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REVIEW PAPER
Genetic determination of pancreatitis
 
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Submission date: 2018-01-30
 
 
Final revision date: 2018-03-07
 
 
Acceptance date: 2018-03-07
 
 
Publication date: 2018-03-30
 
 
Medical Studies 2018;34(1):70-77
 
KEYWORDS
TOPICS
ABSTRACT
Pancreatitis is a complex disease with varied aetiology and clinical course. Genetic factors, in combination with environmental factors, may play a considerable role in the development of pancreatitis. Genetic studies may help in understanding the transition from acute pancreatitis to recurrent acute pancreatitis and progression to the chronic state. Various groups of genetic mutations may play a role in the pathogenesis of pancreatitis. Mutations in the cationic trypsinogen gene (PRSS1), anionic trypsinogen (PRSS2), the pancreatic secretory trypsin inhibitor gene (SPINK1), cystic fibrosis transmembrane conductance regulator gene (CFTR), chymotrypsinogen gene (CTRC), calcium-sensing receptor gene (CASR), and the protein claudin-2 (CLDN2) were found in different types of pancreatitis. The presented study demonstrates the role of the best recognised genetic mutations in the development of acute and chronic pancreatitis.
Summing up: Identification of patients with pathogenic genetic variants may change the approach to the factors related with lifestyle, such as alcohol consumption and cigarette smoking, and prevent or delay the occurrence of pancreatitis.
REFERENCES (88)
1.
Rijkers AP, Bakker OJ, Ali UA, Hagenaars J, van Santvoort HC, Besselink MG, Bollen TL, van Eijck CH, Dutch Pancreatitis Study G. Risk of Pancreatic Cancer After a Primary Episode of Acute Pancreatitis. Pancreas 2017; 46: 1018-1022.
 
2.
Żuk K, Czkwianianc E, Degowska M, Durlik M, Gąsiorowska A, Ignyś I, Jurkowska G, Krasnodębski I, Lampe P, Małecka-Panas E et al. Zalecenia diagnostyczne i terapeutyczne w przewlekłym zapaleniu trzustki. Rekomendacje Grupy Roboczej Konsultanta Krajowego w dziedzinie Gastroenterologii i Polskiego Klubu Trzustkowego. Prz Gastroenterol 2011; 6: 339-352.
 
3.
Lowenfels AB, Maisonneuve P, Whitcomb DC. Risk factors for cancer in hereditary pancreatitis. International Hereditary Pancreatitis Study Group. Med Clin North Am 2000; 84: 565-573.
 
4.
Bhanot UK, Moller P. Mechanisms of parenchymal injury and signaling pathways in ectatic ducts of chronic pancreatitis: implications for pancreatic carcinogenesis. Lab Invest 2009; 89: 489-497.
 
5.
Irving HM, Samokhvalov AV, Rehm J. Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis. JOP 2009; 10: 387-392.
 
6.
Roberts SE, Morrison-Rees S, John A, Williams JG, Brown TH, Samuel DG. The incidence and aetiology of acute pancreatitis across Europe. Pancreatology 2017; 17: 155-165.
 
7.
Samokhvalov AV, Rehm J, Roerecke M. Alcohol Consumption as a Risk Factor for Acute and Chronic Pancreatitis: A Systematic Review and a Series of Meta-analyses. EBioMedicine 2015; 2: 1996-2002.
 
8.
Papachristou GI, Papachristou DJ, Morinville VD, Slivka A, Whitcomb DC. Chronic alcohol consumption is a major risk factor for pancreatic necrosis in acute pancreatitis. Am J Gastroenterol 2006; 101: 2605-2610.
 
9.
Roberts SE, Akbari A, Thorne K, Atkinson M, Evans PA. The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther 2013; 38: 539-548.
 
10.
Gluszek S, Koziel D. Prevalence and progression of acute pancreatitis in the Swietokrzyskie Voivodeship population. Pol Przegl Chir 2012; 84: 618-625.
 
