Ostapchuk V. Improvement of antihelicobacter therapy in children with peptic ulcer disease, with an allowance for gene polymorphisms of interleukin-1?

The thesis presents the results of a comprehensive study of clinical, instrumental and molecular-genetic features of the origin and course of peptic ulcer disease in children. For the first time, significant risk factors for recurrence of ulcers in the late period have been singled out. We have studied allelic polymorphism of IL-1? and set associative alleles and genotypes connections of the IL-1? gene with clinical and endoscopic features of the disease. Interleukin profile, depending on the nature of peptic ulcer disease course, the presence of H. pylori, the gene IL-1? polymorphism and the treatment regimen has been analysed. For the first time the influence of allelic polymorphism of the gene IL-1? on the effectiveness of eradication therapy in patients with peptic ulcer disease associated with H. pylori has been studied. It has been proved that the best effect of antihelicobacter therapy was observed with the presence of allele (-511)*T IL-1? and its homozygous genotype. A diagnostic and therapeutic algorithm for peptic ulcer disease in children depending on IL-1? gene polymorphism has been developed. The basic criteria for predicting the success of eradication therapy in children depending on the IL-1? gene polymorphism have been singled out. For the first time it was proposed and proved the necessity and effectiveness of the differential approach to the treatment of the disease based on IL-1? gene polymorphisms by including the immunocorrective drug (polyoxidonium). This approach allowed to achieve more rapid regression of the major signs of the disease, ulcer healing and as well as a sustainable long-term remission.