Personalized approach to acute peritonitis treatment based on genetic studies

Abstract

The research presents treatment results of patients with peritonitis by using the personalized medicine principles, which are based on the choice of diagnostic, treatment and preventive measures taking in to account genetic, physiological, biochemical and other features of the patient. Purpose of the study. The treatment results improvement of patients with peritonitis, the reduction of the complications frequency. Materials and methods. 226 patients with signs of acute peritonitis had complex examination with serum cytokines and serotonin levels determination and analysis of the polymorphic sites alleles of IL1ß (-511C / T) and 5-HTTLPR genes by polymerase chain reaction evaluated the treatment outcomes using the developed algorithms. The treatment results with the use of developed algorithms were evaluated. Results. The processes of peroxide oxidation, antioxidant protection, proteolysis, fibrinolytic activity and their role in systemic disorders of homeostasis are shown. The connection between the nature of inflammatory reactions, its distribution in the peritoneal cavity and variants of the IL1ß gene (-511C/T) was proved. The relationship between the character of intestinal motility disorders in the postoperative period and variants of the 5-HTTLPR gene, which regulates the serotoninergic mechanisms of intestinal contractility, is shown. The algorithms for personalized approach to the peritonitis diagnostics, prognosis of and choice of treatment tactics were developed on the basis of the identified genetically determined individual characteristics of the inflammatory process. Advanced stages of surgical intervention were developed. Conclusion. Prediction of the course of peritonitis and the development of various complications based on genetic research allows developing algorithms of personalized therapeutic tactics, significantly improving the results of its treatment. Keywords: peritonitis, genetic studies, IL1β (-511C/T), 5-HTTLPR, diagnostics and treatment algorithms, personalized medicine.