Skip to main content
Log in

Is genetic analysis helpful for diagnosing chronic pancreatitis in its early stage?

  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Diagnosis of chronic pancreatitis in its early stage is an extremely difficult task. If the genetic predispositions are identified, it may help make possible the earlier diagnosis of chronic pancreatitis or the detection of patients at risk. There are two major hypotheses about the pathogenesis of chronic pancreatitis known as the “necrosis–fibrosis” and “pancreatic stone protein” hypotheses. Recent molecular and genetic evidence suggests that both pathways contribute to the pathogenesis of chronic pancreatitis. Chronic pancreatitis may be caused by either increased proteolytic activity [the cationic trypsinogen (PRSS1) gene] or decreased protease inhibition (the pancreatic secretory trypsin inhibitor (PSTI) gene]. The impaired pancreatic duct function [cystic fibrosis transmembrane conductance regulator (CFTR) gene] may also be involved in the pathogenesis of the disease. Except for PRSS1 mutations, the known genetic risk for chronic pancreatitis is not high. The high individual variability and low incidence of chronic pancreatitis suggest that yet unidentified genetic and environmental factors are important. Further genetic analysis is necessary for understanding the pathogenesis of chronic pancreatitis, which may be helpful for the earlier diagnosis of the juvenile- or young-onset disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. T Kondo T Hayakawa A Noda K Ito Y Yamazaki Y Iinuma et al. (1981) ArticleTitleFollow-up study of chronic pancreatitis Gastroenterol Jpn 16 46–53 Occurrence Handle7227758 Occurrence Handle1:STN:280:DyaL3M7ovFOhtA%3D%3D

    PubMed  CAS  Google Scholar 

  2. RW Ammann A Akovbiantz F Largiader G Schueler (1984) ArticleTitleCourse and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients Gastroenterology 86 820–8 Occurrence Handle6706066 Occurrence Handle1:STN:280:DyaL2c7lvFeluw%3D%3D

    PubMed  CAS  Google Scholar 

  3. T Hayakawa T Kondo T Shibata Y Sugimoto M Kitagawa (1989) ArticleTitleChronic alcoholism and evolution of pain and prognosis in chronic pancreatitis Dig Dis Sci 34 33–8 Occurrence Handle2910680 Occurrence Handle10.1007/BF01536151 Occurrence Handle1:STN:280:DyaL1M%2FptVOrtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. P Layer H Yamamoto L Kalthoff JE Clain LJ Bakken EP DiMagno (1994) ArticleTitleThe different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis Gastroenterology 107 1481–7 Occurrence Handle7926511 Occurrence Handle1:STN:280:DyaK2M%2FhtFejtg%3D%3D

    PubMed  CAS  Google Scholar 

  5. PG Lankisch AB Lowenfels P Maisonneuve (2002) ArticleTitleWhat is the risk of alcoholic pancreatitis in heavy drinkers? Pancreas 25 411–2 Occurrence Handle12409838 Occurrence Handle10.1097/00006676-200211000-00015

    Article  PubMed  Google Scholar 

  6. G Klöppel B Maillet (1993) ArticleTitlePathology of acute and chronic pancreatitis Pancreas 8 659–70 Occurrence Handle8255882 Occurrence Handle10.1097/00006676-199311000-00001

    Article  PubMed  Google Scholar 

  7. H Sarles JP Bernard L Gullo (1990) ArticleTitlePathogenesis of chronic pancreatitis Gut 31 629–32 Occurrence Handle2199345 Occurrence Handle1:STN:280:DyaK3czjslCiug%3D%3D

    PubMed  CAS  Google Scholar 

  8. O Guy G Robles-Diaz Z Adrich J Sahel H Sarles (1983) ArticleTitleProtein content of precipitates present in pancreatic juice of alcoholic subjects and patients with chronic calcifying pancreatitis Gastroenterology 84 102–7 Occurrence Handle6401181 Occurrence Handle1:CAS:528:DyaL3sXmvFyktw%3D%3D

    PubMed  CAS  Google Scholar 

  9. DC Whitcomb MC Gorry RA Preston W Furey MJ Sossenheimer CD Ulrich et al. (1996) ArticleTitleHereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene Nat Genet 14 141–5 Occurrence Handle8841182 Occurrence Handle10.1038/ng1096-141 Occurrence Handle1:CAS:528:DyaK28XmtVKnt7g%3D

