Variation in SPINK-1 N34S Effect Size Is Population-Dependant
Makaleler > Tam Makale · 2006
Yazarlar: Elie Aoun, Chung-Chou Chang, Georges I. Papachristou, Nevin ORUÇ, Michael M. Barmada, Whitcomb C. David
American Journal of Gastroenterology, Uluslararası, Wos, 2006, cilt 101, ss S112-S112
DOI: 10.14309/00000434-200609001-00209
Özet
Purpose: SPINK-1 is a specific trypsin inhibitor expressed in the pancreas and currently thought of as the first-line of defense against premature pancreatic trypsin activation. Mutations in the SPINK-1 gene are associated with pancreatitis but their reported effect varies widely among studies. Our aim is to systematically review the effect size of the SPINK1 N34S high-risk haplotype in patients with acute pancreatitis (AP) and chronic pancreatitis (CP) in different populations using meta-analysis. Methods: Case-control studies published by October 2005 were identified by Medline search. The significance of the association of the N34S mutation with pancreatitis was evaluated for each study separately [OR (95% CI)]. Separate meta-analyses were carried for the different disease subtypes. Results: The N34S mutation was associated with CP in general (OR: 10.50, 95% CI: 6.92–15.92). Patients with ACP had a weaker association (OR: 5.13, 95% CI: 3.26–8.08). The strongest association was with TCP (OR: 31.15, 95% CI 13.21–73.47). The association with AP was weak (OR:2.98, 95% CI: 1.71–5.22). There was no evidence of publication bias. Conclusions: SPINK-1 N34S has only a small effect in AP and ACP, but is strongly associated with young-onset chronic pancreatitis. The marked differences between the effect size in the disease subsets suggest that the previously proposed mechanism of SPINK-1 associated protection must be reconsidered.Table