| Popis: |
Background: it is known that some genes (FDPS, LCT, VDR) which determine the calcium, vitamin D and lactate metabolism may have impact on osteoarthritis (OA) development and course, and thus, has a possible influence on OA treatment efficacy. Objectives: To determine the influence of genetic factors (genotyping of FDPS, LCT, VDR) on the efficacy of standard and modified treatment (with use of the platelet autologous plasma (PAP) in the early stages of knee OA. Methods: WOMAC index and the frequency of genotype variants for the FDPS, LCT, and VDR genes were studied in 96 patients (57 women, 38 men, 41.7 ± 1.2 years old) with primary knee OA (X-ray stage I-II). All patients had OA exacerbation with no clinical evidence of synovitis. Enrolled patients were divided into 2 groups: the first group consisted of 49 patients (27 women, 22 men, mean age 41.7 ± 1.2 years) who agreed to receive standard OA treatment (NSAID, exercises, orthopedic devises – as needed) and 3 intra-articular PAP injections (2 courses in 12 month, plasma volume 12-15ml/course, total platelet count per injection 1260,24 ± 22,1x109). The second group - 47 patients with OA who received standard treatment. Both groups were comparable by age, gender, body mass index and initial WOMAC. Genetic parameters and its influence on OA course and treatment efficacy was analyzed during 12 months. Results: The earliest age (37.2 ± 2.01 years) of clinical manifestation of knee OA was connected to homozygous genotype variants: LCT (relative risk 6.3:1), FDPS (relative risk 6.5:1) and VDR (relative risk 6.8:1). The best positive WOMAC changes was determined in patients with the CC genotype of LCT both in first and second groups. The WOMAC changes showed lower treatment efficacy in patients with CC genotype of FDPS and VDR in both groups, but results of patients who received PAP were better and their remission was longer (in 1.7 times) than in the standard treatment group. Conclusion: age of knee OA clinical manifestation and the treatment efficacy (both standard and with the use of platelet autologous plasma) has genetic predisposition. Disclosure of interests: None declared |
