ALPHA2 MACROGLOBULIN STATE IN ACUTE-PANCREATITIS - RAISED VALUES OF ALPHA-2 MACROGLOBULIN-PROTEASE COMPLEXES IN SEVERE AND MILD ATTACKS

Plasma values of C reactive protein, alpha-1 proteinase inhibitor, alpha-2 macroglobulin, and complexed alpha-2 macroglobulin have been determined in serial samples from 27 patients with acute pancreatitis. Complexed alpha-2 macroglobulin was measured by a novel enzyme linked immunosorbent assay with a monoclonal antibody specific for the complexed form. Patients with severe illness had lower concentrations of total alpha-2 macroglobulin and higher concentrations of complexed alpha-2 macroglobulin than those with mild illness, and in the majority of severe attacks the abnormal amounts of complexed alpha-2 macroglobulin were present throughout the eight days of the study. The proportion of total alpha-2 macroglobulin in the uncomplexed form, however, was generally > 90%, and in 26% of the mild cases completely normal concentrations of uncomplexed alpha-2 macroglobulin (> 99% of total) were found throughout the eight days of the study. This suggests that exhaustion of alpha-2 macroglobulin in plasma is unlikely to be a major factor in the pathogenesis of acute pancreatitis.