TESAŘÍKOVÁ, Pavla, Lumír KUNOVSKÝ, Jan TRNA, Petr DÍTĚ, Petr JABANDŽIEV, Jitka VACULOVÁ and Zdeněk KALA. Cystic fibrosis and exocrine pancreatic insufficiency. Gastroenterologie a Hepatologie. Ambit Media a.s., 2019, vol. 73, No 4, p. 303-307. ISSN 1804-7874. Available from: https://dx.doi.org/10.14735/amgh2019303.
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Basic information
Original name Cystic fibrosis and exocrine pancreatic insufficiency
Name in Czech Cystická fibróza a exokrinní pankreatická insuficience
Authors TESAŘÍKOVÁ, Pavla (203 Czech Republic), Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), Jan TRNA (203 Czech Republic, belonging to the institution), Petr DÍTĚ (203 Czech Republic, belonging to the institution), Petr JABANDŽIEV (203 Czech Republic, belonging to the institution), Jitka VACULOVÁ (203 Czech Republic, belonging to the institution) and Zdeněk KALA (203 Czech Republic, belonging to the institution).
Edition Gastroenterologie a Hepatologie, Ambit Media a.s. 2019, 1804-7874.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30219 Gastroenterology and hepatology
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
WWW URL
RIV identification code RIV/00216224:14110/19:00110723
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.14735/amgh2019303
Keywords in English CFTR; cystic fibrosis; exocrine pancreatic insufficiency; malnutrition; pancreatitis
Tags rivok
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 15/3/2021 11:26.
Abstract
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.
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