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Published in: Journal of Gastroenterology 11/2012

01-11-2012 | Original Article—Liver, Pancreas, and Biliary Tract

Do genetic variants in the SPINK1 gene affect the level of serum PSTI?

Authors: Kiyoshi Kume, Atsushi Masamune, Hiroyuki Ariga, Shintaro Hayashi, Tetsuya Takikawa, Shin Miura, Noriaki Suzuki, Kazuhiro Kikuta, Shin Hamada, Morihisa Hirota, Atsushi Kanno, Tooru Shimosegawa

Published in: Journal of Gastroenterology | Issue 11/2012

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Abstract

Background

The serine protease inhibitor Kazal type 1 (SPINK1), also known as pancreatic secretory trypsin inhibitor (PSTI), is a peptide secreted by pancreatic acinar cells. Genetic studies have shown an association between SPINK1 gene variants and chronic pancreatitis or recurrent acute pancreatitis. The aim of this study was to clarify whether the SPINK1 variants affect the level of serum PSTI.

Methods

One hundred sixty-three patients with chronic pancreatitis or recurrent acute pancreatitis and 73 healthy controls were recruited. Serum PSTI concentrations were determined with a commercial radioimmunoassay kit.

Results

Ten patients with the p.N34S variant, 7 with the IVS3+2T>C variant, two with both the p.N34S and the IVS3+2T>C variants, and one with the novel missense p.P45S variant in the SPINK1 gene were identified. The serum PSTI level in patients with no SPINK1 variants was 14.3 ± 9.6 ng/ml (mean ± SD), and that in healthy controls was 10.7 ± 2.2 ng/ml. The PSTI level in patients carrying the IVS3+2T>C variant (5.1 ± 3.4 ng/ml), but not in those with the p.N34S variant (8.9 ± 3.5 ng/ml), was significantly lower than that in the patients without the SPINK1 variants and the healthy controls. The serum PSTI level in the patient with the p.P45S variant was 4.9 ng/ml. Low levels of serum PSTI (<6.0 ng/ml) showed sensitivity of 80 %, specificity of 97 %, and accuracy of 96 % in the differentiation of IVS3+2T>C and p.P45S carriers from non-carriers.

