title: Comprehensive functional analysis of chymotrypsin C (CTRC) variants reveals distinct loss-of-function mechanisms associated with pancreatitis risk.
abstract: OBJECTIVE
  The digestive enzyme chymotrypsin C (CTRC) protects against pancreatitis by promoting degradation of trypsinogen, thereby curtailing potentially harmful trypsinogen activation. Loss-of-function variants in CTRC increase the risk for chronic pancreatitis. The aim of the present study was to perform comprehensive functional analysis of all missense CTRC variants identified to date.
  
  
  METHODS
  We investigated secretion, activity and degradation of 27 published and five novel CTRC mutants. We also assessed the effect of five mutants on endoplasmic reticulum (ER) stress.
  
  
  RESULTS
  None of the mutants exhibited a gain of function, such as increased secretion or activity. By contrast, 11 mutants showed marked loss of function, three mutants had moderate functional defects, whereas 18 mutants were functionally similar to wild-type CTRC. The functional deficiencies observed were diminished secretion, impaired catalytic activity and degradation by trypsin. Mutants with a secretion defect caused ER stress that was proportional to the loss in secretion. ER stress was not associated with loss-of-function phenotypes related to catalytic defect or proteolytic instability.
  
  
  CONCLUSIONS
  Pathogenic CTRC variants cause loss of function by three distinct but mutually non-exclusive mechanisms that affect secretion, activity and proteolytic stability. ER stress may be induced by a subset of CTRC mutants, but does not represent a common pathological mechanism of CTRC variants. This phenotypic dataset should aid in the classification of the clinical relevance of CTRC variants identified in patients with chronic pancreatitis.
authors.affiliation: Department of Molecular and Cell Biology, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Beer
authors.forename: Jiayi
authors.initials: J
authors.lastname: Zhou
authors.forename: András
authors.initials: A
authors.lastname: Szabó
authors.forename: Steven
authors.initials: S
authors.lastname: Keiles
authors.forename: Giriraj Ratan
authors.initials: GR
authors.lastname: Chandak
authors.forename: Heiko
authors.initials: H
authors.lastname: Witt
authors.forename: Miklós
authors.initials: M
authors.lastname: Sahin-Tóth
mesh_terms: D055162:Biocatalysis; D002918:Chymotrypsin / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism / Q000502:physiology; D017077:Culture Media, Conditioned; D059865:Endoplasmic Reticulum Stress / Q000235:genetics; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D057809:HEK293 Cells; D006801:Humans; D020125:Mutation, Missense; D050500:Pancreatitis, Chronic / Q000201:enzymology / Q000235:genetics*; D014357:Trypsin / Q000494:pharmacology
chemical_list: D017077:Culture Media, Conditioned; D002918:Chymotrypsin; C117569:chymotrypsin C; D014357:Trypsin