Research of Russian physicians' opinions on tuberculosis pharmacogenetics.

BACKGROUND: There is currently no widespread implementation of pharmacogenetic testing (PGx) methods in the practice of phthisiology service. OBJECTIVE: The aim of this study is to determine how informed and prepared phthisiologists, residents, and postgraduate students of the Russian Medical Academy of Continuing Professional Education (RMACPE, Moscow) use PGx techniques in their work to improve treatment safety, predict the occurrence of adverse reactions (ADRs), and personalize therapy. METHODS: A survey was conducted among phthisiologists (n = 314) living in different regions of the Russian Federation and studying at RMACPE, such as residents and post-graduate students (n = 185). The survey was developed on the Testograf.ru web platform and had 25 questions for physicians and 22 for residents and post-graduate students. RESULTS: More than 50% of respondents are ready to use PGx in clinical practice and thus are aware of the method's possibilities. At the same time only a small part of participants were aware of the pharmgkb.org resource. The absence of PGx in clinical guidelines and treatment standards, according to 50.95% of phthisiologists and 55.13% of students of RMACPE, the absence of large-scale randomized clinical trials, according to 37.26% of phthisiologists and 43.33% of students, and the lack of physician knowledge on PGx, according to 41.08% of phthisiologists and 57.83% of students, are all factors that prevent the implementation of PGx in Russia. CONCLUSION: According to the survey, the overwhelming majority of participants recognize the importance of PGx and are willing to use the method in practice. However, there is a low level of awareness among all respondents about the possibilities of PGx and the pharmgkb.org resource. The implementation of this service could significantly increase patient compliance, lower ADRs, and enhance anti-tuberculosis (TB) therapy quality.

[Fractalkine level in chronic heart failure of varying severity].

Purpose of research. To examine the level changes of fractalkine in patients with chronic heart failure (CHF) depending on the ejection fraction of the left ventricle and the stage of the disease. MATERIALS AND METHODS: In total 340 people were examined. Of these, 280 patients with CHF divided into groups depending on the ejection fraction of the left ventricle (with a preserved and reduced ejection fraction) and the stage of the disease (stage I to III). Fractalkine level was determined by method of enzyme immunoassay in blood plasma. RESULTS: We revealed an increase in the level of fractalkine in patients with CHF with preserved and reduced ejection fraction compared with the control group. An increase in the level of fractalkine was more pronounced in patients with reduced ejection fraction. In the group of patients with preserved ejection fraction of stage IIB+III, a statistically significant decrease in the level of fractalkin was observed in comparison with patients with stage I to stage III. The method of correlation analysis established that there is a correlation between the level of fractalkine and clinical manifestations of CHF. CONCLUSION: It was revealed an increase in the level of fractalkine in blood plasma in patients with CHF with the control group, which was more pronounced in patients with reduced ejection fraction and the presence of correlation level fractalkine with indicators of clinical manifestations of CHF.

[Prospects of Pharmacogenetic Testing for Design of Algorithms for Personalized Treatment of Tuberculosis of Respiratory Organs in the Astrakhan Region].

In spite of the availability of many antituberculosis drugs all over the world the morbidity of tuberculosis does not lower. Often the tuberculosis therapy schemes are adapted to every particular patient which is mainly due to the therapy unfavourable effects requiring discontinuation of the drugs used. Polymorphism of the detoxication genes, as predictors of the response to the drug therapy, was shown to be of certain significance. The experimental data would allow to substantiate personalized management of tuberculosis patients and to increase its efficacy and safety.

[Study on phenotypical activity of isoenzyme CYP3A4 in children].

The urine levels of cortisol and 6-beta-hydroxycortisol in 30 healthy children were determined with high performance liquid chromatography. The activity of cytochrome P450 isoenzyme CYP3A4 was estimated by the ratio of 6-beta-hydroxycortisol and cortisol. Differences in the CYP3A4 activity depended on the age sex. At the age of 4 to 9 years the value of the ratio was 9.21 +/- 0.67 which in fact was statistically higher than that in the children at the age of 0 to 3 years (p<0.001). In the female children at the age of 0 to 3 years the value of the isoenzyme CYP3A4 activity was actually lower (p<0,05) vs. the female children of the higher ages and the male children at the age of 0 to 3 years. The results are useful for further researches on improvement of drugs dosing and prevention of adverse reactions.