Genetic predictors of the risk of developing complications in the immediate postoperative period following combat trauma

Abstract

Introduction. Paratraumatic eczema (PTE), being a type of microbial eczema, occurs after surgical interventions, chronic wound healing, accompanied by pronounced inflammatory changes with hyperemia, edema, exudation, soreness and itching. Genetic polymorphisms of cytokines and Toll-like receptors (TLRs) may be pathogenetic factors in the development of PTE, causing the penetration of microorganisms and violation of the protective properties of the skin barrier. Goal. To study the relationship of polymorphisms rs1800629 of the TNFα gene, rs5743708 of the TLR2 gene, rs3775291 of the TLR3 gene, rs4986790 of the TLR4 gene with the development of paratraumatic eczema in combat trauma victims. Material and methods. The study included 162 patients, of whom 82 showed signs of PTE (comparison group), 80 people had no signs of PTE (control group). Genotyping of polymorphisms was carried out using the polymerase chain reaction method with electrophoretic detection using test systems of NPF Litech (Russia). The Statistica 10 program (StatSoft, Inc., USA) was used for statistical data processing. Results. A connection with the development of PTE with variants of genotypes and alleles of polymorphisms was established: rs1800629 of the TNFα gene (χ2=6.9; p=0.033 and χ2=8.12; p=0.005); rs3775291 of the TLR3 gene (χ2=6.9; p=0.039 and χ2=5.74; p=0.018); rs4986790 of the TLR4 gene (χ2=8.17; p=0.018 and χ2=7.85; p=0.005). The increase in the chances of developing PTE was influenced by: genotypes GA (OR=1.64; 95% CI 0.83–3.24) and AA (OR=2.94; 95% CI 0.9–9.67), allele A (OR=2.13; 95% CI 1.26–3.6) rs1800629 TNFα gene; genotypes CT (OR=1.58; 74% CI 0.93–3.24) and TT (OR=1.79; 95% CI 0.67–4.8), allele T (OR=1.76; 95% CI 1.1–2.8) rs3775291 TLR3 gene; genotypes AG (OR=2.58; 95% CI 1.24–5.37) and GG (OR=3.0; 95% CI 0.31–29.47), allele G (OR=2.44; 95% CI 1.29–4.62) rs4986790 of the TLR4 gene. Conclusions. Polymorphisms rs1800629 of the TNFα gene, rs3775291 of the TLR3 gene, rs4986790 of the TLR4 gene are associated with the development of paratraumatic eczema in combat trauma victims