Abstract
Objective: to analyze DNA polymorphism in inpatients with pneumonia. Subjects and methods. Group 1 consisted of 99 patients with acute community-acquired pneumonia (CAP). Group 2 included 95 patients with severe concomitant injury, including wounds (n=63) and generalized peritonitis (n=32). Among Group 2 patients, the authors singled out two subgroups: 2A comprising 57 patients with nosocomial pneumonia (NP) and 2B including 38 patients without NP. A control group was composed of 160 apparently healthy individuals. Polymerase chain reaction genotyping was carried out for the polymorphic genes controlling xenobiotic detoxification (such as GSTM1, GSTT1, GSTP1, and CYP1A1) and the MTHFR gene that is responsible for DNA synthesis and methylation. Results. Predisposition to acute CAP has been shown for the carriers of a minor allele (4889G) at the CYP1A1 locus: 12.7% versus 5.4% in the controls (p=0.034; OR=2.6); In Group 1 patients, the development of complications (toxic myocarditis, pleuritis, pleural empyema, toxic nephropathy) is most probable for a combination of GSTT1 + GSTM1 0/0 genotypes (OR=3.2; p=0.010 versus the control group). It has been established that in severe injury, peritonitis (2B), NP does not develop statistically significantly in 61.1% of cases with the GSTM1 + GSTT1 + genotype versus 38.8% in the controls (p=0.022) or versus 37.5% in subgroup 2A (p=0.045; OR=2.6). Key words: acute community-acquired pneumonia, nosocomial pneumonia, gene polymorphism.
Highlights
Цель — анализ полиморфизма ДНК у больных пневмонией, находившихся на стационарном лечении
Group 1 consisted of 99 patients with acute community acquired pneumonia (CAP)
Among Group 2 patients, the authors singled out two sub groups: 2A comprising 57 patients with nosocomial pneumonia (NP) and 2B including 38 patients without NP
Summary
ПЦР генотипирование проводили для полиморфных ге нов, контролирующих детоксикацию ксенобиотиков (GSTM1, GSTT1, GSTP1, CYP1A1) и MTHFR гена, ответствен ного за синтез и метилирование ДНК. Polymerase chain reaction genotyping was carried out for the polymorphic genes controlling xenobiotic detoxification (such as GSTM1, GSTT1, GSTP1, and CYP1A1) and the MTHFR gene that is responsible for DNA synthesis and methylation. CYP1A1 и глутатион S трансфераз GSTM1, GSTT1, GSTP1, и гена триггера, ответственного за синтез и ме тилирование ДНК — 5,10 метилен тетрагидрофолатре дуктазы MTHFR, на возникновение и течение пневмо нии различного генеза. С одной стороны, уча стием генов детоксикации ксенобиотиков в развитии воспаления в органах дыхания, с другой стороны, широ кой распространенностью минорных вариантов и их комбинаций, что может быть использовано в качестве прогностического критерия при определении тактики ведения пациентов с пневмонией различного генеза
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