THE STATE OF PROTEOLYTIC SYSTEM AND ITS ASSOCIATIONS WITH POLYMORPHISM 1G/2G – 1607 MMP-1 GENE (RS1799750) IN PATIENTS WITH PROBLEM WOUNDS

Objective – to investigate the proteolytic system activity at diff erent phases of the wound healing process and its association with the 1G/2G-1607 polymorphism of the MMP-1 gene.Material and Methods. Twenty patients with problematic lower limb wounds aged 42 to 74 years were examined. To study the polymorphism of the 1G/2G-1607 MMP-1 gene, a qualitative real-time polymerase chain reaction was performed. The proteolytic activity of plasma was determined by spectrophotometry using azoalbumin, azocasein, and azocollagen.Results. It was found that in the fi rst phase of the wound healing process, the proteolytic activity using azoalbumin was the highest in patients with the 2G/2G variant, and lowest in carriers of the 1G/2G variant. In the second phase, this indicator was also the highest in patients with the 2G/2G variant, signifi cantly exceeding that of the carriers of the 1G/1G variant. In the third phase, the highest parameters were observed in patients with the 1G/1G variant, and the lowest in those with the 2G/2G variant. Proteolytic activity using azocasein in the fi rst phase of the wound healing process was the highest in the carriers of the 1G/1G variant, and lowest in those with the 1G/2G variant. The same trend was observed in the second phase. In the third phase, the highest parameters were observedin patients with the 1G/1G variant. Low parameters in patients with the 2G/2G variant mayindicate a defi ciency or dysregulation of the granulation tissue formation process.The proteolytic activity of collagen structures in the fi rst phase was the highest in patientswith the 2G/2G variant, and signifi cantly lower in those with the 1G/2G variant. In thesecond phase, the opposite trend was observed. In the third phase, proteolysis activityof collagen structures in patients with the 2G/2G variant was signifi cantly lower thanin those with the 1G/1G and 1G/2G variants. Analysis of variance revealed a signifi cantcorrelation (p<0.05) between the presence of the 2G/2G polymorphism of the MMP-1gene and low proteolytic activity of collagen structures during the stage of the connectivetissue scar formation and epithelialization.The 2G/2G polymorphism of the MMP-1 gene should be considered unfavorable forwound healing processes. Such patients require personalized therapeutic strategiesaimed at targeted correction of proteolysis and disrupted wound healing mechanisms.Conclusions. 1.There is an association between the 2G/2G-1607 polymorphism of theMMP-1 gene and disruptions in proteolytic activity, which contribute to the delay anddistortion of wound healing processes. 2.The 2G/2G polymorphism of the 1G/2G-1607MMP-1 gene can be considered unfavorable for wound healing processes. Such patientsrequire personalized therapeutic strategies aimed at correcting disturbed mechanisms ofthe wound healing process.