Àññîöèàöèè ïîëèìîðôíûõ âàðèàíòîâ ãåíîâ ðåïàðàöèè ÄÍÊ è ìåòàáîëèçìà êñåíîáèîòèêîâ ñ óðîâíåì õðîìîñîìíûõ íàðóøåíèé â ëèìôîöèòàõ åëîâåêà*

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ÎÐÈÃÈÍÀËÜÍÛÅ ÈÑÑËÅÄÎÂÀÍÈß Àññîöèàöèè ïîëèìîðôíûõ âàðèàíòîâ ãåíîâ ðåïàðàöèè ÄÍÊ è ìåòàáîëèçìà êñåíîáèîòèêîâ ñ óðîâíåì õðîìîñîìíûõ íàðóøåíèé â ëèìôîöèòàõ åëîâåêà* Áàáóøêèíà Í.Ï., Êó åð À.Í., Ëåáåäåâ È.Í., Âàñèëüåâ Ñ.À., Òè ìî øåâ ñêèé Â.À., Áðà ãè íà Å.Þ., Ñó õà íî âà Í.Í., Òîð õî âà Í.Á., ßêîâ ëå âà Þ.Ñ. ÔÃÁÓ «ÍÈÈ ìå äè öèí ñêîé ãå íå òè êè» ÑÎ ÐÀÌÍ, 634050, ã.òîìñê, óë. Íà áå ðåæ íàÿ ð. Óøàé êè, 10, òåë. (3822) 513146, ôàêñ (3822) 513744, e-ma il: nad.ba bus h ki na@med ge ne tics.ru Ïðåäñòàâëåíû äàííûå î àñòîòàõ ïîëèìîðôíûõ âàðèàíòîâ ãåíîâ ñèñòåì ðåïàðàöèè ÄÍÊ (MLH1 (rs1799977), PMS2 (rs1805321), XRCC1 (rs25487)), êîíòðîëÿ êëåòî íîãî öèêëà (TP53 (rs1042522)) è äåòîêñèêàöèè êñåíîáèîòèêîâ (Cyp2C19 (rs4244285), GSTT1 (del) è GSTM1 (del)) ó èíäèâèäîâ ñ íàëè èåì â îðãàíèçìå èíêîðïîðèðîâàííîãî ïëóòîíèÿ-239 è â êîíòðîëü - íîé ãðóïïå, à òàêæå â ïîäãðóïïàõ, õàðàêòåðèçóþùèõñÿ ðàçëè íîé àñòîòîé õðîìîñîìíûõ àíîìàëèé (òðè ãðóïïû ñðàâíåíèÿ: ñ âû - ñîêèì è íèçêèì óðîâíåì àñòîòû õðîìîñîìíûõ àáåððàöèé, àíåóïëîèäèè è ìèêðîÿäåð). Íè ïî îäíîìó èç èññëåäîâàííûõ ëîêóñîâ íå çàðåãèñòðèðîâàíî ñòàòèñòè åñêè çíà èìûõ ðàçëè èé ïî àñòîòàì àëëåëåé è ãåíîòèïîâ ìåæäó ãðóïïîé êîíòðîëÿ è ãðóïïîé ñ íàëè èåì â îðãàíèçìå èíêîðïîðèðîâàííîãî ïëóòîíèÿ-239. Îäíàêî óñòàíîâëåíû ñòàòèñòè åñêè çíà èìûå ðàçëè èÿ â àñòîòàõ ãåíîòèïîâ ïî rs1799977 ãåíà MLH1 ìåæäó ïîäãðóïïàìè ñ âûñîêèì è íèçêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé (p=0,047), à òàêæå ïî àñòîòå êîìáèíàöèé ãåíîòèïîâ GSTT1/GSTM1 ìåæäó ïîäãðóïïàìè ñ ðàçíûì óðîâíåì àíåóïëîèäèè (p=0,032). Äëÿ äðóãèõ èññëåäîâàííûõ ëîêóñîâ îòìå åíû íåêîòîðûå ðàçëè èÿ ïî àñòîòàì ãåíîòèïîâ ìåæäó ãðóïïàìè ñ âûñîêîé è íèçêîé àñòîòîé õðîìîñîìíûõ íàðóøåíèé ðàçíûõ òèïîâ, êîòîðûå, îäíàêî, íå äîñòèãàëè óðîâíÿ ñòàòèñòè åñêîé çíà èìîñòè. àñòîòû àëëåëåé ìåæäó ñðàâíèâàåìûìè ãðóïïàìè âàðüèðîâàëè â ìåíüøåé ñòåïåíè; ñòàòèñòè åñêè çíà èìûå ðàçëè èÿ çàðåãèñòðèðîâàíû òîëüêî ìåæäó ïîäãðóïïàìè ñ ðàçíûì óðîâíåì õðîìîñîìíûõ àáåððàöèé (äëÿ rs25487 â ãåíå XRCC1, p=0,039). Êëþ åâûå ñëîâà: èíäèâèäóàëüíàÿ ðàäèî óâñòâèòåëüíîñòü, ïîëèìîðôèçì ãåíîâ, ðåïàðàöèÿ ÄÍÊ, õðîìîñîìíûå àáåððà - öèè, ìèêðîÿäðà Ââåäåíèå Â íàñòîÿùåå âðåìÿ ñóùåñòâîâàíèå ôåíîìåíà èíäèâèäóàëüíîé ðàäèî óâñòâèòåëüíîñòè íè ó êîãî íå âûçûâàåò ñîìíåíèÿ, òàê æå êàê è íàëè èå ãåíåòè åñêîãî êîìïîíåíòà, îêàçûâàþùåãî âëèÿíèå íà ñïîñîáíîñòü îðãàíèçìà âûäåðæèâàòü âîçäåéñòâèå èîíèçèðóþùåãî èçëó åíèÿ. Ýòî ïîäòâåðæäàåòñÿ ñõîäíîé èíäèâèäóàëüíîé ðàäèî óâ - ñòâèòåëüíîñòüþ â ïàðàõ îäíîÿéöåâûõ áëèçíåöîâ, à òàêæå ïîâûøåííîé ðàäèî óâñòâèòåëüíîñòüþ ïàöèåíòîâ ñ íàñëåäñòâåííûìè çàáîëåâàíèÿìè, îáóñëîâëåííûìè ìóòàöèÿìè ãåíîâ ðåïàðàöèè ÄÍÊ. Ïîýòîìó îöåíêà èíäèâè - äóàëüíîé ðàäèî óâñòâèòåëüíîñòè è èçó åíèå îïðåäåëÿþùèõ å ôàêòîðîâ ÿâëÿþòñÿ îäíèìè èç ïðèîðèòåòíûõ íàïðàâëåíèé ñîâðåìåííîé ðàäèîáèîëîãèè. Àêòèâíîå èñïîëüçîâàíèå èîíèçèðóþùèõ èçëó åíèé â ïîâñåäíåâíîé æèçíè (ðåíòãåíîëîãèÿ, ðàäèîòåðàïèÿ, àòîìíàÿ ýëåêòðîýíåðãåòèêà) óâåëè èâàåò òåõíîãåííóþ íàãðóçêó íà åëîâåêà è åãî ñðåäó îáèòàíèÿ. Êîíòàêò ñ èîíèçèðóþùèì èçëó åíèåì ïðîèñõîäèò, ïðåèìóùåñòâåííî, â äèàïàçîíå ìàëûõ äîç, ðåàêöèÿ îðãàíèçìà íà êîòîðûå ìîæåò çàìåòíî âàðüèðîâàòü. Èçâåñòíî, òî ñóùåñòâóþò ðàçëè èÿ ïî ðàäèî óâñòâèòåëüíîñòè ìåæäó âèäàìè, ïîïóëÿöèÿìè, ïîëîâîçðàñòíûìè ãðóïïàìè; ðåàêöèÿ íà ðàäèàöèþ ìîæåò çàâèñåòü îò ôèçèîëîãè åñêîãî ñîñòîÿíèÿ îðãàíèçìîâ, îòëè àòüñÿ ó êëåòîê ðàçíûõ òèïîâ, çàâèñåòü îò ñòàäèè äèôôåðåíöèðîâêè è ñòàäèè êëåòî íîãî öèêëà [36]. Òàêèì îáðàçîì, ïðè ðàâíîì ðàäèàöèîííîì âîçäåéñòâèè ðåàê - öèÿ îðãàíèçìà ìîæåò îòëè àòüñÿ ó ðàçíûõ èíäèâèäîâ. Ïîêà íåò îäíîçíà íûõ ñóæäåíèé î òîì, êàêèå èìåííî ãåíû ÿâëÿþòñÿ êëþ åâûìè â îïðåäåëåíèè èíäèâèäóàëüíîé ðàäèî óâñòâèòåëüíîñòè. Îäíàêî àñòî ê êàíäèäàòíûì îò - íîñÿò ãåíû ðåïàðàöèè ÄÍÊ, êîíòðîëÿ êëåòî íîãî öèêëà, ìåòàáîëèçìà êñåíîáèîòèêîâ è äð. [2]. Â íàñòîÿùåì èññëåäîâàíèè èçó åí ïîëèìîðôèçì ãå - íîâ ñèñòåì ðåïàðàöèè ÄÍÊ (ìèññ-ìàò MLH1 (rs1799977) è PMS2 (rs1805321); ýêñöèçèîííîé ðåïàðà - öèè îñíîâàíèé XRCC1 (rs25487)), êîíòðîëÿ êëåòî íî - ãî öèê ëà (TP53 (rs1042522)), äåòîêñèêàöèè êñåíîáèîòè - êîâ (Cyp2C19 (rs4244285) ïåð âîé ôà çû, GSTT1 (del) è GSTM1 (del) âòî ðîé ôà çû) â ãðóï ïàõ èí äè âè äîâ, ñ îä - íîé ñòîðîíû äèôôåðåíöèðîâàííûõ ïî íàëè èþ/îò - ñóòñòâèþ â îðãàíèçìå èíêîðïîðèðîâàííîãî ïëóòî - íèÿ-239, ñ äðóãîé, õàðàêòåðèçóþùèõñÿ ðàçëè íîé à - ñòîòîé õðîìîñîìíûõ àíîìàëèé. Íà ñòî ÿ ùåå èñ ñëå äî âà íèå âû ïîë íå íî â ðàì êàõ ãî ñó äàð ñò âåí íî ãî êîí ò ðàê òà ¹16.512.11.2063 ÔÖÏ «Èñ ñëå äî âà íèÿ è ðàç ðà áîò êè ïî ïðè î ðè òåò íûì íà ïðàâ ëå íè ÿì ðàç âè òèÿ íà ó íî-òåõ íî ëî ãè å ñêî ãî êîì ï ëåê ñà Ðîñ ñèè íà 2007 2013 ãî äû». ISSN 2073-7998 19

ÎÐÈ ÃÈ ÍÀ ËÜ ÍÛÅ ÈÑ ÑËÅ ÄÎ ÂÀ ÍÈß Ìàòåðèàëû è ìåòîäû Âñå ãî îá ñëå äî âà íî 145 åë., èç íèõ 71 åë. ëè öà ñ íà - ëè èåì â îðãàíèçìå èíêîðïîðèðîâàííîãî ïëóòîíèÿ-239 (àêòèâíîñòü 10 188 íêè) (ðàáîòíèêè ÎÀÎ «Ñèáèðñêèé õèìè åñêèé êîìáèíàò», ã.ñåâåðñê; äàëåå «Pu»). 