IL4-589C>T GENE POLYMORPHISM AND EXPRESSION OF INTERLEUKIN-4 IN PATIENTS WITH DEVELOPING CHRONIC TRAUMATIC OSTEOMYELITIS
Our aim was to study the influence of IL4-589C>T gene polymorphism on IL-4 expression in patients, living in Zabaikalsky Region with a diagnosis of chronic traumatic osteomyelitis developing after fractures of long bones of extremities.The study included 132 patients with fractures of long bones at the age of 20 to 40 years old. The first group consisted of 83 patients with uncomplicated course of fractures; the second group (n = 49) included patients with chronic traumatic osteomyelitis healed
... steomyelitis healed by primary wound closure, however, developing chronic traumatic osteomyelitis over late postoperative period. The control group consisted of 100 practically healthy men and women of the same age group. These groups were homogeneous and similar by age, sex, origin and localization of fractures. Presence of acute or chronic comorbidities was the exclusion criterion. We applied clinical examination, instrumental tests (X-ray studies), laboratory methods (microbiological, immunological, ELISA for IL-4 measurement). IL-4 point mutation at position 589 (C>T) was tested by PCR; the DNA for this analysis was extracted from peripheral blood. The genetic studies were performed when patients entered the hospital. IL-4 contents, clinical and instrumental indicators were detected on 1, 2, 10 and 90 days after fracture. Results of the study were as follows: the frequency of the C allele and the homozygous genotype of the IL4- 589C>T gene in the patients with complicated clinical course was decreased 1.7- and 3.6-fold compared with the comparison clinical group, respectively. Frequency of T allele, by contrast, increased 3.7-fold, whereas heterozygous and mutant genotypes were changed 2.5 and 15 times against the comparison group. The persons from control group with IL4-589C/C genotype, showed a 1.4- and 2.5-fld increased IL-4 concentration as compared with the carriers of the -589C/T and -589T/T genotypes, respectively, and in -589C C/T genotype, 1.7-fold compared to -589Т/T genotype. A similar trend of IL-4 expression, depending on the IL4 genotype, was recorded in the group with both uncomplicated and complicated course of fractures. In conclusion, the patients with developing traumatic osteomyelitis showed ncreased frequency of the IL4 -589T allele (3.7-fold as compared with uncomplicated group). Meanwhile, higher frequency of the -589C/T -589T/T genotypes of the IL4 gene were registered. Genotype -589T/T of the IL4 gene is associated with lower IL-4 expression.