    Article  PubMed  CAS  Google Scholar 

  10. H Witt W Luck HC Hennies M Classen A Kage U Lass et al. (2000) ArticleTitleMutations in the gene encoding the serine protease inhibitor, Kazal type 1 are associated with chronic pancreatitis Nat Genet 25 213–6 Occurrence Handle10835640 Occurrence Handle10.1038/76088 Occurrence Handle1:CAS:528:DC%2BD3cXjvFOgtLk%3D

    Article  PubMed  CAS  Google Scholar 

  11. RH Pfützer MM Barmada AP Brunskill R Finch PS Hart J Neoptolemos et al. (2000) ArticleTitlePINK1/PSTI polymorphisms act as disease modifiers in familial and idiopathic chronic pancreatitis Gastroenterology 119 615–23 Occurrence Handle10982753 Occurrence Handle10.1053/gast.2000.18017

    Article  PubMed  Google Scholar 

  12. H Witt M Sahin-Toth O Landt JM Chen T Kahne JP Drenth et al. (2006) ArticleTitleA degradation-sensitive anionic trypsinogen (PRSS2) variant protects against chronic pancreatitis Nat Genet 38 668–73 Occurrence Handle16699518 Occurrence Handle10.1038/ng1797 Occurrence Handle1:CAS:528:DC%2BD28XltVOhtbc%3D

    Article  PubMed  CAS  Google Scholar 

  13. N Sharer M Schwarz G Malone A Howarth J Painter M Super et al. (1998) ArticleTitleMutations of the cystic fibrosis gene in patients with chronic pancreatitis N Engl J Med 339 645–52 Occurrence Handle9725921 Occurrence Handle10.1056/NEJM199809033391001 Occurrence Handle1:CAS:528:DyaK1cXmtVWmt7g%3D

    Article  PubMed  CAS  Google Scholar 

  14. JA Cohn KJ Friedman PG Noone MR Knowles LM Silverman PS Jowell (1998) ArticleTitleRelation between mutations of the cystic fibrosis gene and idiopathic pancreatitis N Engl J Med 339 653–8 Occurrence Handle9725922 Occurrence Handle10.1056/NEJM199809033391002 Occurrence Handle1:CAS:528:DyaK1cXmtVWmt7k%3D

    Article  PubMed  CAS  Google Scholar 

  15. MC Steward H Ishiguro RM Case (2005) ArticleTitleMechanisms of bicarbonate secretion in the pancreatic duct Annu Rev Physiol 67 377–409 Occurrence Handle15709963 Occurrence Handle10.1146/annurev.physiol.67.031103.153247 Occurrence Handle1:CAS:528:DC%2BD2MXjsFeksr0%3D

    Article  PubMed  CAS  Google Scholar 

  16. SB Ko S Naruse M Kitagawa H Ishiguro S Furuya N Mizuno et al. (2002) ArticleTitleAquaporins in rat pancreatic interlobular ducts Am J Physiol Gastrointest Liver Physiol 282 G324–31 Occurrence Handle11804854 Occurrence Handle1:CAS:528:DC%2BD38XhtFGiu78%3D

    PubMed  CAS  Google Scholar 

  17. R Graf M Schiesser T Reding P Appenzeller LK Sun F Fortunato et al. (2006) ArticleTitleExocrine meets endocrine: pancreatic stone protein and regenerating protein—two sides of the same coin J Surg Res 133 113–20 Occurrence Handle16360171 Occurrence Handle10.1016/j.jss.2005.09.030 Occurrence Handle1:CAS:528:DC%2BD28XkvVGjtbY%3D

    Article  PubMed  CAS  Google Scholar 

  18. CX Jin S Naruse M Kitagawa H Ishiguro T Kondo S Hayakawa et al. (2002) ArticleTitlePancreatic stone protein of pancreatic calculi in chronic calcified pancreatitis in man JOP 3 54–61 Occurrence Handle11884767

    PubMed  Google Scholar 

  19. H Sarles JC Dagorn D Giorgi JP Bernard (1990) ArticleTitleRenaming pancreatic stone protein as ‘lithostathine Gastroenterology 99 900–1 Occurrence Handle2379794 Occurrence Handle1:STN:280:DyaK3czjslWkuw%3D%3D

