Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Pathways to injury in chronic pancreatitis: Decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis

Aoun, E and Chang, CCH and Greer, JB and Papachristou, GI and Barmada, MM and Whitcomb, DC (2008) Pathways to injury in chronic pancreatitis: Decoding the role of the high-risk SPINK1 N34S haplotype using meta-analysis. PLoS ONE, 3 (4).

[img]
Preview
PDF
Published Version
Available under License : See the attached license file.

Download (235kB) | Preview
[img] Plain Text (licence)
Available under License : See the attached license file.

Download (1kB)

Abstract

Background: The complex interactions between recurrent trypsin-mediated pancreatic injury, alcohol-associated pancreatic injury and SPINK1 polymorphisms in chronic pancreatitis (CP) are undefined. We hypothesize that CP occurs as a result of multiple pathological mechanisms (pathways) that are initiated by different metabolic or environmental factors (etiologies) and may be influenced differentially by downstream genetic risk factors. We tested this hypothesis by evaluating the differences in effect size of the high risk SPINK1 N34S haplotype on CP from multiple etiologies after combining clinical reports of SPINK1 N34S frequency using meta-analysis. Methods and Findings: The Pubmed and the Embase databases were reviewed. We studied 24 reports of SPINK1 N34S in CP (2,421 cases, 4,857 controls) using reported etiological factors as surrogates for pathways and multiple meta-analyses to determine the differential effects of SPINK1 N34S between alcoholic and non-alcoholic etiologies. Using estimates of between-study heterogeneity, we sub-classified our 24 studies into four specific clusters. We found that SPINK1 N34S is strongly associated with CP overall (OR 11.00; 95% CI: 7.59-15.93), but the effect of SPINK1 N34S in alcoholic CP (OR 4.98, 95% CI: 3.16-7.85) was significantly smaller than in idiopathic CP (OR 14.97, 95% C.I. = 9.09-24.67) or tropical CP (OR 19.15, 95% C.I. = 8.83-41.56). Studies analyzing familial CP showed very high heterogeneity suggestive of a complex etiology with an I2 = 80.95%. Conclusion: The small effect of SPINK1 N34S in alcoholic subjects suggests that CP is driven through a different pathway that is largely trypsin-independent. The results also suggest that large effect sizes of SPINK1 N34S in small candidate gene studies in CP may be related to a mixture of multiple etiologic pathways leading to the same clinical endpoint. © 2008 Aoun MD et al.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Aoun, E
Chang, CCH
Greer, JBjbg6@pitt.eduJBG6
Papachristou, GIpapachri@pitt.eduPAPACHRI
Barmada, MMbarmada@pitt.eduBARMADA
Whitcomb, DCwhitcomb@pitt.eduWHITCOMB
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorLewis, CathrynUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 16 April 2008
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 3
Number: 4
DOI or Unique Handle: 10.1371/journal.pone.0002003
Schools and Programs: School of Public Health > Biostatistics
School of Public Health > Human Genetics
Refereed: Yes
PubMed ID: 18414673
Date Deposited: 18 Jul 2012 20:50
Last Modified: 22 Jun 2021 11:55
URI: http://d-scholarship.pitt.edu/id/eprint/12951

Metrics

Monthly Views for the past 3 years

Plum Analytics

Altmetric.com


Actions (login required)

View Item View Item