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Objectives.To determine the role of the genetic genotypes of the CTLA4 gene (49A/G) in psoriasis of different severity. Material and methods.60 patients with psoriasis of different severity were examined. Two groups were identified: the first (n=30) – moderately severe psoriasis, the second (n=30) – severe psoriasis. Comprehensive examination included the determination of the level of nitric oxide (NO), lipid peroxidation products (diene conjugates, malondialdehydes, and antioxidant activity (superoxide dismutase, SOD), cytokines (interleukin 1β (IL-1β), tumor necrosis factor alpha (TNF-α) , IL-10) in blood plasma.molecular genetic study of polymorphism (49A/G) of the CTLA4 gene by real-time PCR (CFX96 Touch System, USA).
Results.During the study it was established that the psoriasis of varying severity is characterized by a significant disturbance in the homeostasis system in the form of a significant activation of lipid peroxidation (LPO), increased secretion of nitric oxide and various types of cytokines. The presence of conditionally "pathogenic" genotypes G/G and A/G of the CTLA4 gene,the course of psoriasis is more severe: pronounced oxidative stress, significant inhibition of antioxidant activity, rapid development of nitrogenous intoxication, excessive pro-inflammatory response and inhibition of the anti-inflammatory component of the immune system. Conclusions.Our data allow us to make another conclusion that in order to select the optimal diagnostic and therapeutic algorithm for psoriasis of varying severity, it is necessary to be guided by the information on genetic analyzes of the CTLA4 gene polymorphism (49A/G). This will make it possible to personalize the approach to the treatment of patients with psoriasis of varying severity, which has recently been given the main role by modern dermatovenerology.