The role of the carboxyl ester lipase (CEL) gene in pancreatic disease

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 18; no. 1; pp. 12 - 19
• Main Authors: Johansson, Bente B., Fjeld, Karianne, El Jellas, Khadija, Gravdal, Anny, Dalva, Monica, Tjora, Erling, Ræder, Helge, Kulkarni, Rohit N., Johansson, Stefan, Njølstad, Pål R., Molven, Anders
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01.01.2018; Elsevier Limited
• Subjects: Acinar cells; Alleles; Amino acids; Animals; Apolipoproteins; Bile; Biochemistry; Carboxyl ester lipase; Cholesterol; Chromosome 9; Chronic pancreatitis; Copy number; Cysts; Diabetes; Diabetes mellitus; Duodenum; Elastase; Enzymes; Esters; Exocrine dysfunction; Gene Expression Regulation, Enzymologic; Genetic diversity; Genome-wide association studies; Genomes; Glands; Humans; Lipase; Lipase - genetics; Lipase - metabolism; Lipomatosis; Metabolism; Metabolites; MODY8; Mucin; Mutation; Pancreas; Pancreatic Diseases - enzymology; Pancreatic Diseases - genetics; Pancreatic Diseases - metabolism; Pancreatitis; Protein folding; Proteins; Rodents; Secretion; Vitamins; MODY8; Carboxyl ester lipase; Exocrine dysfunction; Chronic pancreatitis; Diabetes mellitus
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2017.12.001

The enzyme carboxyl ester lipase (CEL), also known as bile salt-dependent or -stimulated lipase (BSDL, BSSL), hydrolyzes dietary fat, cholesteryl esters and fat-soluble vitamins in the duodenum. CEL is mainly expressed in pancreatic acinar cells and lactating mammary glands. The human CEL gene resides on chromosome 9q34.3 and contains a variable number of tandem repeats (VNTR) region that encodes a mucin-like protein tail. Although the number of normal repeats does not appear to significantly influence the risk for pancreatic disease, single-base pair deletions in the first VNTR repeat cause a syndrome of endocrine and exocrine dysfunction denoted MODY8. Hallmarks are low fecal elastase levels and pancreatic lipomatosis manifesting before the age of twenty, followed by development of diabetes and pancreatic cysts later in life. The mutant protein forms intracellular and extracellular aggregates, suggesting that MODY8 is a protein misfolding disease. Recently, a recombined allele between CEL and its pseudogene CELP was discovered. This allele (CEL-HYB) encodes a chimeric protein with impaired secretion increasing five-fold the risk for chronic pancreatitis. The CEL gene has proven to be exceptionally polymorphic due to copy number variants of the CEL-CELP locus and alterations involving the VNTR. Genome-wide association studies or deep sequencing cannot easily pick up this wealth of genetic variation. CEL is therefore an attractive candidate gene for further exploration of links to pancreatic disease.