Pathogenesis of reproductive failure induced by Trypanosoma vivax in experimentally infected pregnant ewes

The present study was aimed at investigating the effect of experimental infection by Trypanosoma vivax in different stages of pregnancy, determining the pathogenesis of reproductive failure, and confirming transplacental transmission. We used 12 pregnant ewes distributed into four experimental groups: G1, was formed by three ewes infected with T. vivax in the first third of pregnancy (30 days); G2 comprised three infected ewes in the final third of pregnancy (100 days); G3 and G4 were composed of three non-infected ewes with the same gestational period, respectively. Each ewe of G1 and G2 was inoculated with 1.25 × 105 tripomastigotes. Clinical examination, determination of parasitemia, serum biochemistry (albumin, total protein, glucose, cholesterol, and urea), packed cell volume (PCV), serum progesterone, and pathological examination were performed. Placenta, amniotic fluid, blood and tissues from the fetuses and stillbirths were submitted to PCR. Two ewes of G1 (Ewe 1 and 3) presented severe infection and died in the 34th and 35th days post-infection (dpi), respectively; but both fetuses were recovered during necropsy. In G2, Ewe 5 aborted two fetuses on the 130th day (30 dpi) of pregnancy; and Ewe 6 aborted one fetus in the 140th day (40 dpi) of gestation. Ewes 2 and 4 delivered two weak lambs that died five days after birth. Factors possibly involved with the reproductive failure included high parasitemia, fever, low PCV, body score, serum glucose, total protein, cholesterol, and progesterone. Hepatitis, pericarditis, and encephalitis were observed in the aborted fetuses. The presence of T. vivax DNA in the placenta, amniotic fluid, blood, and tissues from the fetuses confirms the transplacental transmission of the parasite. Histological lesion in the fetuses and placenta also suggest the involvement of the parasite in the etiopathogenesis of reproductive failure in ewes.

Uptake of oxLDL and IL-10 production by macrophages requires PAFR and CD36 recruitment into the same lipid rafts

Macrophage interaction with oxidized low-density lipoprotein (oxLDL) leads to its differentiation into foam cells and cytokine production, contributing to atherosclerosis development. In a previous study, we showed that CD36 and the receptor for platelet-activating factor (PAFR) are required for oxLDL to activate gene transcription for cytokines and CD36. Here, we investigated the localization and physical interaction of CD36 and PAFR in macrophages stimulated with oxLDL. We found that blocking CD36 or PAFR decreases oxLDL uptake and IL-10 production. OxLDL induces IL-10 mRNA expression only in HEK293T expressing both receptors (PAFR and CD36). OxLDL does not induce IL-12 production. The lipid rafts disruption by treatment with βCD reduces the oxLDL uptake and IL-10 production. OxLDL induces co-immunoprecipitation of PAFR and CD36 with the constitutive raft protein flotillin-1, and colocalization with the lipid raft-marker GM1-ganglioside. Finally, we found colocalization of PAFR and CD36 in macrophages from human atherosclerotic plaques. Our results show that oxLDL induces the recruitment of PAFR and CD36 into the same lipid rafts, which is important for oxLDL uptake and IL-10 production. This study provided new insights into how oxLDL interact with macrophages and contributing to atherosclerosis development.

Charakterisierung der biologischen Funktion der Plasmodium falciparum Calcium-abhängigen Proteinkinase 1

Im Rahmen dieser Arbeit wurden biologische Funktionen einer Proteinkinase des Erregers der Malaria tropica, genauer der „Plasmodium falciparum calcium dependent protein kinase 1“ (PfCDPK1), in parasitären Blutstadien untersucht.rnUm Einblicke in die Funktion der Kinase, die sie in den extrazellulären Kompartimenten des Parasiten übernimmt, zu gewinnen, wurden sechs Proteine untersucht, die dasselbe Translokationsignal wie PfCDPK1 besitzen. Es konnte gezeigt werden, dass fünf der untersuchten Proteine mit der PfCDPK1 im Bereich der parasitophoren Vakuole sowie des tubovesikulären Systems co-lokalisiert sind. Deletionsmutanten, denen das Translokationssignal fehlte, sowie ein Peptid, das lediglich aus diesem bestand, bestätigten, dass die Translokation in die extrazellulären Kompartimente von keinen weiteren Faktoren, außer dem Signalmotiv abhängt. Mit PfCAP und PfRKIP konnten zwei Regulatoren der PfCDPK1 identifiziert werden. PfARM, Pfrab_5b sowie PfGAP45 sind Substrate der PfCDPK1. Mit Hilfe von massenspektrometrischen Messungen wurde der Phosphorylierungsstatus der untersuchten Proteine durch die PfCDPK1 sowie der Autophosphorylierungsstatus der Kinase bestimmt, um Rückschlüsse auf regulatorische Prozesse ziehen zu können.rnDie Phosphorylierung von PfGAP45 durch die PfCDPK1 steht vermutlich mit dem Invasionsprozess des Parasiten in direktem Zusammenhang, da gezeigt wurde, dass eine Hemmung der Kinase mit PP1 einen 90%igen Rückgang an neu infizierten Erythrozyten zur Folge hatte.rnrn

