Whole Exome Sequencing Reveals FCGBP Variant Associated with Spontaneous Intraabdominal Hemorrhage in Severe Acute Pancreatitis

Qiuyi Tang, Yue-Peng Hu, Qi Yang, Jing Zhou, Jing-Zhu Zhang, Jie Yang, Haibin Hao, Gang Li, Bai-Qiang Li, Lu Ke, Zhi-Hui Tong, Yu-Xiu Liu, Evan Yi-Wen Yu, Wei-Qin Li
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Abstract

This study sought to identify genetic cause of spontaneous intraabdominal hemorrhage (SIH) in severe acute pancreatitis (SAP) to develop more effective treatment for this life-threatening complication. A four-phase study was conducted, leveraging a large-scale acute pancreatitis (AP) patients (n=600); the first phase involved whole-exome sequencing analyses, and identified specific exonic variant located in FCGBP (i.e., rs1326680184) that was consistently associated with SIH; the second phase performed serum ELISA tests, and revealed that FCGBP variant altered FCGBP level and further led to predisposition of SIH; the third phase conducted an i) in-vivo experiment with a Fcgbp-knockdown mouse model, and demonstrated lower expression of Fcgbp led to more severe AP morphology and higher risk of hemorrhage; ii) in-vitro experiment with FCGBP-knockdown human vascular fibroblasts demonstrated that down-regulated FCGBP expression could destabilize the vascular wall, and lead to vascular injury in SAP; the fourth phase compared FCGBP variant carriers to non-carriers with clinical characteristics, and found FCGBP variant associated with higher risks of poor complications and AP prognosis and enhanced the diagnostic capability as an indicator. These findings provide important insights into the underlying mechanism of SIH in SAP, and facilitate therapeutic development for AP prognosis and critical care in an early phase.
全外显子组测序发现 FCGBP 变异与重症急性胰腺炎自发性腹腔出血有关
这项研究旨在确定重症急性胰腺炎(SAP)患者自发性腹腔内出血(SIH)的遗传学原因,从而针对这种危及生命的并发症开发出更有效的治疗方法。研究利用大规模急性胰腺炎(AP)患者(n=600)进行了四个阶段的研究;第一阶段涉及全外显子组测序分析,确定了位于 FCGBP 的特定外显子变异(即:rs1326680184)、rs1326680184)与 SIH 存在一致性关联;第二阶段进行了血清 ELISA 检测,发现 FCGBP 变异改变了 FCGBP 水平,并进一步导致了 SIH 的易感性;第三阶段进行了 i) Fcgbp 敲除小鼠模型的体内实验,结果表明 Fcgbp 的低表达会导致更严重的 AP 形态和更高的出血风险;第四阶段比较了FCGBP变异携带者和非携带者的临床特征,发现FCGBP变异与较高的不良并发症风险和AP预后相关,并增强了作为指标的诊断能力。这些研究结果为了解 SAP 中 SIH 的内在机制提供了重要依据,有助于早期开发针对 AP 预后和危重症护理的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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