ПЕРСОНАЛІЗАЦІЯ ЛІКУВАЛЬНОЇ ТАКТИКИ У ПАЦІЄНТІВ ІЗ ХРОНІЧНИМИ РАНАМИ НА ОСНОВІ ГЕНЕТИЧНИХ ДОСЛІДЖЕНЬ

It is possible to increase the effectiveness of treatment of sick wounds by studying the damaged mechanisms of regeneration, determining their genetic determinism. An important role in wound healing is played by matrix metalloproteinase-1 (MMP-1), the activity of which depends on the 1G/2G-1607 polymorphism variant of the MMP-1 gene, which affects regeneration processes.Objective. To investigate the associative relationships between the 1G/2G-1607 polymorphism variants of the MMP-1 gene and the nature of some regeneration mechanisms and to develop personalized treatment tactics for patients with chronic wounds.Results. 27 patients with chronic wounds of the lower extremities were examined, in whom polymorphism variants of the MMP1 gene were determined, the state of pro- and antioxidant systems, fibrinolytic and proteolytic activity were assessed. Associative relationships between the nature of regeneration mechanisms and variants of the MMP1 gene polymorphism were revealed. The greatest violations were observed in carriers of the 2G/2G , which is recognized as an unfavorable factor for wound healing. Personalized treatment of patients is proposed depending on the results of genetic studies. Thus, carriers of the 1G/1G variant require additional correction of fibrinolytic activity, and carriers of the 2G/2G - antioxidant therapy, correction of fibrinolysis and proteolysis. A positive result was obtained in 92.6% of patients, two of the 2G/2G genotypes required radical surgical intervention.Conclusions 1. To select a personalized treatment strategy for patients with chronic wounds, it is advisable to conduct genetic studies to determine the variants of the 1G/2G-1607 polymorphism of the MMP-1 gene. 2. There is an associative relationship between the nature of the wound process and the variants of the 1G/2G-1607 MMP-1 gene. Carrying the 2G/2G variant can be considered an unfavorable factor for wound healing processes. 3. Personalizing the treatment of patients with chronic wounds consists of detecting genetically determined factors of wound process disorders in different phases of wound healing and their targeted preventive correction. 4. The use of local low-intensity laser irradiation is an effective method in the complex treatment of chronic wounds.