Bishu Shrinivas, Koutroumpakis Efstratios, Mounzer Rawad, Stello Kimberly, Pollock Nijole, Evans Anna, Whitcomb David C, Papachristou Georgios I
Pancreas. 2018 Jan;47(1):87-91. doi: 10.1097/MPA.0000000000000967.
Inflammation in the setting of acute pancreatitis (AP) is partially driven by pathogen recognition receptors that recognize damage-associated molecular patterns. Interleukin (IL)-8 is a chemotactic factor produced by pathogen recognition receptor-expressing cells. A single-nucleotide polymorphism in IL8 promoter region (-251 A/T) has been implicated in inflammatory diseases. We examined whether this IL8 polymorphism confers susceptibility to AP.
Patients with AP (n = 357) were prospectively recruited. Clinical data and blood were collected in subjects and controls (n = 347). Severity was defined following the Revised Atlanta Classification. Genotypes were assessed by quantitative polymerase chain reaction using TaqMan probes.
Patients and controls had similar demographics and had no difference in Hardy-Weinberg (patients, P = 0.29; controls, P = 0.66). Twenty-five percent of patients developed severe AP. Compared with controls, the A/A genotype was more common in AP (P = 0.041; odds ratio, 1.42; 95% confidence interval, 1-1.99). Obese patients with the A/A genotype were more likely to develop mild AP (P = 0.047).
The -251 polymorphism confers susceptibility to AP and disease severity in obese patients. However, its effect is moderate. One potential mechanism for this susceptibility is via increased IL8 production by innate cells, with subsequent enhanced neutrophil influx and pancreatic injury.
急性胰腺炎(AP)中的炎症部分由识别损伤相关分子模式的病原体识别受体驱动。白细胞介素(IL)-8是由表达病原体识别受体的细胞产生的趋化因子。IL8启动子区域的单核苷酸多态性(-251 A/T)与炎症性疾病有关。我们研究了这种IL8多态性是否会使个体易患AP。
前瞻性招募AP患者(n = 357)。收集受试者和对照组(n = 347)的临床资料和血液样本。根据修订的亚特兰大分类法定义疾病严重程度。使用TaqMan探针通过定量聚合酶链反应评估基因型。
患者和对照组的人口统计学特征相似,Hardy-Weinberg平衡无差异(患者,P = 0.29;对照组,P = 0.66)。25%的患者发展为重症AP。与对照组相比,A/A基因型在AP患者中更常见(P = 0.041;优势比,1.42;95%置信区间,1 - 1.99)。具有A/A基因型的肥胖患者更易发生轻症AP(P = 0.047)。
-251多态性使肥胖患者易患AP及病情更严重。然而,其影响程度中等。这种易感性的一种潜在机制是通过固有细胞增加IL8的产生,随后增强中性粒细胞流入和胰腺损伤。