Methotrexate effect on biochemical indices of psoriasis patients depends on MTHFR gene polymorphism

Methotrexate (MTX) is the immunosuppressive anti-inflammatory drug and the antagonist of the enzyme dihydrofolate reductase. Pharmacogenomic studies and clinical evidences suggest that altered response to MTX in patients with different diseases is associated with polymorphisms of genes that regulate folate metabolism. The purpose of the article was to analyze the methotrexate effect on the biochemical indices of psoriasis patients depending on methylenetetrahydrofolate reductase gene (MTHFR) polymorphisms. Effects of two single-nucleotide polymorphisms, C677T and A1298C, were studied. An increase of alanine aminotransferase and aspartate aminotransferase activity above the normal level in the patients with both MTHFR gene polymorphisms after methotrexate intake was observed. In patients with CC, TT, CT genotypes for C677T polymorphism and AA genotype for A1298C polymorphism of MTHFR gene, significant differen­ces in alpha-amylase activity before and after treatment with methotrexate were detected. Analysis of the biochemical indices of patients with arthropathic and vulgaris psoriasis showed that the positive effect of MTX treatment could be associated with wild-type alleles in both polymorphisms of MTHFR gene, while the ineffectiveness of methotrexate was associated with the dihеterozygous genotype. The largest number of smokers was found within the CTAA genotype group (37.5%), while no smokers were observed within TTAA patients and most of CCAA patients. The data obtained testify the utility of the individual approach to the psoriasis patients therapy taking into account genetic background

Integrative communications and parameters of the provision of medical assistance to patients of the dermato-venerological profile at the level of primary medical

В Україні велике значення належить первинній медико-санітарній допомозі, яку надають лікарі загальної практики/сімейні лікарі. У державі є більше ніж 600 центрів первинної медико-санітарної допомоги, велика кількість лікарських амбулаторій і ФАПів.В Украине большую роль играет первичная медико-санитарная помощь, которую оказывают врачи общей практики / семейные врачи. В государстве более 600 центров первичной медико-санитарной помощи, большое количество врачебных амбулаторий и ФАПов.Primary care in Ukraine is given by primary care practitioners / family doctors. The state has more than 600 primary health care centers, a large number of outpatient clinics and paramedic and obstetric stations