Paper| Volume 22, ISSUE 3, P219-222, May 1991

Download started.


Released prophospholipase A2 activation peptides in the rapid early prediction of trauma outcome: a preliminary report

      This paper is only available as a PDF. To read, Please Download here.


      Clinical scores of trauma severity may not be adequate measures of trauma-related systemic pathophysiology to be useful in the early prediction of individual patient outcome. This preliminary study evaluates the role of Prophospholipase A2 Activation Peptide (PLAP), measured in patient urine by modified enzyme-linked immunosorbent assay (ELISA), as an early prognostic in the severely injured. Of nine polytrauma patients requiring intensive care after a major accident, two died and one was permanently severely disabled (group 1), whilst six made a full recovery (group 2). These two groups had different ranges of urine PLAP concentration (P = 0.024). Phospholipase A2 (PLA2) activation may be an early event in tissue damage pathways that lead to multisystem organ failure (MSOF). We believe urine and plasma PLAP concentrations merit further evaluation for the early prediction of individual trauma outcome.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Abbreviated Injury Scale. American Association for Automotive Medicine, Des Plaines Ill.,1985
      2. Lancet. 1988; 1 (Anon.): 840
        • Baker S.P.
        • O'Neill B.
        • Haddon W.
        • et al.
        The Injury Severity Score: A method for describing patients with multiple injuries and evaluating emergency care.
        J. Trauma. 1974; 14: 187
        • Baur M.
        • Schmid T.
        • Landauer B.
        Role of phospholipase A in multiorgan failure with special reference to ARDS and acute renal failure (ARF).
        Klin. Wochenschr. 1989; 67: 196
        • Beverland D.
        • Rutherford W.
        An assessment of the validity of the injury severity score when applied to gunshot wounds.
        Injury. 1983; 15: 19
        • Bird N.C.
        • Goodman A.J.
        • Johnson A.G.
        Serum phospholipase A2 activity in acute pancreatitis: an early guide to severity.
        Br. J. Surg. 1989; 76: 731
        • Bull J.
        The Injury Severity Score of road traffic casualties in relation to mortality, time of death, hospital treatment time and disability.
        Acccid. Anal. Prev. 1975; 7: 249
        • Camussi G.
        • et al.
        Tumor necrosis factor/cachectin stimulates peritoneal macrophages, polymorphonuclear neutrophils and vascular endothelial cells to sythesize and release platelet activating factor.
        J. Exp. Med. 1987; 166: 1390
        • Champion H.
        • Sacco W.
        • Copes W.
        • et al.
        A revision of the Trauma Score.
        J. Trauma. 1989; 29: 623
      3. Confidential Enquiry into Perioperative Deaths.
        Nuffield Provincial Hospitals Trust, The Kings Fund, London1987
        • Department Of Health and Social Security
        On the State of the Public Health for the Year 1984. HMSO, London1986
        • Grataroli R.
        • Dijkman R.
        • Dutilh C.E.
        • et al.
        Studies on prophospholipase A2 and its enzyme from human pancreatic juice. Catalytic properties and sequence of the N-terminal region.
        Eur. J. Biochem. 1982; 122: 111
        • Gudgeon A.M.
        • Jehanli A.
        • Patel G.
        • et al.
        Immunoassay for free prophospholipase A2 activation peptides (PLAP) reporting prophospholipase activation.
        Pancreas. 1988; 3: 599
        • Haegele E.
        • Scharch E.
        • Rauscher E.
        • et al.
        Action of human pancreatic alpha amylase on maltoheptose, a substrate for determining alpha amylase in serum.
        J. Chromatogr. 1981; 223: 69
        • Hoffmann G.E.
        • Heifinger R.
        • Steinbrückner D.
        Serum phospholipase A in hospitalized patients.
        Clin. Chim. Acta. 1989; 183: 59
        • Jennet B.
        Inappropriate use of intensive care.
        Br. Med. J. 1984; 289: 1709
        • Kellermann W.
        • Frenzel-Beyme R.
        • Welte M.
        • et al.
        Phospholipase A in acute lung injury after trauma and sepsis: its relation to the inflammatory mediators PNM-elastase, C3a and neopterin.
        Klin. Wochenschr. 1989; 67: 190
        • Ledwig J.
        • McManus L.
        • Clark P.
        Modulation of platelet activating factor (PAF) synthesis and release from human polymorphonuclear leucocytes (PMN): role of extracellular CA2+.
        Arch. Biochem. Biophysiol. 1984; 232: 102
        • Lefer A.
        Induction of tissue injury and altered cardiovascular performance by platelet activating factor: relevance to multiple systems organ failure.
        Crit. Care Clin. 1989; 5: 331
        • Leutenegger A.
        • Schmid T.
        • Frutiger A.
        • et al.
        Injury Severity Score und Verlauf bei intensivpflegebedürftigen Unfallopfern.
        Z. Unfallchir. Vers. Med. Berusfkr. 1986; 79: 181-188
        • Olerud S.
        • Allgöwer M.
        Evaluation and management of the polytraumatized patient in various centres.
        World J. Surg. 1983; 7: 13
        • Sacco W.
        • Jameson J.
        • Copes W.
        • et al.
        Progress toward a new injury severity characterization: Severity Profiles.
        Comput. Biol. Med. 1988; 18: 419
        • Seibel R.
        • La Duca J.
        • Hasset J.
        • et al.
        Blunt multiple trauma (ISS36), femur traction and the pulmonary failure — septic state.
        Ann. Surg. 1985; 202: 283
        • Seilhamer J.
        • Randall T.
        • Yamanaka M.
        • et al.
        Pancreatic phospholipase A2: Isolation of the human gene and cDNAs from porcine pancreas and human lung.
        DNA. 1986; 5: 519
        • Seilhamer J.
        • Pruzanski W.
        • Vadas P.
        • et al.
        Cloning and recombinant expression of phospholipase A2 present in rheumatoid arthritic synovial fluid.
        J. Biol. Chem. 1989; 264: 5335
        • Shoemaker W.
        • Apple P.
        • Kram H.
        • et al.
        Prospective trial of supranormal values for survivors as therapeutic goals in high risk surgical patients.
        Chest. 1988; 94: 1176
        • Siegel S.
        Nonparametric Statistics for the Behavioral Sciences. McGraw-Hill, New York1956
        • Vadas P.
        Elevated plasma phospholipase A2 levels; correlation with the hemodynamic and pulmonary changes in Gramnegative septic shock.
        J. Lab. Clin. Med. 1984; 104: 873
        • West J.
        • Williams M.
        • Trunkey D.
        • et al.
        Trauma systems, current status, future challenges.
        JAMA. 1988; 259: 3597