Paraoxonase 1-192Q Allele is a Risk Factor for Idiopathic Chronic Pancreatitis

The Role of PON1 Variants in Disease Susceptibility in a Turkish Population

Paraoxonase 1 (PON1) enzyme plays a major role in antioxidant defense and protects the cells against reactive species. The most common PON1 Q192R and L55M polymorphisms are responsible for a wide variation of PON1 activity, which showed an up to 13-fold interindividual variation among the same genotype. PON1 genotypes were evaluated with the development of pancreatitis, colorectal cancer, and hypothyroidism in a hospital-based, case-control study. Individuals with rs662 G allele had a two-fold risk of developing hypothyroidism. A weak association was found between rs854560 T allele and pancreatitis. The results were preliminary. Further studies with a larger number and detailed biochemical parameters are needed.

Glutathione S-transferase M1 and glutathione S-transferase T1 genotype in chronic pancreatitis: a meta-analysis

OBJECTIVE

A meta-analysis to determine the association between chronic pancreatitis and glutathione-S transferase (GST) mu 1 (GSTM1) and theta 1 (GSTT1) deletions.

METHODS

Case-control studies concerning the relationship between chronic pancreatitis and GSTM1 or GSTT1 deletions were identified (up to October 2013). Meta-analyses of the association between GSTM1 and GSTT1 genotype and chronic pancreatitis or alcoholic chronic pancreatitis (ACP) were performed.

RESULTS

Seven studies were included in the meta-analysis (650 patients/1382 controls for GSTM1 and 536 patients/1304 controls for GSTT1). There were no significant relationships between GSTM1/GSTT1 and chronic pancreatitis or GSTT1 and ACP. There was a significant association between GSTM1 null genotype and ACP (odds ratio 1.16, 95% confidence intervals 1.03, 1.30).

CONCLUSION

The GSTM1 null genotype was significantly associated with ACP risk.

Decreased serum paraoxonase activity in patients with chronic pancreatitis

BACKGROUND

Recent evidences suggest that oxidative stress is involved in the mechanism of chronic pancreatitis (CP). Paraoxonase 1 (PON1) plays an important role as an endogenous free-radical scavenging molecule. The aim of our study is to investigate whether serum PON1 activity is associated with the presence of CP.

METHODS

A total of 186 patients with alcoholic CP and 132 healthy subjects were enrolled in this study. Serum PON1 activity was measured using paraoxon as a substrate.

RESULTS

Serum PON1 activity was significantly decreased in CP patients compared with healthy subjects. Multivariable logistic regression analysis revealed that serum PON1 activity was a determinant of the presence of CP (OR = 0.992, 95% CI = 0.987-0.998; P = 0.006).

CONCLUSIONS

Decreased serum PON1 activity may be considered as a predicting marker of the presence of CP.

Genetic factors in chronic pancreatitis; implications for diagnosis, management and prognosis

Chronic pancreatitis (CP) is a clinical situation with persisting inflammation leading to destruction of the pancreas ensuing endocrine and exocrine failure. There are 4 subtypes: hereditary, idiopathic, alcoholic and tropical pancreatitis. Genetic factors can explain a significant proportion of CP cases. The PRSS1 gene, encoding cationic trypsinogen, was found to be correlated with hereditary CP. This signalled the extensive search for other candidate genes within the trypsin pathway. Genes like SPINK1 and CTRC are associated with CP and should be considered as important contributing factors rather than causative. The search for candidate genes not part of the trypsin pathway has been less successful and the only gene consistently associated with CP is the Cystic Fibrosis Transmembrane Regulator. In this review we will discuss the various CP subtypes in relation to the respective genetic variants. This review will also address the implications of genetic testing in daily clinical practise.