74 åë., íå èìåþùèå îòíîøåíèÿ ê ïëóòîíèåâîìó ïðîèçâîäñòâó, ñîñòàâèëè êîíòðîëüíóþ ãðóïïó (äàëåå «Ê») (òàáë. 1). Âñå èíäèâèäû â îáåèõ ãðóïïàõ áûëè ìóæñêîãî ïîëà, ïðåîáëàäàëè ïðåäñòàâèòåëè ðóññêîé íàöèîíàëüíîñòè. Îò êàæäîãî èíäèâèäà ïîëó åíî èíôîðìèðîâàííîå ñîãëàñèå íà ïðîâåäåíèå ãåíåòè åñêîãî èññëåäîâàíèÿ. Êóëüòèâèðîâàíèå ëèìôîöèòîâ ïåðèôåðè åñêîé êðîâè è ïðèãîòîâëåíèå ïðåïàðàòîâ õðîìîñîì äëÿ öèòîãåíåòè åñêîãî àíàëèçà ïðîâîäèëè ñ èñïîëüçîâàíèåì ñòàíäàð - òíûõ ìåòîäîâ [29]. Àíàëèç õðîìîñîìíûõ íàðóøåíèé ïðî - âîäèëñÿ ñ èñïîëüçîâàíèåì êëàññè åñêèõ öèòîãåíåòè åñêèõ (ïðèìåíÿëàñü ðóòèííàÿ îêðàñêà õðîìîñîì ïî Ãèìçà è äèôôåðåíöèàëüíàÿ îêðàñêà õðîìîñîì ïî G-ìåòîäó (Ðîìàíîâñêîãî Ãèìçà)) [29] è ìîëåêóëÿðíî-öèòîãåíåòè- å ñêèõ ìå òî äîâ [12] â ñëó àå ó òà ìèê ðî ÿäåð. Áî ëåå ïî - äðîáíî èñïîëüçîâàííûå ìîëåêóëÿðíî-öèòîãåíåòè åñêèå ìåòîäû îïèñàíû íàìè ðàíåå [4]. Ó êàæäîãî èíäèâèäà ïðîàíàëèçèðîâàíî 300 ðóòèííî îêðàøåííûõ ìåòàôàç è 100 ìåòàôàçíûõ ïëàñòèíîê ñ äèôôåðåíöèàëüíîé îêðàñêîé. àñòîòó àíîìàëüíûõ ñåãðåãàöèîííûõ ñîáûòèé äëÿ êàæäîé ïàðû àíàëèçèðóåìûõ íà îäíîì ïðåïàðàòå õðîìîñîì îöåíèâàëè â 1000 äâóõúÿäåðíûõ êëåòîê, â êîòîðûõ ïðîâîäèëè ó åò ìèêðîÿäåð. ÄÍÊ äëÿ ïðîâåäåíèÿ ìîëåêóëÿðíî-ãåíåòè åñêîãî àíàëèçà âûäåëÿëè èç ëèìôîöèòîâ ïåðèôåðè åñêîé êðîâè ïî ñòàíäàðòíîé ìåòîäèêå ñ ôåíîë-õëîðîôîðìíîé î èñòêîé [3]. Ïîëèìîðôíûå âàðèàíòû ãåíîâ àíàëèçèðîâàëè ñ ïîìîùüþ ÏÖÐ-ÏÄÐÔ. Ñòðóêòóðà ïðàéìåðîâ, òåìïåðàòóðà îòæèãà è ïàòòåðí ðåñòðèêöèè ïðåäñòàâëåíû â òàáë. 2. Ïðîãðàììû àìïëèôèêàöèè âêëþ àëè ñëåäóþùèå áëîêè: ïåðâè íàÿ äåíàòóðàöèÿ â òå åíèå 5 7 ìèí ïðè 94 95 Ñ, 30 35 öèêëîâ îòæèãà ïðàéìåðîâ ïðè ñïåöèôè åñêîé äëÿ êàæäîãî snp òåìïåðàòóðå (òàáë. 2), ýëîíãàöèÿ öåïè ïðè 72 Ñ è äåíàòóðàöèÿ ïðè 94 Ñ. Ïðîãðàììû çàâåðøàëà ôèíàëüíàÿ ýëîí ãà öèÿ â òå å íèå 5 10 ìèí ïðè 72 Ñ. Äëÿ îïðå äå ëå íèÿ ãåíîòèïîâ ïðîäóêòû àìïëèôèêàöèè ïîäâåðãàëè ãèäðîëèçó ñïåöèôè åñêîé ýíäîíóêëåàçîé ðåñòðèêöèè (ñîãëàñíî ïðîòîêîëó ôèðìû-ïðîèçâîäèòåëÿ), çàòåì