In-vivo-Tumorbiologie mittels 68 Ga-PET: Beurteilung der p-Glykoprotein-Aktivität in Weichgewebe-Tumoren sowie Diagnose und Therapie von Knochenmetastasen

Krebs ist eine der häufigsten Krankheiten und stellt eine der wichtigsten medizinischen Herausforderungen des 21. Jahrhunderts dar. Eine frühzeitige Diagnose ist dabei essentiell für eine individuell angepasste Therapie zur Verbesserung der Lebensqualität und -erwartung der Patienten. Hierbei kommen der 68Ge/68Ga-Generator und das daraus resultierende PET-Nuklid 68Ga immer stärker in den Fokus von Wissenschaft und Medizin. rnrnFür eine erfolgreiche Therapie stellt die Chemoresistenz (Multi-Drug-Resistance) zahlreicher Tumore eine schwerwiegende Komplikation dar. Für das Therapieversagen ist die Aktivierung des Transportproteins p-Glykoprotein (pGP) maßgeblich mit verantwortlich. Mit Hilfe der Schiff’schen Base [68Ga]MFL6.MZ konnte die Aktivitätsänderung von pGP unter verschiedener Beeinflussung erstmals in vivo beobachtet werden. So zeigte sich, dass sich unter azidotischen Bedingungen in Tumoren die Aktivität des pGP erhöht und somit vermehrt auch Zytostatika, die pGP-Substrate sind, aus den Tumoren transportiert werden. Durch Aufklärung der Abhängigkeit der pGP-Aktivität von dessen Signalkaskade konnte gezeigt werden, dass durch eine Blockade der MAP-Kinase p38 eine Erniedrigung der pGP-Aktivität zu verzeichnen ist. Die ebenfalls in der Signalkaskade eingebundene MAP-Kinase ERK1/2 hingegen spielt hier nur eine untergeordnete Rolle.rnrnNeben dem Versagen der Chemotherapie stellt auch die Metastasierung eines Malignoms massive Einschnitte in die Lebensqualität von Erkrankten dar. Befallen die Metastasen das Skelett eines Menschen, wird dies zumeist erst spät registriert. 68Ga-markierte Bisphosphonate bieten nun die Möglichkeit, Patienten quantitativ auf Knochenmetastasen hin untersuchen zu können. So konnten zu Beginn einfache Phosphonate wie EDTMP und DOTP nicht die nötige in vivo Stabilität bzw. hohe radiochemische Ausbeuten liefern und sind damit für die Anwendung am Menschen uninteressant. Jedoch die DOTA-basierten Bisphosphonate allen voran der Ligand BPAMD zeigen ein großes Potential. In vivo-Versuche an Ratten mit Knochenmetastasen zeigten, dass sich [68Ga]BPAMD an den Metastasen anreichert und einen sehr guten Kontrast zum gesunden Knochen darstellt. Der Tracer konnte erstmals am Menschen angewendet werden und zeigte in ausgewählten Regionen eine höhere Anreicherung als eine zuvor durchgeführte PET-Aufnahme mit [18F]Fluorid. Der Ligand BPAMD bietet außerdem den Vorteil, neben 68Ga auch andere dreiwertige Radionuklide wie das therapeutische 177Lu komplexieren zu können. Durch Studien zur Komplexbildung und Stabilität konnte auch [177Lu]BPAMD in der klinischen Anwendung erprobt werden und zeigte eine Anreicherung an den Knochenmetastasen. So ist es nun möglich, Knochenmetastasen mittels 68Ga-PET zu diagnostizieren, eine entsprechende Dosisberechnung anzustellen und anschließend mit dem gleichen Liganden eine Therapie mit [177Lu]BPAMD durchzuführen.

