Changing phenotype and disease behaviour of chronic pancreatitis in India: evidence for gene-environment interactions.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2016-10-18 eCollection Date: 2016-01-01 DOI:10.1017/gheg.2016.13

P K Garg, D Narayana

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引用次数: 7

Abstract

Background: The idiopathic variety of chronic pancreatitis (CP) in India particularly in Kerala state was earlier called 'tropical pancreatitis' with peculiar features: early age of onset, severe malnutrition, diabetes and poor prognosis. A change in disease phenotype and behaviour has been observed recently.

Objective: To review the changing profile of CP in India and examine its relationship with environmental influences and socio-economic development.

Methods: Relevant studies on CP in India were reviewed along with social and economic parameters in Kerala over the past 4 decades.

Results: There has been a definite change in the phenotype of CP in India with onset in mid twenties, better nutritional status, and a much better prognosis compared with the reports in 1970s. Genetic susceptibility due to genetic mutations particularly in SPINK1, CFTR, CTRC, and CLDN2/MORC4 genes is the most important factor and not malnutrition or dietary toxins for idiopathic CP suggesting the term 'tropical pancreatitis' is a misnomer. We observed a close relationship between socio-economic development and rising income in Kerala with late onset of disease, nutritional status, and better prognosis of CP.

Conclusion: Changing profile of CP in India and better understanding of risk factors provide evidence for gene-environmental interactions in its pathobiology.

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印度慢性胰腺炎的改变表型和疾病行为:基因-环境相互作用的证据。

背景:印度特别是喀拉拉邦的特发性慢性胰腺炎(CP)早期被称为“热带胰腺炎”，具有特殊的特征:发病年龄早、严重营养不良、糖尿病和预后差。最近观察到疾病表型和行为的变化。目的:回顾印度CP的变化概况，并探讨其与环境影响和社会经济发展的关系。方法:结合喀拉拉邦近40年来的社会经济指标，对印度CP的相关研究进行综述。结果:与20世纪70年代的报道相比，印度CP的表型发生了明显的变化，发病年龄在20岁左右，营养状况更好，预后也更好。由于基因突变，特别是SPINK1、CFTR、CTRC和CLDN2/MORC4基因的遗传易感性是特发性CP的最重要因素，而不是营养不良或饮食毒素，这表明“热带胰腺炎”一词是用词不当。我们观察到喀拉拉邦的社会经济发展和收入增加与CP的发病晚、营养状况和预后良好密切相关。结论:印度CP的变化和对危险因素的更好了解为其病理生物学中的基因-环境相互作用提供了证据。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.