Department of Medical Genetics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey; Department of Medical Genetics, SBÜ Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
Department of Internal Medicine, Division of Gastroenterology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey.
Turk J Gastroenterol. 2023 Dec;34(12):1240-1248. doi: 10.5152/tjg.2023.22773.
BACKGROUND/AIMS: Pancreatitis is one of the leading causes of digestive system-related hospital admissions, and it has a genetic background in a considerable portion of the patients. In this study, we aimed to investigate the genetic risk factors of idiopathic pancreatitis in Turkish patients and the contribution of copy number variations to the pathogenesis.
Idiopathic pancreatitis is defined as failure to detect risk factors despite comprehensive clinical assessments. Next-generation sequencing and multiple ligand-dependent probe amplification of PRSS1, SPINK1, CTRC, and CFTR were performed. For further genotype-phenotype correlations, patients were also questioned for the age of onset, family history, and pancreatic divisum.
A total of 68 idiopathic pancreatitis cases were enrolled. Variants with potential clinical significance of PRSS1 were identified in 13.4%, SPINK1 in 6.3%, CTRC in 4.7%, and CFTR in 26.5% of the patients. No copy number variants were seen in any of these genes. At least 7.4% of the participants had complex genetic etiology involving 2 genes.
At least 42.6% of the participants had a potential genetic risk factor. Five novel genetic variants were identified, and distinctive genetic risk factors of Turkish population were shown. The results showed that genetic etiology was frequent in pancreatitis and it was even more prominent in patients with early-onset disease. Considering that genetic risk factors may be informative for decisionmaking in the treatment options in addition to providing extensive prognostic value and familial genetic consultation; clinicians need to be more eager to offer genetic tests to pancreatitis patients.
背景/目的:胰腺炎是导致消化系统相关住院的主要原因之一,相当一部分患者存在遗传背景。本研究旨在探讨土耳其患者特发性胰腺炎的遗传危险因素,以及拷贝数变异对发病机制的贡献。
特发性胰腺炎定义为尽管进行了全面的临床评估,但仍未能检测到危险因素。对 PRSS1、SPINK1、CTRC 和 CFTR 进行了下一代测序和多种配体依赖性探针扩增。为了进一步进行基因型-表型相关性研究,还询问了患者的发病年龄、家族史和胰腺分裂情况。
共纳入 68 例特发性胰腺炎患者。在 13.4%的患者中发现了 PRSS1 具有潜在临床意义的变异,6.3%的患者中发现了 SPINK1 变异,4.7%的患者中发现了 CTRC 变异,26.5%的患者中发现了 CFTR 变异。在这些基因中均未发现拷贝数变异。至少有 7.4%的参与者存在涉及 2 个基因的复杂遗传病因。
至少有 42.6%的参与者存在潜在的遗传危险因素。发现了 5 种新的遗传变异,显示了土耳其人群独特的遗传危险因素。结果表明,遗传病因在胰腺炎中较为常见,在发病早的患者中更为突出。鉴于遗传危险因素除了提供广泛的预后价值和家族遗传咨询外,还可能为治疗选择提供信息,临床医生需要更积极地为胰腺炎患者提供基因检测。