Combined bicarbonate conductance-impairing variants in CFTR and SPINK1 variants are associated with chronic pancreatitis in patients without cystic fibrosis.

Combined bicarbonate conductance-impairing variants in CFTR and SPINK1 variants are associated with chronic pancreatitis in patients without cystic fibrosis.
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DOI:
10.1053/j.gastro.2010.10.045
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发表时间:
2011-01
期刊:
影响因子:
29.4
通讯作者:
Whitcomb DC
Whitcomb DC
中科院分区:
医学1区
文献类型:
--
作者:
Schneider A;Larusch J;Sun X;Aloe A;Lamb J;Hawes R;Cotton P;Brand RE;Anderson MA;Money ME;Banks PA;Lewis MD;Baillie J;Sherman S;Disario J;Burton FR;Gardner TB;Amann ST;Gelrud A;George R;Rockacy MJ;Kassabian S;Martinson J;Slivka A;Yadav D;Oruc N;Barmada MM;Frizzell R;Whitcomb DC

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特发性慢性胰腺炎(ICP)是一种与多种遗传和环境因素相关的复杂炎症性疾病。在没有囊性纤维化(CF)的个体中,抑制碳酸氢盐电导但维持氯电导的 CFTR 变体可能选择性地损害胰液的分泌,导致胰蛋白酶激活和胰腺炎。我们研究了编码胰腺分泌性胰蛋白酶抑制剂 SPINK1 的基因中的序列变异是否会进一步增加这些患者患胰腺炎的风险。我们筛查了 ICP 患者(散发性或家族性)和对照患者中与慢性胰腺炎 (CP) 风险(外显子 3)和 CFTR 所有 27 个外显子相关的 SPINK1 变异。最终研究组包括 53 名散发性 ICP 患者、27 名具有家族性 ICP 的先证者、150 名无关对照者,以及 503 名进行有限基因分型的对照者。 CFTR 野生型 (wt) 和 p.R75Q 在 HEK293 细胞中克隆和表达,并测量 HCO3− 和 Cl− 的相对电导。 36% 的受试者和 3% 的对照者发现了 SPINK1 变异(比值比 [OR]=16.5)。 16% 的受试者和 5.4% 的对照者中发现了一种与 CF 无关的 CFTR 变体 p.R75Q(OR=3.4)。 CFTR p.R75Q 和 SPINK1 变异的共同遗传发生在 8.75% 的患者和 0.15% 的对照中 (OR=62.5)。表达 CFTR p.R75Q 的细胞的膜片钳记录显示氯离子电流正常,但碳酸氢盐电流显着降低 (P=0.0001)。 CFTR 变体 p.R75Q 会导致碳酸氢盐电导选择性缺陷,并增加胰腺炎的风险。 CF 相关的以及一些不相关的 CFTR 变异与 SPINK1 变异的共同遗传显着增加了 ICP 的风险。
Idiopathic chronic pancreatitis (ICP) is a complex inflammatory disorder associated with multiple genetic and environmental factors. In individuals without cystic fibrosis (CF), variants of CFTR that inhibit bicarbonate conductance but maintain chloride conductance might selectively impair secretion of pancreatic juice, leading to trypsin activation and pancreatitis. We investigated whether sequence variants in the gene encoding the pancreatic secretory trypsin inhibitor, SPINK1, further increase the risk of pancreatitis in these patients. We screened patients with ICP (sporadic or familial) and controls for variants in SPINK1 associated with chronic pancreatitis (CP) risk (in exon 3) and in all 27 exons of CFTR. The final study group included 53 patients with sporadic ICP, 27 probands with familial ICP, and 150 unrelated controls, plus 503 controls for limited genotyping. CFTR wild-type (wt) and p.R75Q were cloned and expressed in HEK293 cells and relative conductances of HCO3− and Cl− were measured. SPINK1 variants were identified in 36% of subjects and 3% controls (odds ratio [OR]=16.5). One variant of CFTR that has not been associated with CF, p.R75Q, was found in 16% of subjects and 5.4% controls (OR=3.4). Co-inheritance of CFTR p.R75Q and SPINK1 variants occurred in 8.75% of patients and 0.15% controls (OR=62.5). Patch-clamp recordings of cells that expressed CFTR p.R75Q demonstrated normal chloride currents but significantly reduced bicarbonate currents (P=0.0001). The CFTR variant p.R75Q causes a selective defect in bicarbonate conductance and increases risk for pancreatitis. Co-inheritance of CF-associated, and some not associated, CFTR variants with SPINK1 variants significantly increase risk of ICP.
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发表时间: 2008-03-01
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