Conclusion

Serum PSTI levels were decreased in patients with the IVS3+2T>C and p.P45S variants of the SPINK1 gene.
Literature
2.
go back to reference Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120:682–707.PubMedCrossRef Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120:682–707.PubMedCrossRef
3.
go back to reference Whitcomb DC, Gorry MC, Preston RA, Furey W, Sossenheimer MJ, Ulrich CD, et al. Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet. 1996;14:141–5.PubMedCrossRef Whitcomb DC, Gorry MC, Preston RA, Furey W, Sossenheimer MJ, Ulrich CD, et al. Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet. 1996;14:141–5.PubMedCrossRef
4.
go back to reference Masson E, Le Maréchal C, Delcenserie R, Chen JM, Férec C. Hereditary pancreatitis caused by a double gain-of-function trypsinogen mutation. Hum Genet. 2008;123:521–9.PubMedCrossRef Masson E, Le Maréchal C, Delcenserie R, Chen JM, Férec C. Hereditary pancreatitis caused by a double gain-of-function trypsinogen mutation. Hum Genet. 2008;123:521–9.PubMedCrossRef
5.
go back to reference Witt H, Luck W, Hennies HC, Classen M, Kage A, Lass U, et al. Mutations in the gene encoding the serine protease inhibitor, Kazal type 1 are associated with chronic pancreatitis. Nat Genet. 2000;25:213–6.PubMedCrossRef Witt H, Luck W, Hennies HC, Classen M, Kage A, Lass U, et al. Mutations in the gene encoding the serine protease inhibitor, Kazal type 1 are associated with chronic pancreatitis. Nat Genet. 2000;25:213–6.PubMedCrossRef
6.
go back to reference Pfützer RH, Barmada MM, Brunskill AP, Finch R, Hart PS, Neoptolemos J, et al. SPINK1/PSTI polymorphisms act as disease modifiers in familial and idiopathic chronic pancreatitis. Gastroenterology. 2000;119:615–23.PubMedCrossRef Pfützer RH, Barmada MM, Brunskill AP, Finch R, Hart PS, Neoptolemos J, et al. SPINK1/PSTI polymorphisms act as disease modifiers in familial and idiopathic chronic pancreatitis. Gastroenterology. 2000;119:615–23.PubMedCrossRef
7.
go back to reference Chen JM, Mercier B, Audrezet MP, Raguenes O, Quere I, Ferec C. Mutations of the pancreatic secretory trypsin inhibitor (PSTI) gene in idiopathic chronic pancreatitis. Gastroenterology. 2001;120:1061–4.PubMedCrossRef Chen JM, Mercier B, Audrezet MP, Raguenes O, Quere I, Ferec C. Mutations of the pancreatic secretory trypsin inhibitor (PSTI) gene in idiopathic chronic pancreatitis. Gastroenterology. 2001;120:1061–4.PubMedCrossRef
8.
go back to reference Kume K, Masamune A, Mizutamari H, Kaneko K, Kikuta K, Satoh M, et al. Mutations in the serine protease inhibitor Kazal type 1 (SPINK1) gene in Japanese patients with pancreatitis. Pancreatology. 2005;5:354–60.PubMedCrossRef Kume K, Masamune A, Mizutamari H, Kaneko K, Kikuta K, Satoh M, et al. Mutations in the serine protease inhibitor Kazal type 1 (SPINK1) gene in Japanese patients with pancreatitis. Pancreatology. 2005;5:354–60.PubMedCrossRef
9.
go back to reference Aoun E, Chang CC, Greer JB, Papachristou GI, Barmada MM, Whitcomb DC. Pathways to injury in chronic pancreatitis: decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis. PLoS ONE. 2008;3:e2003.PubMedCrossRef Aoun E, Chang CC, Greer JB, Papachristou GI, Barmada MM, Whitcomb DC. Pathways to injury in chronic pancreatitis: decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis. PLoS ONE. 2008;3:e2003.PubMedCrossRef
10.
go back to reference Rosendahl J, Witt H, Szmola R, Bhatia E, Ozsvári B, Landt O, et al. Chymotrypsin C (CTRC) variants that diminish activity or secretion are associated with chronic pancreatitis. Nat Genet. 2008;40:78–82.PubMedCrossRef Rosendahl J, Witt H, Szmola R, Bhatia E, Ozsvári B, Landt O, et al. Chymotrypsin C (CTRC) variants that diminish activity or secretion are associated with chronic pancreatitis. Nat Genet. 2008;40:78–82.PubMedCrossRef
