Clinical and molecular genetic parallels of steroid resistance of acantholytic pemphigus

Abstract

The problem of pharmacological resistance is becoming a challenge for doctors of all specialties, especially for people suffering from severe chronic diseases, which lead to disability and death consequences, which are patients on acantholytic pemphigus (AP), who have to take system glucocorticosteroids (SGCS) for a long term. Among the existing hypotheses of formation of steroid resistance (SR) is perspective study of genetic factors, which are one of the main mechanisms of occurrence of resistance and can be connected with the alleles polymorphism of gene of multidrug resistance (MDR1). The increased expression of this gene leads to the acceleration of the elimation of drugs from cells. The study of molecular genetic peculiarities of SR in patients with AP has not been carried out until now. Thus, the study of polymorphism of MDR1 gene in patients with AP is relevant. The aim. Study the frequency of polymorphism of marker C3435T in gene MDR1 in the relationship with clinical and anamnestic peculiarities of the AP course. Materials and methods. Under the supervision were 33 patients on the AP aged from 29 to 73 years, treated in the dermatological department of the SE "IDV NAMS of Ukraine". The buccal epithelium obtained by scraping mucosa of the oral cavity was examined. The polymorphism of the C3435T marker in the MDR1 gene was determined by the PCR method. The clinical and anamnestic features of patients on AP were evaluated on a specially developed scale. Discussion. The results of the study showed clinical-anamnestic signs of lack of sensitivity to SGCS, which correlated with the results of MDR1 gene expression. The presence in patients with AP in the CT haplotype of the T allele gives reason to classify the group of patients with AP with an index of resistance (IR) as SGCS 7.3 ± 0.6 as a risk group for the development of SR. Conclusion. According to the results of the study in patients with AP, the correlation of clinical-anamnestic signs of SR with the results of gene expression was established MDR