Alymenko MA, Balobanova NP, Valiev RS, Valiev NR, Pozdeev OK, et al. (2025) Features of A Clinical Course of a Pulmonary Tuberculosis Depending on Polymorphism of a Gene of Enzyme of Biotransformation of a Xenobiotic (GSTM 1). Ann Clin Cytol Pathol 10(1): 1148.

Tuberculosis is to the multifactorial diseases which are formed as a result of difficult interaction of a genotype of the person and environmental factors. Therefore a certain circle of people is most subject to development of a tuberculosis infection [1-4].

Speed of metabolism of xenobiotics is defined by polymorphisms of genes of enzymes of biotransformation of xenobiotics [5,6]. Adaptation of an organism to influence of toxic exogenous and endogenous substances was evolutionarily created on the basis of polymorphism of genes of enzymes of metabolism of xenobiotics [7-9]. It is well-known that susceptibility to cardiovascular, atopichesy, chronic diseases of lungs including to tuberculosis, are associated with any given genotype of a gene of enzyme of biotransformation of xenobiotics [10,11].

In the researches conducted by us earlier it was established that certain genotypes of enzymes of biotransformation of xenobiotics have significant effect on susceptibility to a pulmonary tuberculosis and also are connected with forming of destruction of pulmonary fabric [12].

Research Objective

Studying objectively existing dependence of polymorphic options of genes of enzyme of metabolism of biotransformation of a xenobiotic of GSTM1 (E/D) with specifics of a clinical course of a pulmonary tuberculosis in a phase of an intensive course of chemotherapy.

The group of a research is provided by 212 patients with for the first time the detected pulmonary tuberculosis aged from 18 up to 65 years, receiving an intensive phase of chemotherapy. Statistical data processing was carried out on the personal computer with use of the Excel 2013 SPSS Statistica 26.0 and MS software packages. For assessment of compliance of distributions of genotypes to the expected values at Hardy-Weinberg’s balance used criterion χ2 Pearson. Associations of alleles and genotypes, the studied DNA markers with clinical features of a course of a tuberculosis infection, estimated by means of the relation of chances (OR) from 95% Confidence Intervals (CI).

As a result of the analysis of the association of allelic variants of xenobiotic biotransformation enzyme genes with pulmonary tuberculosis in the studied population, it was found that the presence of the EE genotype of the GSTM1 gene in 71.4% (n = 68, p < 0.01) of cases in patients with newly diagnosed pulmonary tuberculosis is associated with normal body temperature, and the presence of the DD genotype of the GSTM1 gene is associated with temperature the body weight is higher than normal (26.0% (n = 30, (p < 0.01)), general weakness is observed in patients with the DD genotype of the GSTM1 gene in 68.9% (n = 80, p < 0.05) cases, and the absence of weakness in 38.1% of cases - with the DD genotype of the GSTM1 gene (n = 36, p < 0.05), lack of appetite in 25.6% of cases was associated with the genotype of EE of the GSTM1 gene (n = 25, p < 0.05), the presence of sweating in 66.6% of cases was associated with EE genotype of the GSTM1 gene (n = 57, p < 0.01), and the absence was associated with the DD genotype of the GSTM1 gene (n = 72.0, (p < 0.01), weight loss was associated in 52.3% of cases with the DD genotype of the GSTM1 gene (n = 49, p < 0.05) (Figure 1).

Figure 1: Association of polymorphism of a gene GSTM1 with intoxication symptoms at for the first time the revealed suffering from tuberculosis lungs Note: *-? < 0,05; **- ? < 0,01; ***- ? < 0,01

Respiratory disturbances in bigger percent of cases were noted at patients with a genotype of the DD gene of GSTM1 (Figure 2).

Figure 2: Association of polymorphism of a gene GSTM1 with respiratory disturbances at for the first time the revealed suffering from tuberculosis lungs Note: *-? < 0,05; **- ? < 0,01Note: *-? < 0,05; **- ? < 0,01; ***- ? < 0,01

So, at patients with for the first time the detected pulmonary tuberculosis presence of short wind is noted at 30.7% of cases with a genotype of the DD gene of GSTM1 (n = 35, r < 0.05) while the lack of an shortness of breath in 72.8% of cases is connected with a genotype of EE of this gene (n = 69, r < 0.05), the absence of cough in 10.0% of percent of cases is associated with a genotype of its gene of GSTM1 (n = 9, r < 0.05), dry cough in 30.0% of cases is associated with a genotype of ITS gene of GSTM1 (n = 29, r < 0.01), productive cough in 78.5% of cases is associated with a genotype of the DD gene of GSTM1 (n = 78, r < 0.05). Existence of a pneumorrhagia in 92.4% of cases is associated with a genotype of the DD gene of GSTM1 (n = 86, r < 0.01), lack of a pneumorrhagia – in 83.3% of cases with a genotype of EE of this gene (n = 76, r < 0.01). The pain syndrome in a thorax in 80.7% of cases is associated with a genotype of the DD gene of GSTM1 (n = 95, r < 0.01), and in 16.7% - with its absence at patients with a genotype of EE of this gene (n = 19, r < 0.01). The lack of a phlegm in 35.4% of cases is associated with GSTM1 gene EE genotype (n = 34, r < 0.01), the mucopurulent phlegm in 37.9% of cases is associated with a genotype of the DD gene of GSTM1 (n = 43, r < 0.01) (Figure 2).

Thus, genetically determined differences in the speed of degradation of various exogenous and endogenous substances can be the cornerstone of different features of a clinical course of a tuberculosis infection that can have clinical value when developing programs for prevention, early identification and treatment of a pulmonary tuberculosis.

1. During the conducted research it was revealed that existence of certain genotypes of a gene of GSTM1 of enzyme of biotransformation xenobiotic significantly are associated with an adverse course of a tuberculosis infection.
2. The genotype of its gene of GSTM1 is associated with the most favorable course of a tuberculosis infection while the genotype of the DD gene of GSTM1 is associated with the most adverse course of this infection.
3. It is reasonable to implement implementation of genotyping of a gene of GSTM1 of enzyme of biotransformation of a xenobiotic in practical health care as an additional marker of forecasting of efficiency of treatment of patients with for the first time the detected pulmonary tuberculosis in an intensive phase of chemotherapy.

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