11.
go back to reference Rinderknecht H. Activation of pancreatic zymogens. Normal activation, premature intrapancreatic activation, protective mechanisms against inappropriate activation. Dig Dis Sci. 1986;31:314–21.PubMedCrossRef Rinderknecht H. Activation of pancreatic zymogens. Normal activation, premature intrapancreatic activation, protective mechanisms against inappropriate activation. Dig Dis Sci. 1986;31:314–21.PubMedCrossRef
12.
go back to reference Bhatia E, Choudhuri G, Sikora SS, Landt O, Kage A, Becker M, et al. Tropical calcific pancreatitis: strong association with SPINK1 trypsin inhibitor mutations. Gastroenterology. 2002;123:1020–5.PubMedCrossRef Bhatia E, Choudhuri G, Sikora SS, Landt O, Kage A, Becker M, et al. Tropical calcific pancreatitis: strong association with SPINK1 trypsin inhibitor mutations. Gastroenterology. 2002;123:1020–5.PubMedCrossRef
13.
go back to reference Kereszturi E, Király O, Sahin-Tóth M. Minigene analysis of intronic variants in common SPINK1 haplotypes associated with chronic pancreatitis. Gut. 2009;58:545–9.PubMedCrossRef Kereszturi E, Király O, Sahin-Tóth M. Minigene analysis of intronic variants in common SPINK1 haplotypes associated with chronic pancreatitis. Gut. 2009;58:545–9.PubMedCrossRef
14.
go back to reference Aoun E, Muddana V, Papachristou GI, Whitcomb DC. SPINK1 N34S is strongly associated with recurrent acute pancreatitis but is not a risk factor for the first or sentinel acute pancreatitis event. Am J Gastroenterol. 2010;105:446–51.PubMedCrossRef Aoun E, Muddana V, Papachristou GI, Whitcomb DC. SPINK1 N34S is strongly associated with recurrent acute pancreatitis but is not a risk factor for the first or sentinel acute pancreatitis event. Am J Gastroenterol. 2010;105:446–51.PubMedCrossRef
15.
go back to reference Masamune A, Ariga H, Kume K, Kakuta Y, Satoh K, Satoh A, et al. Genetic background is different between sentinel and recurrent acute pancreatitis. J Gastroenterol Hepatol. 2011;26:974–8.PubMedCrossRef Masamune A, Ariga H, Kume K, Kakuta Y, Satoh K, Satoh A, et al. Genetic background is different between sentinel and recurrent acute pancreatitis. J Gastroenterol Hepatol. 2011;26:974–8.PubMedCrossRef
16.
go back to reference Ota Y, Masamune A, Inui K, Kume K, Shimosegawa T, Kikuyama M. Phenotypic variability of the homozygous IVS3+2T>C mutation in the serine protease inhibitor Kazal type 1 (SPINK1) gene in patients with chronic pancreatitis. Tohoku J Exp Med. 2010;221:197–201.PubMedCrossRef Ota Y, Masamune A, Inui K, Kume K, Shimosegawa T, Kikuyama M. Phenotypic variability of the homozygous IVS3+2T>C mutation in the serine protease inhibitor Kazal type 1 (SPINK1) gene in patients with chronic pancreatitis. Tohoku J Exp Med. 2010;221:197–201.PubMedCrossRef
17.
go back to reference Ogawa M, Kitahara T, Fujimoto K, Tanaka S, Takatsuka Y, Kosaki G. Serum pancreatic secretory trypsin inhibitor in acute pancreatitis. Lancet. 1980;2:205.PubMedCrossRef Ogawa M, Kitahara T, Fujimoto K, Tanaka S, Takatsuka Y, Kosaki G. Serum pancreatic secretory trypsin inhibitor in acute pancreatitis. Lancet. 1980;2:205.PubMedCrossRef
18.
go back to reference Lasson A, Borgström A, Ohlsson K. Elevated pancreatic secretory trypsin inhibitor levels during severe inflammatory disease, renal insufficiency, and after various surgical procedures. Scand J Gastroenterol. 1986;21:1275–80.PubMedCrossRef Lasson A, Borgström A, Ohlsson K. Elevated pancreatic secretory trypsin inhibitor levels during severe inflammatory disease, renal insufficiency, and after various surgical procedures. Scand J Gastroenterol. 1986;21:1275–80.PubMedCrossRef