The relevance of the silica metabolizing enzyme silicatein-alpha to biomineralization and the formation of biogenic silica in siliceous sponges

Die technische Silikatproduktion erfordert in der Regel hohe Temperaturen und extreme pH-Werte. In der Natur hingegen haben insbesondere Kieselschwämme die außergewöhnliche Fähigkeit, ihr Silikatskelett, das aus einzelnen sogenannten Spiculae besteht, enzymatisch mittels des Proteins Silicatein zu synthetisieren. rnIm Inneren der Spiculae, im zentralen Kanal, befindet sich das Axialfilament, welches hauptsächlich aus Silicatein-α aufgebaut ist. Mittels Antikörperfärbungen und Elektronenmikroskopischen Analysen konnte festgestellt werden, dass Silicatein in mit Kieselsäure-gefüllten Zellorganellen (silicasomes) nachzuweisen ist. Mittels dieser Vakuolen kann das Enzym und die Kieselsäure aus der Zelle zu den Spiculae im extrazellulären Raum befördert werden, wo diese ihre endgültige Länge und Dicke erreichen. Zum ersten Mal konnte nachgewiesen werden, dass rekombinant hergestelltes Silicatein-α sowohl als Siliciumdioxid-Polymerase als auch Siliciumdioxid-Esterase wirkt. Mittels Massenspektroskopie konnte die enzymatische Polymerisation von Kieselsäure nachverfolgt werden. Durch Spaltung der Esterbindung des künstlichen Substrates Bis(p-aminophenoxy)-dimethylsilan war es möglich kinetische Parameter der Siliciumdioxid-Esterase-Aktivität des rekombinanten Silicateins zu ermitteln.rnZu den größten biogenen Silikatstukuren auf der Erde gehören die Kieselnadeln der Schwammklasse Hexactinellida. Nadelextrakte aus den Schwammklassen Demospongien (S. domuncula) und Hexactinellida (M. chuni) wurden miteinander verglichen um die potentielle Existenz von Silicatein oder Silicatein-ähnliche Molekülen und die dazu gehörige proteolytischen Aktivität nachzuweisen. Biochemische Analysen zeigten, dass das 27 kDA große isolierte Polypeptid in Monoraphis mehrere gemeinsame Merkmale mit den Silicateinen der Demospongien teilt. Dazu gehören die Größe und die Proteinase-Aktivität. rnUm die Frage zu klären, ob das axiale Filament selbst zur Formbildung der Skelettelemente beiträgt, wurde ein neues mildes Extraktionsverfahren eingeführt. Dieses Verfahren ermöglichte die Solubilisierung des nativen Silicateins aus den Spiculae. Die isolierten Silicateine lagen als Monomere (24 kDa) vor, die Dimere durch nicht-kovalente Bindungen ausbildeten. Darüber hinaus konnten durch PAGE-Gelelektrophorese Tetramere (95 kDa) und Hexamere (135 kDa) nachgewiesen werden. Die Monomere zeigten eine beträchtliche proteolytische Aktivität, die sich während der Polymerisationsphase des Proteins weiter erhöhte. Mit Hilfe der Lichtmikroskopie und Elektronenmikroskopie (TEM) konnte die Assemblierung der Proteine zu filamentartigen Strukturen gezeigt werden. Die Selbstorganisation der Silicatein-α-Monomeren scheint eine Basis für Form- und Musterbildung der wachsenden Nadeln zu bilden.rn Um die Rolle des kürzlich entdeckten Proteins Silintaphin-1, ein starker Interaktionspartner des Silicatein-α, während der Biosilifizierung zu klären, wurden Assemblierungs-Experimente mit den rekombinanten Proteinen in vitro durchgeführt. Zusätzlich wurde deren Effekt auf die Biosilikatsynthese untersucht. Elektronenmikroskopische Analysen ergaben, dass rekombinantes Silicatein-α zufällig verteilte Aggregate bildet, während die Koinkubation beider Proteine (molekulares Verhältnis 4:1) über fraktal artige Strukturen zu Filamenten führt. Auch die enzymatische Aktivität der Silicatein-α-vermittelte Biosilikatsynthese erhöhte sich in Gegenwart von Silintaphin-1 um das 5,3-fache. rn

