Relationship of circulating levels of long-chain fatty acids to persistent organ failure in acute pancreatitis.
Relationship of circulating levels of long-chain fatty acids to persistent organ failure in acute pancreatitis.
复制标题
长链脂肪酸循环水平与急性胰腺炎持续性器官衰竭的关系。
DOI：
10.1152/ajpgi.00074.2023
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Papachristou,GeorgiosI
中科院分区：
文献类型：
--
作者：
Phillips,AnnaEvans;Wilson,AnnetteS;Greer,PhilJ;Hinton,Alice;Culp,Stacey;Paragomi,Pedram;Pothoulakis,Ioannis;Singh,Vijay;Lee,PeterJ;Lahooti,Ila;Whitcomb,DavidC;Papachristou,GeorgiosI
在急性胰腺炎(AP)过程中，循环中的甘油三酯(TG)释放出游离脂肪酸(FFAs)，胰腺脂肪酶损伤脂肪细胞。循环中的游离脂肪酸被怀疑是AP全身性脂肪毒性的来源之一。然而，对游离脂肪酸的评估是困难和耗时的，而且对不同严重程度的AP患者和对照组之间的游离脂肪酸水平知之甚少。这项研究的目的是评估AP患者与对照组患者早期循环FFA水平(饱和和不饱和)，以及FFA水平与AP严重程度之间的关系。AP患者的血清样本在入院时(住院第1天)采集，对照组的血清样本也采集。提取了棕榈酸、棕榈油酸、硬脂酸、油酸和亚油酸等脂肪酸，并用气相色谱分离对其进行了定量。AP的严重程度由修订的Atlanta分级法确定。比较AP患者与正常对照组及不同严重程度AP患者之间FFA水平和总FFA百分比的差异。共纳入93例AP患者(48例女性，52%)和29例对照组(20例女性，69%)。AP患者中，74例为轻中度AP，19例为重度AP。AP患者血清中除硬脂酸外的所有FFA水平均显著高于正常对照组。研究发现，棕榈油酸水平升高与重症急性胰腺炎之间存在强烈且独立的关联。血清不饱和FFA水平，特别是棕榈油酸，似乎与严重AP相关。这些发现对AP的靶向治疗具有潜在的临床意义。急性胰腺炎炎症反应的驱动因素尚不完全清楚。不饱和脂肪酸，特别是棕榈油酸，似乎与更严重的急性胰腺炎有关。这一发现提出了对脂肪酸毒性的新的临床理解，并强调了未来治疗重症急性胰腺炎的潜在靶点。
During acute pancreatitis (AP), free fatty acids (FFAs) are liberated from circulating triglycerides (TG) and injured adipocytes by pancreatic lipase. Circulating FFAs have been suspected as a source of systemic lipotoxicity in AP. However, assessment of FFAs is difficult and time-consuming, and little is known about relative levels of FFAs between patients with different severities of AP and controls. This study’s aims were to assess early circulating levels of FFAs, (both saturated and unsaturated) in patients with AP vs. controls, and associations between FFA levels and AP severity. Serum samples from patients with AP were collected at enrollment (day 1of hospital stay); serum samples were also collected from controls. FFAs including palmitic, palmitoleic, stearic, oleic, and linoleic acid were extracted and quantitated using gas chromatography separation. Severity of AP was determined by Revised Atlanta Classification. Differences in FFA levels and percentages of total FFAs were assessed between patients with AP and controls and patients with AP of different severity grades. A total of 93 patients with AP (48 female, 52%) and 29 controls (20 female, 69%) were enrolled. Of the patients with AP, 74 had mild/moderate and 19 had severe AP. Serum levels of all FFAs except stearic acid were significantly higher in patients with AP compared with controls. A strong and independent association between elevated palmitoleic acid levels and severe AP was found. Serum unsaturated FFA levels, specifically palmitoleic acid, appear to correlate with severe AP. These findings have potential clinical implications for targeted AP therapies.NEW & NOTEWORTHYDrivers of the inflammatory response in acute pancreatitis remain incompletely understood. Unsaturated fatty acids, specifically palmitoleic, appear to have an association with more severe acute pancreatitis. This finding presents a new clinical understanding of fatty acid toxicity and highlights a potential future target for treatment in severe acute pancreatitis.