2

Supplementary Methods

Resequencing the SPINK1 promoter

French patients

The region spanning -139 to +92 of the SPINK1 genomic sequence (NG_008356.1 was used as the SPINK1 reference sequence; the nucleotide immediately 5' to the A of the ATG translational initiation codon being designated -1.) was analyzed as previously described.7 A ~1.5 kb SPINK1 promoter region spanning -1607 to -44 was sequenced bi-directionally in 213 French patients with idiopathic chronic pancreatitis (ICP) and 550 French controls. The forward and reverse primers used to amplify the SPINK1 promoter were 5’-TCAGCCTCAGAACCTTTGCGCTTA-3’ and 5’-ACTTACCACGTCTCTTCAGAAGC-3’, respectively. PCR was performed using the HotStarTaq™ DNA polymerase (Qiagen, Courtaboeuf, France) with 50 ng genomic DNA in a 20 µL reaction mixture. The PCR program comprised an initial denaturation at 95°C for 15 min, followed by 35 cycles of denaturation at 94°C for 30 s, annealing at 66°C for 30 s and extension at 72°C for 90 s, and a final extension at 72°C for 10 min. PCR products were purified using ExoSAP-IT (GE Healthcare, Orsay, France) and sequenced using the ABI PRISM™ BigDye™ Terminator Cycle Sequencing Kit v.1.1 (PE Applied Biosystems, Foster City, CA, USA).

German patients

The region spanning -357 to +118 of the SPINK1 genomic sequence was sequenced bi-directionally in 418 German ICP patients and 379 German control subjects using the oligonucleotides 5’-TTTGAGTTCATCTTACAGGTGAG-3’ and 5’-GTGCTTCACAAAGCAACAGGTC-3’ as forward and reverse primers. PCR was performed using 0.5 U AmpliTaq Gold polymerase (Perkin Elmer, Braunschweig, Germany), 400 µM dNTPs, and 0.1 µM each primer in a total volume of 25 µL. Cycle conditions were an initial denaturation for 12 min at 95°C, followed by 40 cycles of 15 s denaturation at 95°C, 30 s annealing at 56°C, 40 s primer extension at 72°C, followed by a final extension for 2 min at 72°C in an automated thermal cycler (Biometra, Göttingen, Germany). The PCR products were incubated with shrimp alkaline phosphatase (USB, Freiburg, Germany) and exonuclease I (USB, Freiburg, Germany) and cycle sequencing was performed using BigDye terminator mix (Applied Biosystems, Darmstadt, Germany). The reaction products were then purified by ethanol precipitation and loaded onto an ABI 3730 Sequencer (Applied Biosystems, Darmstadt, Germany).

Indian patients

The SPINK1 promoter region spanning -644 to -1 was sequenced in both directions in a total of 439 chronic pancreatitis patients, of whom 292 were tropical calcific pancreatitis (TCP) patients and 147 were ICP patients; 316 control individuals of Indian origin were also sequenced. The SPINK1 promoter region was amplified using forward primer 5’-CAAAAGTGGCTCCAACAAG-3’ and reverse primer 5’-GGCTGAAGTTCTGCGTC-3’, respectively. PCR was performed using Thermostable Taq DNA Polymerase (Qiagen) with 50 ng genomic DNA in a 20 µL reaction mix following the manufacturer’s instructions. The PCR conditions comprised an initial denaturation at 95°C for 3 min, followed by 35 cycles of denaturation at 95°C for 30 s, annealing at 63°C for 30 s and extension at 72°C for 45 s, with a final extension at 72°C for 5 min. PCR products were purified using Millipore MultiScreen® PCRµ96 Filter Plates and sequenced using the ABI PRISM™ BigDye™ Terminator Cycle Sequencing Kit v.1.1 (PE Applied Biosystems, Foster City, CA, USA).

Only three variants [-253T>C, -215G>T and -142T>C] were identified, of which the latter two were identified only in three and two patients respectively. The -253T>C variant was identified in both patients and controls but exhibited a nominal association with TCP [P = 0.0413; OR (TC vs TT) = 0.65 (95% CI, 0.42-1.00)] and a strong association with ICP [P = 0.0133; OR (TC vs TT) = 0.50 (95% CI, 0.28-0.90)]. Given the similar genotype distribution in TCP and ICP, we combined the two datasets.

