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We read with great interest the recent publication by Németh et al.1 in which the authors demonstrate that a misfolding human cationic trypsinogen (serine protease 1, PRSS1) variant causes autosomal dominant hereditary chronic pancreatitis (CP) by inducing endoplasmic reticulum (ER) stress. Previously, the same mechanism was proposed for carboxypeptidase A1 (CPA1) gene variants strongly associated with early onset sporadic CP;2 however, the association of misfolding CPA1 variants with familial or hereditary CP has not been demonstrated so far.
Here, we report two Polish families with hereditary CP carrying a novel heterozygous c.844T>C (p.Ser282Pro) CPA1 variant. In Family 1, the index patient, her mother and uncle (half-brother of the mother) developed CP (figure 1). The age of diagnosis was 17 years for the index patient and 51 and 31 years (with earlier abdominal pain) for the mother and the uncle, respectively. In Family 2, three members were affected by CP (figure 1): the index patient, her mother and her father with ages of onset of 12, 32 and 34 years, respectively. In both families, the diagnosis of CP was confirmed by …
AAK and DB are equally contributing first authors.
MS-T and AMR are equally contributing senior authors.
Contributors Study concept, design and supervision: AMR and MS-T. Acquisition and analysis of genetic data: AAK, AMR, JA, KW-T and JB. Functional analysis: DB and MS-T. Patient enrolment, clinical data collection and interpretation: GO, KW and EK. Drafting the manuscript: AMR, AAK, MS-T and DB. Final approval of manuscript as submitted: all authors. AMR and MS-T contributed equally to this study. The first authors AAK and DB contributed equally to the laboratory experiments.
Funding This study was supported by the National Science Centre, Poland, grant 2015/19/B/NZ5/02224 (to AMR) and National Institutes of Health grant R01 DK058088 (to MS-T).
Competing interests None declared.
Ethics approval The study was approved by the Committee on Bioethics at Institute of Mother and Child (approval 28/2016).
Provenance and peer review Not commissioned; internally peer reviewed.
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