Author:
Guerra Iván,Barros Francisco,Chaparro María,Benítez José M.,Martín-Arranz María Dolores,de Francisco Ruth,Piqueras Marta,de Castro Luisa,Carbajo Ana Y.,Bermejo Fernando,Mínguez Miguel,Gutiérrez Ana,Mesonero Francisco,Cañete Fiorella,González-Muñoza Carlos,Calvo Marta,Sicilia Beatriz,Alfambra Erika,Rivero Montserrat,Lucendo Alfredo J.,Tardillo Carlos A.,Almela Pedro,Bujanda Luis,van Domselaar Manuel,Ramos Laura,Fernández Sánchez María,Hinojosa Esther,Verdejo Cristina,Gimenez Anna,Rodríguez-Lago Iago,Manceñido Noemí,Pérez Calle José L.,Moreno Mónica del Pilar,Delgado-Guillena Pedro Genaro,Antolín Beatriz,Ramírez de la Piscina Patricia,Casanova María José,Soto Escribano Pilar,Martín Arranz Eduardo,Pérez-Martínez Isabel,Mena Raquel,García Morales Natalia,Granja Alicia,Boscá Watts Marta Maia,Francés Rubén,Fernández Cristina,Calafat Margalida,Roig-Ramos Cristina,Vera María Isabel,Carracedo Ángel,Domènech Eugeni,Gisbert Javier P.,
Abstract
<b><i>Introduction:</i></b> Risk factors for developing pancreatitis due to thiopurines in patients with inflammatory bowel disease (IBD) are not clearly identified. Our aim was to evaluate the predictive pharmacogenetic risk of pancreatitis in IBD patients treated with thiopurines. <b><i>Methods:</i></b> We conducted an observational pharmacogenetic study of acute pancreatitis events in a cohort study of IBD patients treated with thiopurines from the prospectively maintained ENEIDA registry biobank of GETECCU. Samples were obtained and the CASR, CEL, CFTR, CDLN2, CTRC, SPINK1, CPA1, and PRSS1 genes, selected based on their known association with pancreatitis, were fully sequenced. <b><i>Results:</i></b> Ninety-five cases and 105 controls were enrolled; a total of 57% were women. Median age at pancreatitis diagnosis was 39 years. We identified 81 benign variants (50 in cases and 67 in controls) and a total of 35 distinct rare pathogenic and unknown significance variants (10 in CEL, 21 in CFTR, 1 in CDLN2, and 3 in CPA1). None of the cases or controls carried pancreatitis-predisposing variants within the CASR, CPA1, PRSS1, and SPINK1 genes, nor a pathogenic CFTR mutation. Four different variants of unknown significance were detected in the CDLN and CPA1 genes; one of them was in the CDLN gene in a single patient with pancreatitis and 3 in the CPA1 gene in 5 controls. After the analysis of the variants detected, no significant differences were observed between cases and controls. <b><i>Conclusion:</i></b> In patients with IBD, genes known to cause pancreatitis seem not to be involved in thiopurine-related pancreatitis onset.