    PubMed  CAS  Google Scholar 

  20. J Gross RI Carlson AW Brauer MN Margolies AL Warshaw JR Wands (1985) ArticleTitleIsolation, characterization, and distribution of an unusual pancreatic human secretory protein J Clin Invest 76 2115–26 Occurrence Handle3908481 Occurrence Handle1:CAS:528:DyaL28XosFyitQ%3D%3D

    PubMed  CAS  Google Scholar 

  21. R Graf M Schiesser GA Scheele K Marquardt TW Frick RW Ammann et al. (2001) ArticleTitleA family of 16-kDa pancreatic secretory stress proteins form highly organized fibrillar structures upon tryptic activation J Biol Chem 276 21028–38 Occurrence Handle11278730 Occurrence Handle10.1074/jbc.M010717200 Occurrence Handle1:CAS:528:DC%2BD3MXksFGlsb8%3D

    Article  PubMed  CAS  Google Scholar 

  22. H Harada M Takeda H Yabe E Hanafusa T Hayashi K Kunichika et al. (1980) ArticleTitleThe calcium concentration in human pure pancreatic juice in chronic pancreatitis Gastroenterol Jpn 15 355–61 Occurrence Handle7409377 Occurrence Handle1:STN:280:DyaL3M%2FgsV2nuw%3D%3D

    PubMed  CAS  Google Scholar 

  23. H Harada M Takeda H Yabe E Hanafusa T Hayashi K Kunichika et al. (1980) ArticleTitleThe hexosamine concentration and output in human pure pancreatic juice in chronic pancreatitis Gastroenterol Jpn 15 520–6 Occurrence Handle7439624 Occurrence Handle1:STN:280:DyaL3M%2FmslOgtg%3D%3D

    PubMed  CAS  Google Scholar 

  24. I Nishimori M Kamakura K Fujikawa-Adachi M Morita S Onishi K Yokoyama et al. (1999) ArticleTitleMutations in exons 2 and 3 of the cationic trypsinogen gene in Japanese families with hereditary pancreatitis Gut 44 259–63 Occurrence Handle9895387 Occurrence Handle1:CAS:528:DyaK1MXhtl2gsb4%3D Occurrence Handle10.1136/gut.44.2.259

    Article  PubMed  CAS  Google Scholar 

  25. M Otsuki I Nishimori T Hayakawa M Hirota M Ogawa T Shimosegawa (2004) ArticleTitleResearch Committee on Intractable Disease of the Pancreas. Hereditary pancreatitis: clinical characteristics and diagnostic criteria in Japan Pancreas 28 200–6 Occurrence Handle15028953 Occurrence Handle10.1097/00006676-200403000-00012

    Article  PubMed  Google Scholar 

  26. K Kaneko Y Nagasaki T Furukawa H Mizutamari A Sato A Masamune et al. (2001) ArticleTitleAnalysis of the human pancreatic secretory trypsin inhibitor (PSTI) gene mutations in Japanese patients with chronic pancreatitis J Hum Genet 46 293–7 Occurrence Handle11355022 Occurrence Handle10.1007/s100380170082 Occurrence Handle1:CAS:528:DC%2BD3MXjslKks7s%3D

    Article  PubMed  CAS  Google Scholar 

  27. K Kuwata M Hirota I Nishimori M Otsuki M Ogawa (2003) ArticleTitleMutational analysis of the pancreatic secretory trypsin inhibitor gene in familial and juvenile pancreatitis in Japan J Gastroenterol 38 365–70 Occurrence Handle12743777 Occurrence Handle10.1007/s005350300065 Occurrence Handle1:CAS:528:DC%2BD3sXjslWhtrw%3D

    Article  PubMed  CAS  Google Scholar 

  28. K Fujiki H Ishiguro SB Ko N Mizuno Y Suzuki T Takemura et al. (2004) ArticleTitleGenetic evidence for CFTR dysfunction in Japanese: background for chronic pancreatitis J Med Genet 41 e55 Occurrence Handle15121783 Occurrence Handle10.1136/jmg.2003.014456 Occurrence Handle1:STN:280:DC%2BD2c3ivVKmsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  29. H Cuppens W Lin M Jaspers B Costes H Teng A Vankeerberghen et al. (1998) ArticleTitlePolyvariant mutant cystic fibrosis transmembrane conductance regulator genes. The polymorphic (Tg)m locus explains the partial penetrance of the T5 polymorphism as a disease mutation J Clin Invest 101 487–96 Occurrence Handle9435322 Occurrence Handle1:CAS:528:DyaK1cXmtF2hug%3D%3D Occurrence Handle10.1172/JCI639