An overlapping kinase and phosphatase docking site regulates activity of the retinoblastoma protein

The phosphorylation state and corresponding activity of the retinoblastoma tumor suppressor protein (Rb) are modulated by a balance of kinase and phosphatase activities. Here we characterize the association of Rb with the catalytic subunit of protein phosphatase 1 (PP1c). A crystal structure identifies an enzyme docking site in the Rb C-terminal domain that is required for efficient PP1c activity toward Rb. The phosphatase docking site overlaps with the known docking site for cyclin-dependent kinase (Cdk), and PP1 competition with Cdk-cyclins for Rb binding is sufficient to retain Rb activity and block cell-cycle advancement. These results provide the first detailed molecular insights into Rb activation and establish a novel mechanism for Rb regulation in which kinase and phosphatase compete for substrate docking.

Nedd4-1 and beta-arrestin-1 are key regulators of Na+/H+ exchanger 1 ubiquitylation, endocytosis, and function

The ubiquitously expressed mammalian Na(+)/H(+) exchanger 1 (NHE1) controls cell volume and pH but is also critically involved in complex biological processes like cell adhesion, cell migration, cell proliferation, and mechanosensation. Pathways controlling NHE1 turnover at the plasma membrane, however, are currently unclear. Here, we demonstrate that NHE1 undergoes ubiquitylation at the plasma membrane by a process that is unprecedented for a mammalian ion transport protein. This process requires the adapter protein ?-arrestin-1 that interacts with both the E3 ubiquitin ligase Nedd4-1 and the NHE1 C terminus. Truncation of NHE1 C terminus to amino acid 550 abolishes binding to ?-arrestin-1 and NHE1 ubiquitylation. Overexpression of ?-arrestin-1 or of wild type but not ligase-dead Nedd4-1 increases NHE1 ubiquitylation. siRNA-mediated knock-down of Nedd4-1 or ?-arrestin-1 reduces NHE1 ubiquitylation and endocytosis leading to increased NHE1 surface levels. Fibroblasts derived from ?-arrestin-1 and Nedd4-1 knock-out mice show loss of NHE1 ubiquitylation, increased plasmalemmal NHE1 levels and greatly enhanced NHE1 transport compared with wild-type fibroblasts. These findings reveal Nedd4-1 and ?-arrestin-1 as key regulators of NHE1 ubiquitylation, endocytosis, and function. Our data suggest a broader role for ?-arrestins in the regulation of membrane ion transport proteins than currently known.

Claudin-1 induced sealing of blood-brain barrier tight junctions ameliorates chronic experimental autoimmune encephalomyelitis

In experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis (MS), loss of the blood-brain barrier (BBB) tight junction (TJ) protein claudin-3 correlates with immune cell infiltration into the CNS and BBB leakiness. Here we show that sealing BBB TJs by ectopic tetracycline-regulated expression of the TJ protein claudin-1 in Tie-2 tTA//TRE-claudin-1 double transgenic C57BL/6 mice had no influence on immune cell trafficking across the BBB during EAE and furthermore did not influence the onset and severity of the first clinical disease episode. However, expression of claudin-1 did significantly reduce BBB leakiness for both blood borne tracers and endogenous plasma proteins specifically around vessels expressing claudin-1. In addition, mice expressing claudin-1 exhibited a reduced disease burden during the chronic phase of EAE as compared to control littermates. Our study identifies BBB TJs as the critical structure regulating BBB permeability but not immune cell trafficking into CNS during EAE, and indicates BBB dysfunction is a potential key event contributing to disease burden in the chronic phase of EAE. Our observations suggest that stabilizing BBB barrier function by therapeutic targeting of TJs may be beneficial in treating MS, especially when anti-inflammatory treatments have failed.

