmiegel WH, Burchert M, Kalthoff H, Thiele HG, Bützow HG, Klose G, et al. Pancreatic stone protein in serum of patients with pancreatitis. Lancet 1986; 2: 686.PubMedCrossRefGoogle Scholar
  23. 23.
    Wilson C, Heads A, Shenkin A, Imrie CW. C-reactive protein, antiproteases and complement factors as objective markers of severity in acute pancreatitis. Br J Surg 1989; 79: 177–181.CrossRefGoogle Scholar

Copyright information

© Humana Press Inc 1999

Authors and Affiliations

  • Yasuyuki Nakae
    • 1
  • Satoru Naruse
    • 1
  • Motoji Kitagawa
    • 1
  • Hiroshi Ishiguro
    • 1
  • Masanori Kato
    • 2
  • Shinobu Hayakawa
    • 2
  • Takaharu Kondo
    • 1
  • Tetsuo Hayakawa
    • 1
  1. 1.Second Department of Internal MedicineNagoya University School of MedicineNagoyaJapan
  2. 2.Department of Clinical ChemistryMaruko Pharmaceutical Co., Ltd.KasugaiJapan

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