19.
go back to reference Paju A, Stenman UH. Biochemistry and clinical role of trypsinogens and pancreatic secretory trypsin inhibitor. Crit Rev Clin Lab Sci. 2006;43:103–42.PubMedCrossRef Paju A, Stenman UH. Biochemistry and clinical role of trypsinogens and pancreatic secretory trypsin inhibitor. Crit Rev Clin Lab Sci. 2006;43:103–42.PubMedCrossRef
20.
go back to reference Nakano I, Funakoshi A, Sumii T, Miyazaki K, Oogami Y, Kimura T, et al. Appearance mechanism and molecular heterogeneity of serum pancreatic secretory trypsin inhibitor (PSTI). Gastroenterol Jpn. 1985;20:354–60.PubMed Nakano I, Funakoshi A, Sumii T, Miyazaki K, Oogami Y, Kimura T, et al. Appearance mechanism and molecular heterogeneity of serum pancreatic secretory trypsin inhibitor (PSTI). Gastroenterol Jpn. 1985;20:354–60.PubMed
21.
go back to reference Satake K, Inui A, Sogabe T, Yoshii Y, Nakata B, Tanaka H, et al. The measurement of serum immunoreactive pancreatic secretory trypsin inhibitor in gastrointestinal cancer and pancreatic disease. Int J Pancreatol. 1988;3:323–31.PubMed Satake K, Inui A, Sogabe T, Yoshii Y, Nakata B, Tanaka H, et al. The measurement of serum immunoreactive pancreatic secretory trypsin inhibitor in gastrointestinal cancer and pancreatic disease. Int J Pancreatol. 1988;3:323–31.PubMed
22.
go back to reference Kume K, Masamune A, Kikuta K, Shimosegawa T. [-215G>A; IVS3+2T>C] mutation in the SPINK1 gene causes exon 3 skipping and loss of the trypsin binding site. Gut. 2006;55:1214.PubMedCrossRef Kume K, Masamune A, Kikuta K, Shimosegawa T. [-215G>A; IVS3+2T>C] mutation in the SPINK1 gene causes exon 3 skipping and loss of the trypsin binding site. Gut. 2006;55:1214.PubMedCrossRef
23.
go back to reference Király O, Wartmann T, Sahin-Tóth M. Missense mutations in pancreatic secretory trypsin inhibitor (SPINK1) cause intracellular retention and degradation. Gut. 2007;56:1433–8.PubMedCrossRef Király O, Wartmann T, Sahin-Tóth M. Missense mutations in pancreatic secretory trypsin inhibitor (SPINK1) cause intracellular retention and degradation. Gut. 2007;56:1433–8.PubMedCrossRef
24.
go back to reference Boulling A, Le Maréchal C, Trouvé P, Raguénès O, Chen JM, Férec C. Functional analysis of pancreatitis-associated missense mutations in the pancreatic secretory trypsin inhibitor (SPINK1) gene. Eur J Hum Genet. 2007;15:936–42.PubMedCrossRef Boulling A, Le Maréchal C, Trouvé P, Raguénès O, Chen JM, Férec C. Functional analysis of pancreatitis-associated missense mutations in the pancreatic secretory trypsin inhibitor (SPINK1) gene. Eur J Hum Genet. 2007;15:936–42.PubMedCrossRef
25.
go back to reference Ogawa M. Normal level and normal range of serum PSTI concentration. In: Kosaki G, Ogawa M, editors. Pancreatic secretory trypsin inhibitor. Tokyo: Igaku Tosho Shuppan; 1985. p. 91–3 (in Japanese). Ogawa M. Normal level and normal range of serum PSTI concentration. In: Kosaki G, Ogawa M, editors. Pancreatic secretory trypsin inhibitor. Tokyo: Igaku Tosho Shuppan; 1985. p. 91–3 (in Japanese).
26.
go back to reference Boulling A, Keiles S, Masson E, Chen JM, Férec C. Functional analysis of eight missense mutations in the SPINK1 gene. Pancreas. 2011;41:329–30.CrossRef Boulling A, Keiles S, Masson E, Chen JM, Férec C. Functional analysis of eight missense mutations in the SPINK1 gene. Pancreas. 2011;41:329–30.CrossRef
27.
