For over a century the cause of the remarkable inflammatory changes which characterize pancreatitis has commanded the interest of numerous investigators, and has generated a voluminous number of clinical and experimental contributions to the medical literature. Enzymes produced by the pancreas have been implicated as a possible factor in the inflammatory reaction associated with acute pancreatitis. A number of different enzymes are contained in pancreatic juice (amylolytic, proteolytic, lipolytic); however, only the proteases have received consideration as possible mediators of pancreatic inflammation.
A report by Anderson and associates1 in a recent issue of the Archives of Surgery indicates that both purified lipase and phospholipase-A produced an inflammatory response in the canine pancreas which was more severe than that observed with either trypsia or chymotrypsin. Neither amylase nor carboxypeptidase caused a comparable reaction. When trypsin, chymotrypsin, lipase, phospholipase-A, and amylase were incubated with autologous whole blood a highly toxic digestion-product