Quantitative RT-PCR analysis of SPINK1 expression in the COLO-357 cells

Total RNA was extracted from COLO-357 cells with Trizol Reagent (Invitrogen, Cergy Pontoise, France). First-strand cDNA synthesis was performed using oligo(dT) primers (Qiagen, Courtaboeuf, France) and SuperScript® II reverse transcriptase (Invitrogen, Cergy Pontoise, France) in a 20 µL reaction mixture containing 500 ng total RNA. At the end of the RT reaction, RNaseH (Invitrogen, Cergy Pontoise, France) was added to hydrolyze the RNA template.

Primer pairs, targeting either the SPINK1 or the chymotrypsin C (CTRC) cDNA (Table S1), were designed to perform real-time PCR. Real-time PCR was performed using the QuantiTect SYBR Green PCR Kit (Qiagen, Courtaboeuf, France) in a 20 µL reaction mixture containing 0.3 µM each primer and 2 µL each cDNA. The PCR program comprised an initial denaturation at 95°C for 15 min, followed by 40 cycles of denaturation at 95°C for 30 s, annealing at 58°C for 30 s and extension at 72°C for 30 s, and a final extension at 72°C for 10 min. Specific amplification was confirmed by melting curve analysis.

Real-time PCR reactions were performed in triplicate from several cDNA dilutions (no dilution, 1/2, 1/5, 1/10). For each cDNA dilution, means of the cycle threshold values for the SPINK1 and CTRC genes were compared, with the results being shown in Table S2.


Table S1 Primers used for RT-PCR analysis

Gene / Exon / Primer sequence (5’ to 3’) / Size (bp)
SPINK1 / 2-3 / Forward: tgggaagagaggccaaatgt / 137
3-4 / Reverse: gatagaagtctggcgtttccga
CTRC / 4-5 / Forward: ctgcatcagcaacacccg / 146
5-6 / Reverse: caatatcattgcgcaacaggag

Table S2 Expression of SPINK1 and CTRC mRNAs in the COLO-357 cells

Dilution / Cycle threshold (SPINK1) / Mean / Cycle threshold (CTRC) / Mean
No dilution / 23.86 / 23.71
No dilution / 23.60 / 23.69 / 23.68 / 23.66
No dilution / 23.62 / 23.58
1/2 / 24.35 / 24.52
1/2 / 24.33 / 24.37 / 24.57 / 24.56
1/2 / 24.43 / 24.60
1/5 / 24.96 / 25.55
1/5 / 24.67 / 24.92 / 25.26 / 25.28
1/5 / 25.12 / 25.03
1/10 / 25.58 / 25.44
1/10 / 25.82 / 25.64 / 25.95 / 25.83
1/10 / 26.06 / 26.10

a -170G/-164G probe or SpC

5’-AGAACCTGGAGGCCAGGCTATGACAC-3’

b

Competitor - - G/G G/G G/G G/G Ir

Labeled G/G probe + + + + + + +

Nuclear extracts - + + + + + +

Supplementary Figure 1 Confirmation of the functional neutrality of the –170G>A and –164G>C variants by EMSA. (a) Sequence of the labeled probe or specific competitor (SpC) probe. (b) EMSAs performed with labeled probes incubated with COLO 357 nuclear extracts in the presence or absence of SpC or irrelevant (Ir) competitor probes. No specific nucleic acid-protein complexes were evident.


