Molecular biological analysis of clinical and pathogenetic features of the formation of postoperative complications in combat trauma

Introduction. Pathological scars (PS) occur after traumatic injuries, surgical interventions, burns, etc. lead to functional disorders, cosmetic defects, and also significantly affect the quality of life. The results of studies to determine the genetic determination and connection with clinical and morphological indicators of PR are contradictory and require further study.

Purpose of the study: to determine the relationship of the rs1800471 polymorphism of the TGFβ1 gene with the development of PR and to study the influence of genotypes on the characteristics of the clinical and morphological state of scars.

Material and methods. The study included 196 people (148 men and 48 women) aged 18 to 56 years after surgery. 2 groups were formed: Group I (97 people) with wound healing time less than 14 days and Group II (99 people) - more than 14 days. The condition of the scar was assessed by the doctor and the patient 3, 6, 9 and 12 months after discharge using the POSAS scale. The rs1800471 polymorphism of the TGF-β1 gene was determined by polymerase chain reaction with electrophoretic detection using the NPF Litech test system (Russia). For statistical data processing, the Statistica 10 program (StatSoft, Inc., USA) was used.

Results. Analysis of the distribution of genotypes and alleles of the rs1800471 gene of TGFB1 showed a connection between genotypes and alleles and the development of birth control (χ²=6.31; p=0.045 and χ²=5.114; p=0.025, respectively). The ancestral GG genotype and the G allele of rs1800471 of the TGFB1 gene increased the odds of developing PR by 2.34 times and 1.97 times, respectively (OR=2.34; 95% CI 1.2–4.59 and OR=1.97; 95% CI 1.1–3.59) and were risk factors for fibroproliferative scarring of the skin.

The influence of the rs1800471 polymorphism of the TGFB1 gene was established in relation to the total POSAS score when assessed by a physician (p<0.001), vascularization (p<0.001), height (p=0.004), density (p<0.001), area (p=0.015) and external assessment. type of scar (p=0.008) with an increase in median values in carriers of the G/G genotype. Also, the influence of the rs1800471 polymorphism was established in relation to the total POSAS score when assessed by the patient (p<0.001), pain (p=0.011), itching (p<0.001), color (p=0.004), density (p=0.008), thickness (p =0.026), relief (p=0.003) and assessment of the appearance of the scar (p=0.024) and an increase in indicators in the presence of the G/G genotype.

Conclusions. The rs1800471 polymorphism of the TGF-β1 gene was associated with the development of PR; a significant increase in POSAS scores was observed in carriers of the GG genotype with more pronounced fibrosis of scars.