2019
Cystic fibrosis and exocrine pancreatic insufficiency
TESAŘÍKOVÁ, Pavla, Lumír KUNOVSKÝ, Jan TRNA, Petr DÍTĚ, Petr JABANDŽIEV et. al.Základní údaje
Originální název
Cystic fibrosis and exocrine pancreatic insufficiency
Název česky
Cystická fibróza a exokrinní pankreatická insuficience
Autoři
TESAŘÍKOVÁ, Pavla (203 Česká republika), Lumír KUNOVSKÝ (203 Česká republika, domácí), Jan TRNA (203 Česká republika, domácí), Petr DÍTĚ (203 Česká republika, domácí), Petr JABANDŽIEV (203 Česká republika, domácí), Jitka VACULOVÁ (203 Česká republika, domácí) a Zdeněk KALA (203 Česká republika, domácí)
Vydání
Gastroenterologie a Hepatologie, Ambit Media a.s. 2019, 1804-7874
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30219 Gastroenterology and hepatology
Stát vydavatele
Česká republika
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Kód RIV
RIV/00216224:14110/19:00110723
Organizační jednotka
Lékařská fakulta
Klíčová slova anglicky
CFTR; cystic fibrosis; exocrine pancreatic insufficiency; malnutrition; pancreatitis
Štítky
Změněno: 15. 3. 2021 11:26, Mgr. Tereza Miškechová
Anotace
V originále
Cystic fibrosis (CF) is a genetic disease affecting many organs, including the gastrointestinal tract. While the pulmonary damage is the most life threatening, the pancreas is one of the first organs affected by CF and one of the most strongly affected. Mutation in the CF transmembrane conductance regulator (CFTR) gene results in a reduced volume of pancreatic juice and hyperconcentration of macromolecules leading to precipitation in the duct lumina, causing obstruction and damage. The clinical presentation of individual cases depends on a combination of different CFTR mutations, the potential presence of modifier gene mutations and environmental factors. CFTR mutations are historically divided into 5 classes – severe mutations (classes 1–3) and mild mutations (classes 4–5). The CFTR functional status depends on the combined effects of both CFTR allels and the severity of the phenotype depends on the milder mutation. The majority of CF patients exhibit exocrine pancreatic insufficiency in early childhood because functional acinar tissue has been lost in utero or soon after birth. These patients rarely suffer from pancreatic complications such as recurrent acute pancreatitis and/or chronic pancreatitis which, however, can occur in the minority of patients who possess residual pancreatic exocrine function. CFTR mutations are found more frequently in idiopathic and alcoholic chronic pancreatitis but the data is conflicting. A combination with serine protease inhibitor Kazal-type 1 (SPINK-1) mutations can be found in the idiopathic chronic pancreatitis group, as well as the presence of environmental factors. Malnutrition is directly related to a worse prognosis of CF patients and the delivery of active digestive enzymes is a cornerstone of treatment, with acid supression and vitamin supplementation playing an important additional role.