    Article  PubMed  CAS  Google Scholar 

  30. JH Lee JH Choi W Namkung JW Hanrahan J Chang SY Song et al. (2003) ArticleTitleA haplotype-based molecular analysis of CFTR mutations associated with respiratory and pancreatic diseases Hum Mol Genet 12 2321–32 Occurrence Handle12952861 Occurrence Handle10.1093/hmg/ddg243 Occurrence Handle1:CAS:528:DC%2BD3sXntVCru7o%3D

    Article  PubMed  CAS  Google Scholar 

  31. A Noda H Hamano T Shibata T Hayakawa K Tsuchie Y Nimura et al. (1987) ArticleTitleChronic pancreatitis at early age of onset presenting interesting findings through endoscopic retrograde pancreatography and chemical analysis of nonopaque pancreatic concretion Dig Dis Sci 32 433–40 Occurrence Handle3829883 Occurrence Handle10.1007/BF01296299 Occurrence Handle1:STN:280:DyaL2s7mtFaisg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  32. K Suda M Takase Y Fukumura F Suzuki A Jim C Kakinuma et al. (2004) ArticleTitleHistopathologic difference between chronic pancreatitis animal models and human chronic pancreatitis Pancreas 28 e86–9 Occurrence Handle15084989 Occurrence Handle10.1097/00006676-200404000-00030

    Article  PubMed  Google Scholar 

  33. A Sakakibara N Okumura T Hayakawa M Kanzaki (1982) ArticleTitleUltrastructural changes in the exocrine pancreas of experimental pancreatolithiasis in dogs Am J Gastroenterol 77 498–503 Occurrence Handle7091140 Occurrence Handle1:STN:280:DyaL383islKlsg%3D%3D

    PubMed  CAS  Google Scholar 

  34. N Okumura A Sakakibara T Hayakawa A Noda (1982) ArticleTitlePancreatic endocrine function in experimental pancreatolithiasis in dogs Am J Gastroenterol 77 392–6 Occurrence Handle7046428 Occurrence Handle1:CAS:528:DyaL38XksFemsr8%3D

    PubMed  CAS  Google Scholar 

  35. A Khalid S Finkelstein B Thompson L Kelly C Hanck et al. (2006) ArticleTitleA 93 year old man with the PRSS1 R122H mutation, low SPINK1 expression, and no pancreatitis: insights into phenotypic non-penetrance Gut 55 728–31 Occurrence Handle16354799 Occurrence Handle10.1136/gut.2005.067959 Occurrence Handle1:CAS:528:DC%2BD28Xksl2hu7o%3D

    Article  PubMed  CAS  Google Scholar 

  36. PG Noone Z Zhou LM Silverman PS Jowell MR Knowles JA Cohn (2001) ArticleTitleCystic fibrosis gene mutations and pancreatitis risk: relation to epithelial ion transport and trypsin inhibitor gene mutations Gastroenterology 121 1310–9 Occurrence Handle11729110 Occurrence Handle10.1053/gast.2001.29673 Occurrence Handle1:CAS:528:DC%2BD38Xhs12htg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  37. J Threadgold W Greenhalf I Ellis N Howes MM Lerch P Simon et al. (2002) ArticleTitleThe N34S mutation of SPINK1 (PSTI) is associated with a familial pattern of idiopathic chronic pancreatitis but does not cause the disease Gut 50 675–81 Occurrence Handle11950815 Occurrence Handle10.1136/gut.50.5.675 Occurrence Handle1:CAS:528:DC%2BD38XjvFeks7s%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Naruse, S., Fujiki, K. & Ishiguro, H. Is genetic analysis helpful for diagnosing chronic pancreatitis in its early stage?. J Gastroenterol 42 (Suppl 17), 60–65 (2007). https://doi.org/10.1007/s00535-006-1934-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-006-1934-7

Key words

Navigation