THE SIGNIFICANCE OF THE INTERLEUKIN-4 GENE SNP–589C>T AND THE TUMOR NECROSIS FACTOR-ALPHA GENE–308G>A IN THE PATHOGENESIS OF PERIPROSTHETIC INFECTION IN PATIENTS AFTER LARGE JOINT RESTORATION WITH PRIMARY OSTEOARTHRITIS

The aim of the study is to establish the significance of SNP of the IL-4 (C589T) and TNFα (G308A) gene in the pathogenesis of periprosthetic infection in patients after endoprosthetics of large joints with primary osteoarthritis.
Materials and methods. The study included 182 unrelated patients of middle (45–59) and elderly (60–74) age with primary osteoarthritis of large joints stage III who underwent total joint arthroplasty. Group 1 (n = 92) – patients with uncomplicated course. Group 2 (n = 90) – patients with development of periprosthetic infection. Control group – 92 practically healthy individuals. Research methods: clinical; laboratory (immunological – determination of IL-4, TNF-α; genetic – polymorphism of the gene IL-4 (C589T), TNFα (G308A)); instrumental (radiography). Statistical processing of the study results was performed using the IBM SPSS Statistics Version 25.0 software package (IBM, USA).
Results. In patients with an uncomplicated postoperative period after endoprosthetics of large joints for primary osteoarthritis, a predominance of the -589C- allele, -589C/C genotype of the IL-4 gene and the -308G- allele, -308G/G genotype of the TNFα gene was revealed. An increase in the level of IL-4 and TNFα on the 10th day of the postoperative period was established in the first and second groups relative to the control values, and no differences were found between the clinical groups. Carriage of the mutant genotype of the IL-4 gene (C589T) contributes to a decrease in the content of the encoded protein, and carriage of the mutant genotype of the TNFα gene (G308A) is characterized by an increase in the concentration of TNF-α.
Conclusion. The -589T- allele, -589T/T genotype of the IL-4 gene, and the -308A- allele and -308A/A genotype of the TNFα gene are associated with the development of periprosthetic joint infection in patients after endoprosthetics for primary osteoarthritis. In patients, elevated IL-4 and TNFα concentrations are recorded on the tenth postoperative day compared to control values. Carriers of the -589T/T genotype of the IL-4 gene are characterized by decreased IL-4 levels in the blood serum, while carriers of the -308A/A genotype of the TNFα gene are characterized by elevated TNF-α levels.

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