go back to reference Kuwata K, Hirota M, Shimizu H, Nakae M, Nishihara S, Takimoto A, Mitsushima K, Kikuchi N, Endo K, Inoue M, Ogawa M. Functional analysis of recombinant pancreatic secretory trypsin inhibitor protein with amino-acid substitution. J Gastroenterol. 2002;37:928–34.PubMedCrossRef Kuwata K, Hirota M, Shimizu H, Nakae M, Nishihara S, Takimoto A, Mitsushima K, Kikuchi N, Endo K, Inoue M, Ogawa M. Functional analysis of recombinant pancreatic secretory trypsin inhibitor protein with amino-acid substitution. J Gastroenterol. 2002;37:928–34.PubMedCrossRef
28.
go back to reference Masamune A, Kume K, Takagi Y, Kikuta K, Satoh K, Satoh A, Shimosegawa T. N34S mutation in the SPINK1 gene is not associated with alternative splicing. Pancreas. 2007;34:423–8.PubMedCrossRef Masamune A, Kume K, Takagi Y, Kikuta K, Satoh K, Satoh A, Shimosegawa T. N34S mutation in the SPINK1 gene is not associated with alternative splicing. Pancreas. 2007;34:423–8.PubMedCrossRef
29.
go back to reference Tonouchi A, Ohtsuka M, Ito H, Kimura F, Shimizu H, Kato M, Nimura Y, Iwase K, Hiwasa T, Seki N, Takiguchi M, Miyazaki M. Relationship between pancreatic secretory trypsin inhibitor and early recurrence of intrahepatic cholangiocarcinoma following surgical resection. Am J Gastroenterol. 2006;101:1601–10.PubMedCrossRef Tonouchi A, Ohtsuka M, Ito H, Kimura F, Shimizu H, Kato M, Nimura Y, Iwase K, Hiwasa T, Seki N, Takiguchi M, Miyazaki M. Relationship between pancreatic secretory trypsin inhibitor and early recurrence of intrahepatic cholangiocarcinoma following surgical resection. Am J Gastroenterol. 2006;101:1601–10.PubMedCrossRef
30.
go back to reference Gaber A, Johansson M, Stenman UH, Hotakainen K, Pontén F, Glimelius B, Bjartell A, Jirström K, Birgisson H. High expression of tumour-associated trypsin inhibitor correlates with liver metastasis and poor prognosis in colorectal cancer. Br J Cancer. 2009;100:1540–8.PubMedCrossRef Gaber A, Johansson M, Stenman UH, Hotakainen K, Pontén F, Glimelius B, Bjartell A, Jirström K, Birgisson H. High expression of tumour-associated trypsin inhibitor correlates with liver metastasis and poor prognosis in colorectal cancer. Br J Cancer. 2009;100:1540–8.PubMedCrossRef
31.
go back to reference Paju A, Hotakainen K, Cao Y, Laurila T, Gadaleanu V, Hemminki A, Stenman UH, Bjartell A. Increased expression of tumor-associated trypsin inhibitor, TATI, in prostate cancer and in androgen-independent 22Rv1 cells. Eur Urol. 2007;52:1670–9.PubMedCrossRef Paju A, Hotakainen K, Cao Y, Laurila T, Gadaleanu V, Hemminki A, Stenman UH, Bjartell A. Increased expression of tumor-associated trypsin inhibitor, TATI, in prostate cancer and in androgen-independent 22Rv1 cells. Eur Urol. 2007;52:1670–9.PubMedCrossRef
32.
go back to reference Ozaki N, Ohmuraya M, Hirota M, Ida S, Wang J, Takamori H, Higashiyama S, Baba H, Yamamura K. Serine protease inhibitor Kazal type 1 promotes proliferation of pancreatic cancer cells through the epidermal growth factor receptor. Mol Cancer Res. 2009;7:1572–81.PubMedCrossRef Ozaki N, Ohmuraya M, Hirota M, Ida S, Wang J, Takamori H, Higashiyama S, Baba H, Yamamura K. Serine protease inhibitor Kazal type 1 promotes proliferation of pancreatic cancer cells through the epidermal growth factor receptor. Mol Cancer Res. 2009;7:1572–81.PubMedCrossRef
Metadata
Title
Do genetic variants in the SPINK1 gene affect the level of serum PSTI?
Authors
Kiyoshi Kume
Atsushi Masamune
Hiroyuki Ariga
Shintaro Hayashi
Tetsuya Takikawa
Shin Miura
Noriaki Suzuki
Kazuhiro Kikuta
Shin Hamada
Morihisa Hirota
Atsushi Kanno
Tooru Shimosegawa
Publication date
01-11-2012
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 11/2012
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-012-0590-3

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