Year 2021 Vol. 29 No 5

PEDIATRIC SURGERY

M.G. MELNYCHENKO, A.A. KVASHNINA, P.B. ANTONENKO, K.A.ANTONENKO

PREDICTING THE RISK OF DEVELOPING ABDOMINAL ADHESIONS IN CHILDREN DEPENDING ON ACETYLATION GENOTYPE

Odessa National Medical University, Odessa,
Ukraine

Objective. To determine the predictive value of the genetic polymorphism of the N-arylacetyltransferase-2 (NAT-2) gene for assessing the risk of postoperative adhesive intestinal obstruction in children.
Methods. In all children (36 children with adhesive intestinal obstruction (main group) and 35 planned patients (comparative group)) the acetylation genotype was studied by detecting point mutations of the NAT-2 gene using allele-specific amplification method with analysis of a polymerase chain reaction-restriction fragment length polymorphism.
Results. The study of the frequency of mutations at position 481 revealed the greatest diversity of the studied variants of genotypes: 33.3% of the children of the main group were homozygous for the wild-type gene, 44.4% were heterozygotes, 22.2% of patients had a homozygous mutant gene. According to the NAT-2 * 6A genotype (G 590 A), the majority of patients (55.6%) were heterozygotes, 44.4% were homozygotes with the wild-type of the gene. Not a single case of mutation at position 857 has been identified. Among the children of the main group, the share of fast acetylators was 69.4%, in the comparison group 40.0% (χ2=6.215; p=0.013). The development of postoperative adhesive intestinal obstruction in children with the fast acetylation genotype occurred in the absence of clinical and anamnestic risk factors and was characterized by a greater severity and prevalence of intra-abdominal adhesive process (PAI was (14.81.8) and (8.12.4 ), respectively).
Conclusion. The risk of developing postoperative adhesive complications in children can be done preventively by determining the genetic polymorphism of the N-acetyltransferase-2 gene. The risk group for developing adhesive intestinal obstruction is made up of children who are the carriers of NAT-2 alleles and correspond to the genotype of fast and moderate acetylation. Children who are fast acetylators have a more pronounced intra-abdominal adhesion process and a higher risk of complications associated with excessive adhesion even in the absence of other risk factors.

Keywords: adhesive obstruction, adhesions, genetic polymorphism, acetylation genotype, prediction
p. 573-580 of the original issue
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Address for correspondence:
65000, Ukraine,
Odessa, Valikhovsky Lane, 2,
Odessa National Medical University,
Pediatric Surgery Department,
tel. +38050 197-61-85,
e-mail: marina_gm@i.ua,
Melnychenko Maryna G.
Information about the authors:
Melnychenko Maryna G., MD, Professor of the Pediatric Surgery Department, Odessa National Medical University, Odessa, Ukraine.
https://orcid.org/0000-0001-9066-4801
Kvashnina Anastasiia A., Postgraduate Student of the Pediatric Surgery Department, Odessa National Medical University, Odessa, Ukraine.
https://orcid.org/0000-0003-3704-2047
Antonenko Petr B., MD, Professor of the Department of Pharmacology and Pharmacognosy, Odessa National Medical University, Odessa, Ukraine.
https://orcid.org/0000-0002-9697-1615
Antonenko Kateryna A, PhD, Assistant of the Department of Pharmacology and Pharmacognosy, Odessa National Medical University, Odessa, Ukraine.
https://orcid.org/0000-0001-9707-3676
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