Deep resequencing of GWAS loci identifies independent rare variants associated with inflammatory bowel disease

More than 1,000 susceptibility loci have been identified through genome-wide association studies (GWAS) of common variants; however, the specific genes and full allelic spectrum of causal variants underlying these findings have not yet been defined. Here we used pooled next-generation sequencing to study 56 genes from regions associated with Crohn's disease in 350 cases and 350 controls. Through follow-up genotyping of 70 rare and low-frequency protein-altering variants in nine independent case-control series (16,054 Crohn's disease cases, 12,153 ulcerative colitis cases and 17,575 healthy controls), we identified four additional independent risk factors in NOD2, two additional protective variants in IL23R, a highly significant association with a protective splice variant in CARD9 (P < 1 × 10(-16), odds ratio ≈ 0.29) and additional associations with coding variants in IL18RAP, CUL2, C1orf106, PTPN22 and MUC19. We extend the results of successful GWAS by identifying new, rare and probably functional variants that could aid functional experiments and predictive models.

Comparative stability studies of poly(2-methyl-2-oxazoline) and poly(ethylene glycol) brush coatings

Non-fouling surfaces that resist non-specific adsorption of proteins, bacteria, and higher organisms are of particular interest in diverse applications ranging from marine coatings to diagnostic devices and biomedical implants. Poly(ethylene glycol) (PEG) is the most frequently used polymer to impart surfaces with such non-fouling properties. Nevertheless, limitations in PEG stability have stimulated research on alternative polymers that are potentially more stable than PEG. Among them, we previously investigated poly(2-methyl-2-oxazoline) (PMOXA), a peptidomimetic polymer, and found that PMOXA shows excellent anti-fouling properties. Here, we compare the stability of films self-assembled from graft copolymers exposing a dense brush layer of PEG and PMOXA side chains, respectively, in physiological and oxidative media. Before media exposure both film types prevented the adsorption of full serum proteins to below the detection limit of optical waveguide in situ measurements. Before and after media exposure for up to 2 weeks, the total film thickness, chemical composition, and total adsorbed mass of the films were quantified using variable angle spectroscopic ellipsometry (VASE), X-ray photoelectron spectroscopy (XPS), and optical waveguide lightmode spectroscopy (OWLS), respectively. We found (i) that PMOXA graft copolymer films were significantly more stable than PEG graft copolymer films and kept their protein-repellent properties under all investigated conditions and (ii) that film degradation was due to side chain degradation rather than due to copolymer desorption.

Squirrel Monkeys (Saimiri sciureus) Infected with the Agent of Bovine Spongiform Encephalopathy Develop Tau Pathology

Squirrel monkeys (Saimiri sciureus) were infected experimentally with the agent of classical bovine spongiform encephalopathy (BSE). Two to four years later, six of the monkeys developed alterations in interactive behaviour and cognition and other neurological signs typical of transmissible spongiform encephalopathy (TSE). At necropsy examination, the brains from all of the monkeys showed pathological changes similar to those described in variant Creutzfeldt-Jakob disease (vCJD) of man, except that the squirrel monkey brains contained no PrP-amyloid plaques typical of that disease. Constant neuropathological features included spongiform degeneration, gliosis, deposition of abnormal prion protein (PrP(TSE)) and many deposits of abnormally phosphorylated tau protein (p-Tau) in several areas of the cerebrum and cerebellum. Western blots showed large amounts of proteinase K-resistant prion protein in the central nervous system. The striking absence of PrP plaques (prominent in brains of cynomolgus macaques [Macaca fascicularis] with experimentally-induced BSE and vCJD and in human patients with vCJD) reinforces the conclusion that the host plays a major role in determining the neuropathology of TSEs. Results of this study suggest that p-Tau, found in the brains of all BSE-infected monkeys, might play a role in the pathogenesis of TSEs. Whether p-Tau contributes to development of disease or appears as a secondary change late in the course of illness remains to be determined.

Two domains of the V protein of virulent canine distemper virus selectively inhibit STAT1 and STAT2 nuclear import

