Nishimori I, Kamakura M, Fujikawa-Adachi K, Morita M, Onishi S, Yokoyama K, Makino I, Ishida H, Yamamoto M, Watanabe S, Ogawa M
First Department of Internal Medicine, Kochi Medical School, Kochi, Japan.
Gut. 1999 Feb;44(2):259-63. doi: 10.1136/gut.44.2.259.
BACKGROUND/AIMS: Single-point mutations in the cationic trypsinogen gene have been reported in hereditary pancreatitis kindreds in the white population. The aim of the present study was to investigate whether similar gene mutations are present in Japanese hereditary pancreatitis kindreds.
All five exons of the cationic trypsinogen gene were amplified by polymerase chain reaction and sequenced in six Japanese families with hereditary pancreatitis.
Two types of single-point mutation in the cationic trypsinogen gene, which were identical with those reported in white families with hereditary pancreatitis, were observed in separate Japanese families with hereditary pancreatitis: 21Asn (AAC) to Ile (ATC) (N21I) in exon 2 and 117Arg (CGC) to His (CAC) (R117H) in exon 3. Pancreatitis occurred at more advanced ages in patients with the N21I mutation than in those with the R117H mutation. Besides normal polymorphisms in exons 4 and 5, no mutation was found in patients in the remaining four families with hereditary pancreatitis, 21 patients with sporadic chronic pancreatitis, or five normal subjects.
These results show heterogeneity, but no racial specificity, in the cationic trypsinogen gene mutations in hereditary pancreatitis kindreds. A distinctive clinical feature for each of the mutation types is suggested: adult onset for the N21I mutation and childhood onset for the R117H mutation.
背景/目的:在白种人群的遗传性胰腺炎家族中,已报道阳离子胰蛋白酶原基因存在单点突变。本研究的目的是调查日本遗传性胰腺炎家族中是否存在类似的基因突变。
通过聚合酶链反应扩增阳离子胰蛋白酶原基因的所有五个外显子,并对六个日本遗传性胰腺炎家族进行测序。
在不同的日本遗传性胰腺炎家族中观察到阳离子胰蛋白酶原基因的两种单点突变,与白种遗传性胰腺炎家族中报道的突变相同:外显子2中第21位天冬酰胺(AAC)突变为异亮氨酸(ATC)(N21I),外显子3中第117位精氨酸(CGC)突变为组氨酸(CAC)(R117H)。携带N21I突变的患者胰腺炎发病年龄比携带R117H突变的患者更晚。除了外显子4和5中的正常多态性外,在其余四个遗传性胰腺炎家族的患者、21例散发性慢性胰腺炎患者或五名正常受试者中均未发现突变。
这些结果表明遗传性胰腺炎家族中阳离子胰蛋白酶原基因突变存在异质性,但不存在种族特异性。每种突变类型都有一个独特的临床特征:N21I突变型为成人发病,R117H突变型为儿童发病。