11.
Herreros-Villanueva M, Hijona E, Banales JM, Cosme A, Bujanda L. Alcohol consumption on pancreatic diseases. World J Gastroenterol 2013; 19: 638-647.
 
12.
Whitcomb DC, Yadav D, Adam S, Hawes RH, Brand RE, Anderson MA, Money ME, Banks PA, Bishop MD, Baillie J et al. Multicenter approach to recurrent acute and chronic pancreatitis in the United States: the North American Pancreatitis Study 2 (NAPS2). Pancreatology 2008; 8: 520-531.
 
13.
Mounzer R, Whitcomb DC. Genetics of acute and chronic pancreatitis. Curr Opin Gastroenterol 2013; 29: 544-551.
 
14.
Solomon S, Whitcomb DC. Genetics of pancreatitis: an update for clinicians and genetic counselors. Curr Gastroenterol Rep 2012; 14: 112-117.
 
15.
Chandak GR, Idris MM, Reddy DN, Mani KR, Bhaskar S, Rao GV, Singh L. Absence of PRSS1 mutations and association of SPINK1 trypsin inhibitor mutations in hereditary and non-hereditary chronic pancreatitis. Gut 2004; 53: 723-728.
 
16.
Koziel D, Gluszek S, Kowalik A, Chlopek M, Pieciak L. Genetic mutations in SPINK1, CFTR, CTRC genes in acute pancreatitis. BMC Gastroenterol 2015; 15: 70.
 
17.
Keim V. Role of genetic disorders in acute recurrent pancreatitis. World J Gastroenterol 2008; 14: 1011-1015.
 
18.
Working Group IAPAPAAPG: IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology 2013; 13 (4 Suppl 2): e1-15.
 
19.
Rosolowski M, Lipinski M, Dobosz M, Durlik M, Gluszek S, Kusnierz K, Lampe P, Malecka-Panas E, Nowakowska-Dulawa E, Nowak-Niezgoda M et al. Management of acute pancreatitis (AP) – Polish Pancreatic Club recommendations. Prz Gastroenterol 2016; 11: 65-72.
 
20.
 
21.
Mendez-Bailon M, de Miguel Yanes JM, Jimenez-Garcia R, Hernandez-Barrera V, Perez-Farinos N, Lopez-de-Andres A. National trends in incidence and outcomes of acute pancreatitis among type 2 diabetics and non-diabetics in Spain (2001-2011). Pancreatology 2015; 15: 64-70.
 
22.
Farthing M, Roberts SE, Samuel DG, Williams JG, Thorne K, Morrison-Rees S, John A, Akbari A, Williams JC. Survey of digestive health across Europe: Final report. Part 1: The burden of gastrointestinal diseases and the organisation and delivery of gastroenterology services across Europe. United European Gastroenterol J 2014; 2: 539-543.
 
23.
Kozieł D, Głuszek S. Epidemiology of acute pancreatitis in Poland – selected problems. Medical Studies/Studia Medyczne 2016; 32: 1-3.
 
24.
Koziel D, Kozlowska M, Deneka J, Matykiewicz J, Gluszek S. Retrospective analysis of clinical problems concerning acute pancreatitis in one treatment center. Prz Gastroenterol 2013; 8: 320-326.
 
25.
Yadav D. Recent advances in the epidemiology of alcoholic pancreatitis. Curr Gastroenterol Rep 2011; 13: 157-165.
 
26.
Sand J, Lankisch PG, Nordback I. Alcohol consumption in patients with acute or chronic pancreatitis. Pancreatology 2007; 7: 147-156.
 
27.
Whitcomb DC. Genetic risk factors for pancreatic disorders. Gastroenterology 2013; 144: 1292-1302.
 
28.
Yadav D, Whitcomb DC. The role of alcohol and smoking in pancreatitis. Nat Rev Gastroenterol Hepatol 2010; 7: 131-145.
 
