A finger sweat chloride test for the detection of a high-risk group of chronic pancreatitis.
OBJECTIVE
Mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene are associated with chronic pancreatitis in Caucasians. We developed a simple method for measuring finger sweat chloride concentration to test whether CFTR dysfunction underlies chronic pancreatitis in Japan where cystic fibrosis (CF) is rare.


METHODS
We studied 25 patients with chronic (21 alcoholic and 4 idiopathic) pancreatitis and 25 healthy volunteers. Sweat chloride concentrations were measured by a finger sweat chloride test. We analyzed DNA for 20 common CFTR mutations in Europeans, 9 CF-causing mutations in Japanese, and 2 polymorphic loci, a poly-T tract and (TG) repeats, at intron 8.


RESULTS
Thirteen patients (52%) had sweat chloride levels >60 mmol/L, a level consistent with CF, while only 4 (16%) healthy subjects exceeded this level. The 29 CF mutations and the 5T allele were detected in neither the patients nor controls. The (TG) 12 allele was common in both the patients (58%) and controls (48%). The (TG) 12/12 genotype was common in alcoholic pancreatitis (29%) compared with the (TG) 11/11 (10%). Patients with the (TG) 12/12 genotype had significantly higher sweat chloride concentrations than the controls.


CONCLUSIONS
CFTR dysfunction as evidenced by a finger sweat chloride test is present in about half of Japanese patients with chronic pancreatitis, suggesting that this test may be useful for detecting the high-risk group. A higher proportion of the (TG) 12 allele may be a genetic background for elevated sweat chloride concentrations in Japanese patients.
Naruse
Satoru
S
Department of Internal Medicine, Nagoya University Graduate School of Medicine and Nagoya Institute of Technology, Nagoya, Japan. snaruse@med.nagoya-u.ac.jp
Ishiguro
Hiroshi
H
Suzuki
Yasufumi
Y
Fujiki
Kotoyo
K
Ko
Shigeru B H
SB
Mizuno
Nobumasa
N
Takemura
Toshihiro
T
Yamamoto
Akiko
A
Yoshikawa
Toshiyuki
T
Jin
Chunxiang
C
Suzuki
Ryujiro
R
Kitagawa
Motoji
M
Tsuda
Takao
T
Kondo
Takaharu
T
Hayakawa
Tetsuo
T
D000328:Adult; D000368:Aged; D002712:Chlorides / Q000032:analysis*; D002908:Chronic Disease; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D005260:Female; D005385:Fingers; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010195:Pancreatitis / Q000175:diagnosis* / Q000235:genetics; D011110:Polymorphism, Genetic; D012091:Repetitive Sequences, Nucleic Acid; D012307:Risk Factors; D013542:Sweat / Q000737:chemistry*
C505032:CFTR protein, human; D002712:Chlorides; D019005:Cystic Fibrosis Transmembrane Conductance Regulator