Zusammenfassung
Langjähriger Alkoholkonsum und Genmutationen sind die wichtigsten Ursachen einer chronischen Pankreatitis. Genetische Studien der letzten Jahre haben dabei das Krankheitsverständnis entscheidend verändert. Lange Zeit galt die erbliche Pankreatitis als seltene Erkrankung. Der Nachweis von Mutationen in Verdauungsenzymen und ihren Inhibitoren bei Patienten mit idiopathischer Pankreatitis zeigt jedoch, dass erbliche Fälle der Erkrankung weitaus häufiger sind. Diese Befunde stellen zugleich die Unterscheidung zwischen erblicher und idiopathischer Pankreatitis infrage. Die Assoziation von SPINK1- und CTRC-Mutationen mit tropischer Pankreatitis und alkoholischer Pankreatitis verwischt weiter die Grenzen zwischen den einzelnen Unterformen. In den nächsten Jahren wird sich wahrscheinlich zeigen, dass sehr komplexe Interaktionen zwischen Umwelteinflüssen und zahlreichen genetischen Faktoren bestehen.
Abstract
Long-term alcoholism and gene mutations are the most important risk factors for developing chronic pancreatitis. Genetic studies in the last two decades have revolutionized the understanding of the mechanisms mediating pancreatic damage. For a long time hereditary pancreatitis was thought to be a rare disease. The identification of mutations in digestive enzymes and their inhibitors in patients with idiopathic chronic pancreatitis showed that inherited cases of the disease are much commoner than initially believed. These findings question the differentiation between hereditary and idiopathic pancreatitis. The association between SPINK1 and CTRC mutations with tropical and alcoholic pancreatitis further blurs the border between the single subtypes. Most probably, future research will reveal a complex interaction between environmental and various genetic factors.
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Witt, H. Pathogenese der chronischen Pankreatitis. Gastroenterologe 9, 6–13 (2014). https://doi.org/10.1007/s11377-013-0818-7
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DOI: https://doi.org/10.1007/s11377-013-0818-7