Canine distemper virus (CDV) causes in dogs a severe systemic infection, with a high frequency of demyelinating encephalitis. Among the six genes transcribed by CDV, the P gene encodes the polymerase cofactor protein (P) as well as two additional nonstructural proteins, C and V; of these V was shown to act as a virulence factor. We investigated the molecular mechanisms by which the P gene products of the neurovirulent CDV A75/17 strain disrupt type I interferon (IFN-alpha/beta)-induced signaling that results in the establishment of the antiviral state. Using recombinant knockout A75/17 viruses, the V protein was identified as the main antagonist of IFN-alpha/beta-mediated signaling. Importantly, immunofluorescence analysis illustrated that the inhibition of IFN-alpha/beta-mediated signaling correlated with impaired STAT1/STAT2 nuclear import, whereas the phosphorylation state of these proteins was not affected. Coimmunoprecipitation assays identified the N-terminal region of V (VNT) responsible for STAT1 targeting, which correlated with its ability to inhibit the activity of the IFN-alpha/beta-mediated antiviral state. Conversely, while the C-terminal domain of V (VCT) could not function autonomously, when fused to VNT it optimally interacted with STAT2 and subsequently efficiently suppressed the IFN-alpha/beta-mediated signaling pathway. The latter result was further supported by a single mutation at position 110 within the VNT domain of CDV V protein, resulting in a mutant that lost STAT1 binding while retaining a partial STAT2 association. Taken together, our results identified the CDV VNT and VCT as two essential modules that complement each other to interfere with the antiviral state induced by IFN-alpha/beta-mediated signaling. Hence, our experiments reveal a novel mechanism of IFN-alpha/beta evasion among the morbilliviruses.

Genome-wide analysis of rare copy number variations reveals PARK2 as a candidate gene for attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a common, highly heritable neurodevelopmental disorder. Genetic loci have not yet been identified by genome-wide association studies. Rare copy number variations (CNVs), such as chromosomal deletions or duplications, have been implicated in ADHD and other neurodevelopmental disorders. To identify rare (frequency 1%) CNVs that increase the risk of ADHD, we performed a whole-genome CNV analysis based on 489 young ADHD patients and 1285 adult population-based controls and identified one significantly associated CNV region. In tests for a global burden of large (>500 kb) rare CNVs, we observed a nonsignificant (P=0.271) 1.126-fold enriched rate of subjects carrying at least one such CNV in the group of ADHD cases. Locus-specific tests of association were used to assess if there were more rare CNVs in cases compared with controls. Detected CNVs, which were significantly enriched in the ADHD group, were validated by quantitative (q)PCR. Findings were replicated in an independent sample of 386 young patients with ADHD and 781 young population-based healthy controls. We identified rare CNVs within the parkinson protein 2 gene (PARK2) with a significantly higher prevalence in ADHD patients than in controls (P=2.8 × 10(-4) after empirical correction for genome-wide testing). In total, the PARK2 locus (chr 6: 162 659 756-162 767 019) harboured three deletions and nine duplications in the ADHD patients and two deletions and two duplications in the controls. By qPCR analysis, we validated 11 of the 12 CNVs in ADHD patients (P=1.2 × 10(-3) after empirical correction for genome-wide testing). In the replication sample, CNVs at the PARK2 locus were found in four additional ADHD patients and one additional control (P=4.3 × 10(-2)). Our results suggest that copy number variants at the PARK2 locus contribute to the genetic susceptibility of ADHD. Mutations and CNVs in PARK2 are known to be associated with Parkinson disease.Molecular Psychiatry advance online publication, 20 November 2012; doi:10.1038/mp.2012.161.

A degradation-sensitive anionic trypsinogen (PRSS2) variant protects against chronic pancreatitis

Chronic pancreatitis is a common inflammatory disease of the pancreas. Mutations in the genes encoding cationic trypsinogen (PRSS1) and the pancreatic secretory trypsin inhibitor (SPINK1) are associated with chronic pancreatitis. Because increased proteolytic activity owing to mutated PRSS1 enhances the risk for chronic pancreatitis, mutations in the gene encoding anionic trypsinogen (PRSS2) may also predispose to disease. Here we analyzed PRSS2 in individuals with chronic pancreatitis and controls and found, to our surprise, that a variant of codon 191 (G191R) is overrepresented in control subjects: G191R was present in 220/6,459 (3.4%) controls but in only 32/2,466 (1.3%) affected individuals (odds ratio 0.37; P = 1.1 x 10(-8)). Upon activation by enterokinase or trypsin, purified recombinant G191R protein showed a complete loss of trypsin activity owing to the introduction of a new tryptic cleavage site that renders the enzyme hypersensitive to autocatalytic proteolysis. In conclusion, the G191R variant of PRSS2 mitigates intrapancreatic trypsin activity and thereby protects against chronic pancreatitis.