29.
Hofner P, Balog A, Gyulai Z, Farkas G, Rakonczay Z, Takacs T, Mandi Y. Polymorphism in the IL-8 gene, but not in the TLR4 gene, increases the severity of acute pancreatitis. Pancreatology 2006; 6: 542-548.
 
30.
Anilir E, Ozen F, Yildirim IH, Ozemir IA, Ozlu C, Alimoglu O. IL-8 gene polymorphism in acute biliary and non biliary pancreatitis: probable cause of high level parameters? Ann Hepatobiliary Pancreat Surg 2017; 21: 30-38.
 
31.
Chen WC, Nie JS. Genetic polymorphism of MCP-1-2518, IL-8-251 and susceptibility to acute pancreatitis: a pilot study in population of Suzhou, China. World J Gastroenterol 2008; 14: 5744-5748.
 
32.
Jupp J, Fine D, Johnson CD. The epidemiology and socioeconomic impact of chronic pancreatitis. Best Pract Res Clin Gastroenterol 2010; 24: 219-231.
 
33.
Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 2001; 120: 682-707.
 
34.
Whitcomb DC, Gorry MC, Preston RA, Furey W, Sossenheimer MJ, Ulrich CD, Martin SP, Gates LK, Jr., Amann ST, Toskes PP et al. Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet 1996; 14: 141-145.
 
35.
Hao L, Zeng X-P, Xin L, Wang D, Pan J, Bi Y-W, Ji J-T, Du T-T, Lin J-H, Zhang D et al. Incidence of and risk factors for pancreatic cancer in chronic pancreatitis: A cohort of 1656 patients. Digestive and Liver Disease 2017; 49: 1249-1256.
 
36.
Lai Y, Yang H, Han W, Guo T, Lv H, Li J, Qian J-M. Cigarette smoking associated with chronic pancreatitis: a case control study in China. Tobacco Induced Diseases 2017, 15.
 
37.
Lee B, Zhao Q, Habtezion A. Immunology of pancreatitis and environmental factors. Current Opinion in Gastroenterology 2017; 33: 383-389.
 
38.
Xu Z, Pothula SP, Lee ATK, Tran D, Pandol SJ, Pirola RC, Wilson JS, Apte MV. Smoking worsens the fibrosis of alcoholic chronic pancreatitis via activation of pancreatic stellate cells. J Gastroenterol Hepatol 2017; 32: 13-14.
 
39.
Klein AP: Genetic susceptibility to pancreatic cancer. Mol Carcinog 2012, 51(1):14-24.
 
40.
Dufour MC, Adamson MD. The epidemiology of alcohol-induced pancreatitis. Pancreas 2003; 27: 286-290.
 
41.
Grauvogel J, Daemmrich TD, Ryschich E, Gebhard MM, Werner J. Chronic alcohol intake increases the severity of pancreatitis induced by acute alcohol administration, hyperlipidemia and pancreatic duct obstruction in rats. Pancreatology 2010; 10: 603-612.
 
42.
Hanck C, Schneider A, Whitcomb DC. Genetic polymorphisms in alcoholic pancreatitis. Best Pract Res Clin Gastroenterol 2003; 17: 613-623.
 
43.
Whitcomb DC. Genetic polymorphisms in alcoholic pancreatitis. Dig Dis 2005; 23: 247-254.
 
44.
Comfort MW, Steinberg AG. Pedigree of a family with hereditary chronic relapsing pancreatitis. Gastroenterology 1952; 21: 54-63.
 
45.
Aghdassi AA, Weiss FU, Mayerle J, Lerch MM, Simon P. Genetic susceptibility factors for alcohol-induced chronic pancreatitis. Pancreatology 2015; 15 (4 Suppl): S23-31.
 
