PECULIARITIES OF THE EFFECT OF POLYMORPHISM CYTOKINE'S GENES ON THE DEVELOPMENT OF LIVER FIBROSIS IN PATIENTS WITH A CHRONIC MIXT-HEPATITIS

Usychenko E. N. PECULIARITIES OF THE EFFECT OF POLYMORPHISM CYTOKINE'S GENES ON THE DEVELOPMENT OF LIVER FIBROSIS IN PATIENTS WITH A CHRONIC MIXT-HEPATITIS. Актуальні проблеми транспортної медицини / Actual problems of transport medicine / 2019;3(57):57-68. ISSN 1818-9385 DOI http://dx.doi.org/10.5281/zenodo.3465435 http://aptm.org.ua УДК 616.36-002.12-036.12-018.22: 575.17. PECULIARITIES OF THE EFFECT OF POLYMORPHISM CYTOKINE'S GENES ON THE DEVELOPMENT OF LIVER FIBROSIS IN PATIENTS WITH A CHRONIC MIXT-HEPATITIS Usychenko E. N. Odessa National Medical University, Odessa, Ukraine There are different points of view on the course of mixed hepatitis. Chronic viral mixed — hepatitis is often caused by a combination of HCV and HBV, or HCV + + HBV + HDV. At the same time, replication of more than one virus contributes to the progression of a chronic process with subsequent transformation into cirrhosis of the liver. The association of polymorphic markers of the genes of the immune system with pathogenetically significant signs, the rate of development of liver fibrosis in patients with chronic hepatitis C and CHB is shown. In our studies, the functional significance of the most important cytokines IL-10 (G1082A), IL-4 (C589T) and TNFα (G308A) in the rate of progression of liver fibrosis in patients with chronic hepatitis virus viral etiology (HBV, HCV) was demonstrated. Materials and methods The study examined 31 patients with chronic hepatitis of mixed etiology (B + C), 100 patients with chronic hepatitis C, 41 patients with chronic hepatitis B. The polymorphism of cytokine genes was studied using PCR amplification of the corresponding regions of the genome. Evaluation of morphological changes in the liver tissue was determined using the non-invasive Fibrotest method according to the METAVIR scale. To identify correlations between individual indicators, the Spearman correlation coefficient was used. Results and discussions In patients with chronic hepatitis C, it has been established that a lower degree of fibrosis is noted in carriers of the CC IL 4 (C589T) genotype, GG TNF (G308A), and a higher degree of fibrosis in carriers of the TT IL 4 (C589T) genotype, AA TNF (G308A). An inverse moderate correlation was found between the IL 4 genotype (C589T) and the TNF genotype (G308A). In patients with chronic hepatitis B, it has been established that a lower degree of fibrosis is noted in carriers of the CC IL 4 (C589T) genotype and GG TNF (G308A), and a higher degree of fibrosis is found in carriers of the CT IL 4 (C589T) and AA TNF (G308A) genotypes. An inverse moderate correlation was found between the IL 4 genotype (C589T) and the TNF genotype (G308A). In patients with chronic hepatitis B + C, it has been established that a lower degree of fibrosis is observed in carriers of the GG TNF genotype (G308A), CC IL 4 (C589T), AA IL 10 (G-1082A), and a higher degree of fibrosis in carriers of the TT IL 4 genotype (C589T), GG IL 10 (G-1082A), AA TNF (G308A). An inverse moderate correlation was found between the IL 4 genotype (C589T) and the TNF genotype (G308A). The genetic component of pronounced fibrosis in patients with hepatitis of various etiologies is not significantly different: in all the studied groups the degree of F3 fibrosis is associated with the AA genotype TNF (G308A) and the genotype CC IL 4 (C589T). In patients with chronic hepatitis B + C, susceptibility to a more pronounced degree of fibrosis is associated with the GG genotype IL 10 (G-1082A). The interaction of the IL 4 (C589T) and TNF (G308A) genes — AA genes TNF (G308A) and CC IL 4 (C589T) is associated with a high degree of liver fibrosis in all the studied groups, and GG TNF (G308A) and CT genotypes IL 4 (C589T) — with a lesser degree of fibrosis; (p < 0.01) Key words: chronic hepatitis B + C, chronic hepatitis B, chronic hepatitis C, liver fibrosis, polymorphisms of the cytokine genes IL-10 (G1082A), IL-4 (C589T) and TNFα (G308A