Human ------CAGAAT-CTTTGCCTTGCATGTTTCAGGCCCA 31

Chimpanzee ------CAGAAT-CTTTGCCTTGCATGTTTCAGGCCCA 31

Rhesus monkey ------CAGAAT-GTTTGCCTTGCATGTTTCAGGCCCA 31

Cow ------TTGCAC-ATTTACCTAGGAAGGCCTAGGGCAT 31

Dog ------TCTGACAGAAT-CTTGGCCTTGAATATTCCAGGCCTG 36

Rat AAACCTGAGAGGATGTTGGGAAT-CAGTTAACTTGCTTTTCCTGGCAGAATTTAGGTCCA 59

Mouse ------GGATGTCAGGAATGCAGCTAATTTGCTTTTCCTGGAAGAATTTGGGTCCA 50

** *** * * ** *

-215G>A/T -170G>A -164G>C

Human CCTGGCTCCTTTCACCTTTCTTACACAGGTGACATTC-CCAGAACCTGGAGGCCAGGCTA 90

Chimpanzee CCTGGCTCCTTTCACCTTTCTTACACAGGTGACATTC-CCAGAACCTGGAGGCCAGGCTA 90

Rhesus monkey CCTGGCTCCTTTCACCTTTCTTACGCAGGTGACATTC-CCAGAACCTGGAGGCCAGGCTA 90

Cow TCCT-CTCCTA-CACCTTTCTTACACTGGTGGTGTGC-CCCAAACCTGGAGGACAGGCTA 88

Dog CACTGTTTCTT-TCACTTTCTTATGCAGATA-CATTC-CCGAAACATGG-GGCCAGGCTA 92

Rat ATCT-TAACTGCCCTTTTTCCTACCTAGGTAACATTTTCCCCAGCCTGGAGGCCA----- 113

Mouse AAGT-TTTCTGCCCTTCTTCCTACCTAGGTTACATTTTCCCCAGCCTGGAGGCCA----- 104

** *** ** * * * ** * * *** ** **

-147A>G -142T>C

Human TGACACAGAGTCAATCAATAACCAGGGAGATCTGTGATATAGCCCAGTAGGTGGGGCCTT 150

Chimpanzee CGACACAGAGTCAATCAATAACCAGGGAGATCTGTGATATAGCCCAGTAGGTGGGGCCTT 150

Rhesus monkey CAACACAGAGTCAATCAATAACCAGGGAGATCTATGATATAGCCCAGTAGGTGGGGCCTT 150

Cow TACTACGGAGTCAATCAATAACCAAGGAGATCTGTGACGCAGAGCAGGAGGTGGAGACTG 148

Dog TGCTACAGAGTCAATCAGTCACCAA--AGATCCATGA--CAAGGCAGGAGGTGGAGCCTG 148

Rat ----ACAAAGTCAATCAATAACCAGAGATACCTATTATAGGGCACAGTGGGT------161

Mouse ----CACAAGTCAATCAATAACCAAAGATACCTATTATAGGGCACAGTGGGTGGAGCCTG 160

********* * **** * * * * * *** ***

-81C>T -53C>T

Human GCTGCC---ATCTGCCATATGACCCTTCCAGTCCCAGGCTTCTGAAGAGACGTGGTAAGT 207

Chimpanzee GCTGCC---ATCTGCCATATGACCCTTCCAGTCCCAGGCTTCTGAAGAGACGTGGTAAGT 207

Rhesus monkey GCTGTC---GTCTGCCATATGACCCTTCCAGTCCCAGGCTTCTGAAGAGACGTGTTAAGT 207

Cow GAAGCCCACGCACACTATATGACCCTTCCAGTCCCAGGGTTCCAGAGCGAAGTG-TAAGT 207

Dog GGTGGCCACCCTGACTATATAACTCTTCCAGTCTCAGGGTTCTGAAGAGAAGTGGTTAGT 208

Rat -ATTACCA-TCTGCCTATATGAC-----CACTCCTCAGTTTCTGAAGAGAAGCA-----C 209

Mouse TATTACCA-TCTGCCTATATGAC-----CACTCCTCAGTTTCTGAAGAGAAGCA-----C 209

* * **** ** ** ** * *** ** ** *

-41G>A -22C>T -7T>G

Human GCGGTGCAGTTTTCAACTGACCTCTGGACGCAGAA-CTTCAGCCATGAAGGTAA 260

Chimpanzee GCGGTGCAGTTTTCAACTGACCTCTGGACGCAGAA-CTTCAGCCATGAAGGTAA 260

Cow TCGGTGCAGTTTTCGACTGAGCTCTAGAACCAGCA-TTTCAGCCATGAAGGTGG 260

Dog TCAAT--AGTTTTCAACTGAGCTCTGGAAGCAGAACTTTCAGCTATGAAGGTAA 260

Rhesus monkey GCAGTGCAGTTTTCAACTGACCTCTGGACGCAGAA-TTTCAGCCATGAAGGTAA 260

Rat CCTGCACAGTTCTT--CTGAGTTTTGGACCTAGGT-CTACAACCATGAAGGTAG 260

Mouse CCTGTATAGTTCTT--CTGGCTTTTGCACCCAGAT-CTTCGACAATGAAGGTGG 260

* **** * *** * * * ** * * * ********

Supplementary Figure 2 Evolutionary conservation of the HNF1-binding site (shaded in grey) across mammalian species.