46.
Rebours V, Levy P, Ruszniewski P: An overview of hereditary pancreatitis. Dig Liver Dis 2012; 44: 8-15.
 
47.
Szmola R, Sahin-Toth M. Uncertainties in the classification of human cationic trypsinogen (PRSS1) variants as hereditary pancreatitis-associated mutations. J Med Genet 2010; 47: 348-350.
 
48.
Howes N, Lerch MM, Greenhalf W, Stocken DD, Ellis I, Simon P, Truninger K, Ammann R, Cavallini G, Charnley RM et al. Clinical and genetic characteristics of hereditary pancreatitis in Europe. Clin Gastroenterol Hepatol 2004; 2: 252-261.
 
49.
Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology 2013; 144: 1252-1261.
 
50.
Teich N, Rosendahl J, Toth M, Mossner J, Sahin-Toth M. Mutations of human cationic trypsinogen (PRSS1) and chronic pancreatitis. Hum Mutat 2006; 27: 721-730.
 
51.
Nemoda Z, Sahin-Toth M. Chymotrypsin C (caldecrin) stimulates autoactivation of human cationic trypsinogen. J Biol Chem 2006; 281: 11879-11886.
 
52.
Raty S, Piironen A, Babu M, Pelli H, Sand J, Uotila S, Nordback I, Herzig KH. Screening for human cationic trypsinogen (PRSS1) and trypsinogen inhibitor gene (SPINK1) mutations in a Finnish family with hereditary pancreatitis. Scand J Gastroenterol 2007; 42: 1000-1005.
 
53.
Chen JM, Mercier B, Ferec C. Strong evidence that the N21I substitution in the cationic trypsinogen gene causes disease in hereditary pancreatitis. Gut 1999; 45: 916.
 
54.
Whitcomb DC, LaRusch J, Krasinskas AM, Klei L, Smith JP, Brand RE, Neoptolemos JP, Lerch MM, Tector M, Sandhu BS et al. Common genetic variants in the CLDN2 and PRSS1-PRSS2 loci alter risk for alcohol-related and sporadic pancreatitis. Nat Genet 2012; 44: 1349-1354.
 
55.
Gasiorowska A, Malecka-Panas E. Znaczenie mutacji genetycznych w patogenezie przewlekłego zapalenia trzustki. Gastroenterol Pol 2012; 19: 30-36.
 
56.
Chen JM, Piepoli Bis A, Le Bodic L, Ruszniewski P, Robaszkiewicz M, Deprez PH, Raguenes O, Quere I, Andriulli A, Ferec C. Mutational screening of the cationic trypsinogen gene in a large cohort of subjects with idiopathic chronic pancreatitis. Clin Genet 2001; 59: 189-193.
 
57.
XXXXXXXXXXXXXXX.
 
58.
Masson E, Chen JM, Audrezet MP, Cooper DN, Ferec C. A conservative assessment of the major genetic causes of idiopathic chronic pancreatitis: data from a comprehensive analysis of PRSS1, SPINK1, CTRC and CFTR genes in 253 young French patients. PLoS One 2013; 8: e73522.
 
59.
Wang W, Sun XT, Weng XL, Zhou DZ, Sun C, Xia T, Hu LH, Lai XW, Ye B, Liu MY et al. Comprehensive screening for PRSS1, SPINK1, CFTR, CTRC and CLDN2 gene mutations in Chinese paediatric patients with idiopathic chronic pancreatitis: a cohort study. BMJ Open 2013; 3: e003150.
 
60.
Gasiorowska A, Talar-Wojnarowska R, Czupryniak L, Smolarz B, Romanowicz-Makowska H, Kulig A, Malecka-Panas E. The prevalence of cationic trypsinogen (PRSS1) and serine protease inhibitor, Kazal type 1 (SPINK1) gene mutations in Polish patients with alcoholic and idiopathic chronic pancreatitis. Dig Dis Sci 2011; 56: 894-901.
 
