Evolution of Phenotypic and Genetic Profile of T...
Prachand Issarapu，Sumit Paliwal，Seema Bhaskar，and Giriraj Ratan Chandak(https://www.daowen.com)
Abstract Historically，tropical calcific pancreatitis（TCP）was defined as a juvenile form of chronic calcific，non-alcoholic pancreatitis with younger age of onset，presence of large intraductal calculi，accelerated course of the disease and，high risk of developing diabetes and pancreatic cancer.The clinical features of TCP have evolved over the past few decades with relatively older age of onset and a milder form of the disease.In addition，the proportion of cases presenting with imaging abnormalities like calcification，ductal dilation and glandular atrophy is variably reported.This may be related to the technological advances that allow early detection of the disease，as well as to better awareness about the disease.Etiology of TCP is still obscure.The proposed causal role of malnutrition and cassava toxicity has been refuted；instead，role of micronutrient deficiencies is being investigated.Over last two decades，there has been great emphasis on understanding the genetic basis of chronic pancreatitis（CP）including TCP.As a result，several susceptibility genes including cationic and anionic trypsinogens，serine protease inhibitor kazal type I，cathepsin B，chymotrypsin C，carboxypeptidase Al，claudin 2 and others have been discovered.Results from our studies have supported the notion that there exists genetic and mutational diversity between TCP in Indians and CP in Western populations.Overall results suggest that TCP is a complex multifactorial disease and further exhaustive studies are required to dissect the role of individual factors as well as understand their cumulative effect in the disease pathophysiology.