Phospholipase A2 as a point of care alternative to serum amylase and pancreatic lipase

Abstract

Acute pancreatitis is a relatively common and potentially fatal condition, but the presenting symptoms are non-specific and diagnosis relies largely on the measurement of amylase activity by the hospital clinical laboratory. In this work we develop a point of care test for pancreatitis measuring concentration of secretory phospholipase A2 group IB (sPLA₂-IB). Novel antibodies for sPLA₂-IB were raised and used to design an ELISA and a lateral flow device (LFD) for the point of care measurement of sPLA₂-IB concentration, which was compared to pancreatic amylase activity, lipase activity, and sPLA₂-IB activity in 153 serum samples. 98 of these samples were obtained from the pathology unit of a major hospital and classified retrospectively according to presence or absence of pancreatitis, and the remaining 55 were obtained from commercial sources to serve as high lipase (n = 20), CA19-9 positive (n = 15), and healthy (n = 20) controls. sPLA₂-IB concentration correlated well with the serum activity of both amylase and lipase, and performed at least as well as either markers in the differentiation of pancreatitis from controls.