61.
Monaghan KG, Jackson CE, KuKuruga DL, Feldman GL. Mutation analysis of the cystic fibrosis and cationic trypsinogen genes in patients with alcohol-related pancreatitis. Am J Med Genet 2000; 94: 120-124.
 
62.
Grabarczyk AM, Oracz G, Wertheim-Tysarowska K, Kujko AA, Wejnarska K, Kolodziejczyk E, Bal J, Koziel D, Kowalik A, Gluszek S et al. Chymotrypsinogen C Genetic Variants, Including c.180TT, Are Strongly Associated With Chronic Pancreatitis in Pediatric Patients. J Pediatr Gastroenterol Nutr 2017; 65: 652-657.
 
63.
Oracz G, Kolodziejczyk E, Sobczynska-Tomaszewska A, Wejnarska K, Dadalski M, Grabarczyk AM, Kierkus J, Woynarowski M, Wertheim-Tysarowska K, Ryzko J et al. The clinical course of hereditary pancreatitis in children – A comprehensive analysis of 41 cases. Pancreatology 2016; 16: 535-541.
 
64.
Wejnarska K, Kolodziejczyk E, Wertheim-Tysarowska K, Dadalski M, Sobczynska-Tomaszewska A, Kierkus J, Bal J, Rygiel AM, Oracz G. The Etiology and Clinical Course of Chronic Pancreatitis in Children With Early Onset of the Disease. J Pediatr Gastroenterol Nutr 2016; 63: 665-670.
 
65.
Raimondi S, Lowenfels AB, Morselli-Labate AM, Maisonneuve P, Pezzilli R. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol 2010; 24: 349-358.
 
66.
Teich N, Nemoda Z, Kohler H, Heinritz W, Mossner J, Keim V, Sahin-Toth M. Gene conversion between functional trypsinogen genes PRSS1 and PRSS2 associated with chronic pancreatitis in a six-year-old girl. Hum Mutat 2005; 25: 343-347.
 
67.
Rygiel AM, Beer S, Simon P, Wertheim-Tysarowska K, Oracz G, Kucharzik T, Tysarowski A, Niepokoj K, Kierkus J, Jurek M et al. Gene conversion between cationic trypsinogen (PRSS1) and the pseudogene trypsinogen 6 (PRSS3P2) in patients with chronic pancreatitis. Hum Mutat 2015; 36: 350-356.
 
68.
Ravi Kanth V, Nageshwar Reddy D. Genetics of acute and chronic pancreatitis: An update. World J Gastrointest Pathophysiol 2014; 5: 427-437.
 
69.
Witt H, Luck W, Hennies HC, Classen M, Kage A, Lass U, Landt O, Becker M. Mutations in the gene encoding the serine protease inhibitor, Kazal type 1 are associated with chronic pancreatitis. Nat Genet 2000; 25: 213-216.
 
70.
Kume K, Masamune A, Mizutamari H, Kaneko K, Kikuta K, Satoh M, Satoh K, Kimura K, Suzuki N, Nagasaki Y et al. Mutations in the serine protease inhibitor Kazal Type 1 (SPINK1) gene in Japanese patients with pancreatitis. Pancreatology 2005; 5: 354-360.
 
71.
Masamune A: Genetics of pancreatitis: the 2014 update. Tohoku J Exp Med 2014; 232: 69-77.
 
72.
Raphael KL, Willingham FF. Hereditary pancreatitis: current perspectives. Clin Exp Gastroenterol 2016; 9: 197-207.
 
73.
Masamune A, Ariga H, Kume K, Kakuta Y, Satoh K, Satoh A, Shimosegawa T. Genetic background is different between sentinel and recurrent acute pancreatitis. J Gastroenterol Hepatol 2011; 26: 974-978.
 
74.
Aoun E, Chang CC, Greer JB, Papachristou GI, Barmada MM, Whitcomb DC. Pathways to injury in chronic pancreatitis: decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis. PLoS One 2008; 3: e2003.
 
