Abstract
Chronic pancreatitis (CP) is a progressive, irreversible inflammatory disorder of the pancreas, which results from interrelations between different genetic and environmental factors. Genetic variants are the primary cause of the disease in early-onset nonalcoholic CP patients. Novel CP-associated genes are continuously emerging from genetic studies on CP cohorts, providing important clues for distinct mechanisms involved in CP development. On the basis of functional studies, the genetic alterations have been sub-grouped into CP-driving pathological pathways. This review focuses on the concept of CP as a complex disease driven by multiple genetic factors. We will discuss only well-defined genetic risk factors and distinct functional pathways involved in CP development, especially in the context of the early-onset nonalcoholic CP group. The diagnostic implications of the genetic testing will be addressed as well.
Highlights
Genes 2021, 12, 785. https://doi.org/Chronic pancreatitis (CP) is a long-lasting inflammatory disease starting from acute pancreatitis (AP) through recurrent acute up to a progressive, irreversible inflammatory disorder
CP—chronic pancreatitis, hereditary pancreatitis (HP)—Hereditary pancreatitis, idiopathic CP (ICP)—idiopathic chronic pancreatitis, familial CP, # examples of most frequent variants; full list of variants for PRSS1, SPINK1, chymotrypisinogen C (CTRC), and CPA1 may be found in http://pancreasgenetics.org/; CFTR and CEL variants—see references cited in the main text, TRPV6, according to Massamune et al and Zou et al [26,27]
Nonalcoholic chronic pancreatitis is a complex disease which may be caused by multiple genetic factors
Summary
Chronic pancreatitis (CP) is a long-lasting inflammatory disease starting from acute pancreatitis (AP) (sudden onset) through recurrent acute (more than one episode of acute pancreatitis) up to a progressive, irreversible inflammatory disorder. Cure) group recommendations, the diagnosis of CP requires 1 of 3 criteria: (1) abdominal pain consistent with pancreatic origin, (2) evidence of exocrine pancreatic insufficiency and (3) evidence of endocrine-pancreatic insufficiency, which were associated with abnormalities on imaging studies (e.g., ductal changes (the irregular contour of the main pancreatic duct or its radicles, intra-ducting-filling defects, calculi, stricture or dilatation) and parenchymal tissues (generalized or focal enlargement, irregular contour cavities, calcifications, heterogeneous echotexture [10])). Imaging studies such as ultrasound, computer tomography (CT scans), magnetic resonance cholangiopacreatography (MRCP), endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). The third mechanisms involve endoplasmic reticulum (ER) stress caused by genetic variants in CPA1, PRSS1 and by CEL-HYB1 alleles, inducing misfolding of these digestive enzymes and leading to acinar cell damage and inflammatory signaling
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