Phospholipase D2: A biomarker for stratifying disease severity in acute pancreatitis?

Abstract

In this editorial, we critically evaluate the recent article by Niu et al, which explores the potential of phospholipase D2 (PLD2) as a biomarker for stratifying disease severity in acute pancreatitis (AP). AP is a clinically heterogeneous inflammatory condition that requires reliable biomarkers for early and accurate classification of disease severity. PLD2, an essential regulator of neutrophil migration and inflammatory responses, has emerged as a promising candidate. Although current biomarkers such as C-reactive protein and procalcitonin provide general indications of inflammation, they lack specificity regarding the molecular mechanisms underlying AP progression. Recent studies, including the research conducted by Niu et al, suggest an inverse correlation between PLD2 expression and AP severity, offering both diagnostic insights and mechanistic understanding. This editorial critically evaluates the role of PLD2 as a biomarker in the broader context of AP research. Evidence indicates that decreased levels of PLD2 are associated with increased neutrophil chemotaxis and cytokine release, contributing to pancreatic and systemic inflammation. However, several challenges remain, including the need for large-scale validation and functional studies to establish causation, and standardization of measurement protocols. Additionally, further investigation into the temporal dynamics of PLD2 expression and its variability across diverse populations is warranted. Looking ahead, PLD2 holds the potential to revolutionize AP management by integrating molecular diagnostics with precision medicine. The utilization of large-scale multi-omics approaches and advancements in diagnostic platforms could position PLD2 as a fundamental biomarker for early diagnosis, prognosis, and potentially therapeutic targeting. While promising, it is crucial to conduct critical evaluations and rigorous validations of PLD2’s role to ensure its efficacy in improving patient outcomes.

Keywords: Phospholipase D2; Acute pancreatitis; Biomarker; Inflammatory response; Severity diagnosis

Core Tip: The identification of reliable biomarkers for early stratification of disease severity is essential in the management of acute pancreatitis (AP). Phospholipase D2 (PLD2), a pivotal regulator of neutrophil migration and inflammatory responses, has emerged as a promising candidate biomarker that may transform AP management by integrating molecular diagnostics with precision medicine. However, several challenges persist, including large-scale validation studies, functional investigations to establish causation, and standardization of measurement protocols. Consequently, it is imperative to critically examine and rigorously validate the role of PLD2 to ensure its effectiveness in improving patient outcomes.