75.
Aoun E, Muddana V, Papachristou GI, Whitcomb DC. SPINK1 N34S is strongly associated with recurrent acute pancreatitis but is not a risk factor for the first or sentinel acute pancreatitis event. Am J Gastroenterol 2010; 105: 446-451.
 
76.
Merilainen S, Makela J, Anttila V, Koivukangas V, Kaakinen H, Niemela E, Ohtonen P, Risteli J, Karttunen T, Soini Y et al. Acute edematous and necrotic pancreatitis in a porcine model. Scand J Gastroenterol 2008; 43: 1259-1268.
 
77.
XXXXXXXX.
 
78.
Schneider A, Larusch J, Sun X, Aloe A, Lamb J, Hawes R, Cotton P, Brand RE, Anderson MA, Money ME et al. Combined bicarbonate conductance-impairing variants in CFTR and SPINK1 variants are associated with chronic pancreatitis in patients without cystic fibrosis. Gastroenterology 2011; 140: 162-171.
 
79.
Cohn JA, Friedman KJ, Noone PG, Knowles MR, Silverman LM, Jowell PS. Relation between mutations of the cystic fibrosis gene and idiopathic pancreatitis. N Engl J Med 1998; 339: 653-658.
 
80.
Sharer N, Schwarz M, Malone G, Howarth A, Painter J, Super M, Braganza J. Mutations of the cystic fibrosis gene in patients with chronic pancreatitis. N Engl J Med 1998; 339: 645-652.
 
81.
LaRusch J, Jung J, General IJ, Lewis MD, Park HW, Brand RE, Gelrud A, Anderson MA, Banks PA, Conwell D et al. Mechanisms of CFTR functional variants that impair regulated bicarbonate permeation and increase risk for pancreatitis but not for cystic fibrosis. PLoS Genet 2014; 10: e1004376.
 
82.
Rosendahl J, Landt O, Bernadova J, Kovacs P, Teich N, Bodeker H, Keim V, Ruffert C, Mossner J, Kage A et al. CFTR, SPINK1, CTRC and PRSS1 variants in chronic pancreatitis: is the role of mutated CFTR overestimated? Gut 2013; 62: 582-592.
 
83.
Szmola R, Sahin-Toth M. Chymotrypsin C (caldecrin) promotes degradation of human cationic trypsin: identity with Rinderknecht’s enzyme Y. Proc Natl Acad Sci U S A 2007; 104: 11227-11232.
 
84.
Hegyi E, Sahin-Toth M. Genetic Risk in Chronic Pancreatitis: The Trypsin-Dependent Pathway. Dig Dis Sci 2017; 62: 1692-1701.
 
85.
Beer S, Zhou J, Szabo A, Keiles S, Chandak GR, Witt H, Sahin-Toth M. Comprehensive functional analysis of chymotrypsin C (CTRC) variants reveals distinct loss-of-function mechanisms associated with pancreatitis risk. Gut 2013; 62: 1616-1624.
 
86.
Masson E, Chen JM, Scotet V, Le Marechal C, Ferec C. Association of rare chymotrypsinogen C (CTRC) gene variations in patients with idiopathic chronic pancreatitis. Hum Genet 2008; 123: 83-91.
 
87.
Koziel D, Gluszek S, Kowalik A, Chlopek M. CTRC gene polymorphism (p.G60=; c.180 C > T) in acute pancreatitis. BMC Gastroenterol 2017; 17: 13.
 
88.
LaRusch J, Lozano-Leon A, Stello K, Moore A, Muddana V, O’Connell M, Diergaarde B, Yadav D, Whitcomb DC. The Common Chymotrypsinogen C (CTRC) Variant G60G (C.180T) Increases Risk of Chronic Pancreatitis But Not Recurrent Acute Pancreatitis in a North American Population. Clin Transl Gastroenterol 2015; 6: e68.
 
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