The comorbidities affect the course of pancreatitis significantly; however, this effect has not been evaluated from the perspective of genetic component.
The objective of the research was to analyse concomitant chronic diseases as potential risk factors for edematous pancreatitis considering genetic predictors.
Materials and methods. The epidemiological analysis of comorbidities (cholelithiasis, urolithiasis, ischemic heart disease, past viral infection) as risk factors for edematous pancreatitis was performed. Polymorphic variants of the IL-4 (rs 2243250) gene being identified in 123 patients and 40 healthy individuals were also involved.
Results. In patients with edematous pancreatitis, urolithiasis was observed more frequently than in the control group - by 37.30% (χ2=18.62, p<0.001). The presence of cholelithiasis insignificantly increases the risk of edematous pancreatitis in the future (RR-1.156; 95% CI: 0.972-1.374). The presence of urolithiasis increased the risk of edematous pancreatitis twofold (RR-2.039; 95% CI: 1.346-3.090; p<0.05).
Conclusions. 1. Cholelithiasis increases the probability of developing edematous pancreatitis in carriers of the mutant T-allele of the IL-4 gene by 3.7 times (RR=3.69; OR=10.13; 95% CI OR: 3.17-32.42; p<0.05). 2. In the C-allele carriers of the IL-4 (C-590T) gene, the risk of developing acute pancreatitis is twice higher in the presence of urolithiasis or ischemic heart disease, and almost five times higher in case of past viral infection (p<0.05).
Apte MV, Pirola RC, Wilson JS. Mechanisms of alcoholic pancreatitis. J Gastroenterol Hepatol. 2010;25(12):1816–1826. DOI: http://doi.org/10.1111/j.1440-1746.2010.06445.x
Bala S, Marcos M, Gattu A, Catalano D, Szabo G. Acute binge drinking increases serum endotoxin and bacterial DNA levels in healthy individuals. PLoS One. 2014;9(5):e96864 DOI: http://doi.org/10.1371/journal.pone.0096864
Chiang CP, Wu CW, Lee SP, Chung CC, Wang CW, Lee SL, et al. Expression pattern, ethanol-metabolizing activities, and cellular localization of alcohol and aldehyde dehydrogenases in human pancreas: implications for pathogenesis of alcohol-induced pancreatic injury. Alcohol Clin Exp Res. 2009;33(6):1059–1068. DOI: http://doi.org/10.1111/j.1530-0277.2009.00927.x
Cote GA, Yadav D, Slivka A, Hawes RH, Anderson MA, Burton FR, et al. Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2011;9(3):266–273. DOI: http://doi.org/10.1016/j.cgh.2010.10.015
Ivashchuk SI, Sydorchuk LP. Cholestatic syndrome activity in patients with acute edematous pancreatitis and genes IL-4 (C-590T), TNF-Α (G-308A), PRSS1 (R122H) and CFTR (DELF508C) polymorphism [Published in Ukrainian]. J Clin Exp Med Res. 2016;4(1):56–64
Law R, Parsi M, Lopez R, Zuccaro G, Stevens T. Cigarette smoking is independently associated with chronic pancreatitis. Pancreatol. 2010;10(1):54–59. DOI: http://doi.org/10.1159/000225927
Lerch MM, Aghdassi AA. The role of bile acids in gallstone-induced pancreatitis. Gastroenterology. 2010;138(2):429–433. DOI: http://doi.org/10.1053/j.gastro.2009.12.012
Lugea A, Waldron RT, Pandol SJ. Pancreatic adaptive responses in alcohol abuse: Role of the unfolded protein response. Pancreatol. 2015;15(4 Suppl):S1–5. DOI: http://doi.org/10.1016/j.pan.2015.01.011
Maleth J, Balazs A, Pallagi P, Balla Z, Kui B, Katona M, et al. Alcohol disrupts levels and function of the cystic fibrosis transmembrane conductance regulator to promote development of pancreatitis. Gastroenterol. 2015;148(2):427–439. DOI: http://doi.org/10.1053/j.gastro.2014.11.002
On approval of standards and clinical protocols of providing medical care in specialty “Surgery”. The order of Ministry of Health of Ukraine of 02.04.2010, No 297. [Published in Ukrainian]. Available from: http://www.moz.gov.ua/ua/portal/dn_20100402_297.html.
Mustafa A, Begaj I, Deakin M, Durkin D, Corless DJ, Wilson R, et al. Long-term effectiveness of cholecystectomy and endoscopic sphincterotomy in the management of gallstone pancreatitis. Surg Endosc. 2014;28(1):127–133. DOI: http://doi.org/10.1007/s00464-013-3138-6
Pezzilli R, Andriulli A, Bassi C, Balzano G, Cantore M, Fave GD, et al. Exocrine pancreatic insufficiency in adults: a shared position statement of the Italian association for the study of the pancreas. World J Gastroenterol. 2013;19(44):7930–7946. DOI: http://doi.org/10.3748/wjg.v19.i44.7930
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