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We have read with interest three related papers that were recently published in this journal.1–3 Taken together, the findings reported in these papers (summarised in online supplementary note) suggest that loss-of-function PRSS1 promoter variants can protect against pancreatitis. The other side of the coin is however that gain-of-function PRSS1 promoter variants predispose to pancreatitis. It therefore follows that the risk-associated [rs4726576C; rs10273639C] allele shares a common pathogenetic mechanism with the previously reported trypsinogen duplication and triplication copy number variants (CNVs)4 5 as both types of variant predispose to pancreatitis by increasing PRSS1 expression; this mechanism is quite distinct from either the increased activation and/or stability of trypsin(ogen) or misfolding-induced endoplasmic reticulum stress caused by disease-associated PRSS1 missense mutations.6 However, despite both serving to increase PRSS1 expression, the promoter variant and the CNVs differ significantly in terms of the …
Contributors EM, J-MC and CF: designed the study. EM: performed the analysis. J-MC: drafted the manuscript. DNC: critically revised the manuscript. All authors: analysed the data and approved the final manuscript.
Funding Support for this study came from the Association des Pancréatites Chroniques Héréditaires, the Association de Transfusion Sanguine et de Biogénétique Gaetan Saleun, and the Institut National de la Santé et de la Recherche Médicale (INSERM), France.
Competing interests None declared.
Ethics approval Ethical Committee of the University of Brest.
Provenance and peer review Not commissioned; internally peer reviewed.
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