Protsiuk L. Polymorphism of serotonin receptor (5-HTR2A) gene in рatients with rheumatic arthritis: clinical manifestations and treatment efficacy

The object of investigation - clinical, laboratory and genetic aspects of rheumatic arthritis (RA) course; the purpose of research - to elaborate an algorithm of patient-specific diagnostic approach to detection of RA patients with unfavourable course requiring early optimization of therapeutic rehabilitation measures, based on the study of polymorphism of serotonin receptor 5-HTR2A gene, its relationship with RA clinical course as well as treatment efficacy; methods - clinical, laboratory, serological, genetic, instrumental, statistical, questioning; novelty and results - peculiarities in distribution of polymorphic variants of Т102С and А-1438-G gene of serotonin receptor 5-HTR2A were first established, and sex dependent distribution of those genotypes in RA patients was studied; study of peculiarities in clinical course of RA in patients with different variants of polymorphic sites revealed associative relation between TC heterozygotic variant of Т102С gene polymorphism and homozygotic AA and GG genotypes of A-1438-G gene polymorphism with various clinical manifestations; study of therapy efficacy in RA patients with different variants of polymorphic sites of promotor region of 5-HTR2A Т102С gene and A-1438-G showed therapy efficacy, working capacity and quality of life to be influenced by the following factors: inflammatory process activity, anxiety depressive disorders, severity and intensity of pain syndrome, T allele being the predictor to therapy resistance; an algorithm of patient-specific diagnostic approach to detection of RA patients with unfavourable course requiring early optimization of therapeutic rehabilitation measures was elaborated based on the study of polymorphism of serotonin receptor 5-HTR2A gene, its relationship with RA clinical course, pain syndrome intensity, peculiarities in mental and personality-psychologic status of patients as well as treatment efficacy; introduction in medical practice - rheumatology departments of Vinnytsia Regional Pirogov Memorial Clinical Hospital and Kropyvnytskyi Regional Clinical Hospital, out-patient departments of Vinnytsia and Kropyvnytskyi regional hospitals, Kropyvnytskyi municipal institution "Primary care clinic of family medicine" and Yablunivska primary care clinic of family medicine (Bila Tserkva district), therapeutic department of Vinnytsia City Hospital of Emergency Medicine, educational process of Vinnytsia National Pirogov Memorial Medical University; usage - treatment and diagnostics at rheumatology, therapy, neurological departments; scientific, teaching and learning activities of therapy departments at medical educational institutions.