Background. We have studied R122H-polymorphism of the PRSS1 gene and N34S-polymorphism of the SPINK1 gene in patients with various forms of acute pancreatitis. On this basis, new methods for prognosticating the course of AP have been developed.
Methods. In the examination of patients clinical, laboratory and instrumental methods of investigation were used in accordance with the protocol for the provision of medical care to patients with acute pancreatitis. In addition, a genetic analysis of R122H-polymorphism of the PRSS1 gene and N34S-polymorphism of the SPINK1 gene was performed.
Results. It was found that in the examined patients with AP, carriers of the favorable R-allele of R122N-polymorphism of the PRSS1 gene are more common (RR- and RH-genotype – 27.27% and 64.77% respectively), with a lower number of pathological NN-homozygotes (7.96 % of individuals), as well as the favorable N-allele of N34S-polymorphism of the SPINK1 gene (NN genotype 42.05% and NS-genotype 54.55%) with less pathological SS-homozygotes (3.40%). The informativeness of the proposed methods for predicting the severity of acute pancreatitis and the development of pancreatic necrosis was 90% and 96.6% respectively.
Conclusions. The working out approaches to the prognostication of the AP course enable an integrated analysis of its clinical, laboratory and instrumental features, with an assessment of the probable negative impact of genetically determined disorders and inactivation of trypsin on the nature of the disease development. The implementation of this approach can significantly increase the reliability of prognosticating the severity of AP course and the development of pancreatic necrosis.
Abbreviations: AP – acute pancreatitis, PRSS1 – cationic trypsinogen, SPINK1 – serine protease inhibitor of Kazal type 1.
Key words: acute pancreatitis, prognostication, mutation, PRSS1, SPINK1.