ïðîäóêòû ðåñòðèêöèè ôðàêöèîíèðîâàëè â 3%-íîì àãàðîçíîì ãåëå, îêðàøåííîì áðîìèñòûì ýòèäèåì. Ãåíîòèïèðîâàíèå ïîëèìîðôíûõ âàðèàíòîâ ãåíîâ GSTT1 è GSTM1 ïðîâîäèëè ñ ïîìîùüþ ìóëüòèïëåêñíîé ÏÖÐ. Îòñóòñòâèå ñîîòâåòñòâóþùèõ ôðàãìåí òîâ ðàç ìå ðîì 131 è 114 ï.í. óêà çû âà ëî íà íà ëè èå ãî ìî - çèãîò ïî «íóëåâûì» àëëåëÿì ãåíîâ GSTT1 è GSTM1 ñî îò - âåòñòâåííî. Íàëè èå ýòèõ ôðàãìåíòîâ ñâèäåòåëüñòâîâàëî î íàëè èè íîðìàëüíîé êîïèè ãåíà â ãîìî-, ëèáî ãåòåðîçèãîòíîì ñîñòîÿíèè. Äëÿ âíóòðåííåãî êîíòðîëÿ àìïëèôèêàöèè îïðåäåëÿëè ôðàãìåíò ãåíà ER ðàç ìå ðîì 181 ï.í. Ðàçëè èÿ ïî âåëè èíàì óñðåäí ííûõ çíà åíèé àñòîò õðîìîñîìíûõ íàðóøåíèé ìåæäó ñðàâíèâàåìûìè ãðóïïàìè îöåíèâàëè ñ ïîìîùüþ îäíîôàêòîðíîãî äèñïåðñèîííîãî àíàëèçà. Ñîîòâåòñòâèå ðàñïðåäåëåíèÿ àñòîò ãåíîòèïîâ ðàâíîâåñèþ Õàðäè Âàéíáåðãà ïðîâåðÿëè ñ ïîìîùüþ êðèòåðèÿ 2 ; äëÿ ñðàâíåíèÿ àñòîò ãåíîòèïîâ è àëëåëåé ìåæäó ðàçëè íûìè ãðóïïàìè èñïîëüçîâàëè êðèòåðèé 2 ñ ïî ïðàâ - êîé Éåò ñà íà íå ïðå ðûâ íîñòü è òî íûé òåñò Ôè øå ðà. Ðåçóëüòàòû è îáñóæäåíèå Âàæíûì âîïðîñîì â îöåíêå èíäèâèäóàëüíîé ðàäèî óâñòâèòåëüíîñòè ÿâëÿåòñÿ àíàëèç çàâèñèìîñòè óðîâíÿ õðîìîñîìíûõ íàðóøåíèé â êëåòêàõ åëîâåêà îò íîñèòåëüñòâà ðàçëè íûõ âàðèàíòîâ ãåíîâ, ïðîäóêòû êîòîðûõ ó àñòâóþò â ðåïàðàöèè ÄÍÊ, ìåòàáîëèçìå êñåíîáèîòèêîâ è äðóãèõ ïðîöåññàõ â îðãàíèçìå, ñâÿçàííûõ ñ îòâåòîì íà âîçäåéñòâèå ðàäèàöèè. Ðàíåå íàìè áûë ïðîâåäåí àíàëèç àñòîòû ñòðóêòóðíûõ è èñëîâûõ õðîìîñîìíûõ íàðóøåíèé è ìèêðîÿäåð â ëèìôîöèòàõ ïåðèôåðè åñêîé êðîâè ó èíäèâèäîâ ñ èíêîðïîðèðîâàííûì ïëóòîíèåì è ëèö êîíòðîëüíîé ãðóïïû, íèêîãäà íå êîíòàêòèðîâàâøèõ ñ ðàäèàöèåé â ðàìêàõ ïðîôåññèîíàëüíîé äåÿòåëüíîñòè [4]. Îñíîâíûå ðåçóëüòàòû äàííîãî èññëåäîâàíèÿ ïðåäñòàâëåíû â òàáë. 3. Â ãðóïïå èíäèâèäîâ ñ èíêîðïîðèðîâàííûì ïëóòîíèåì-239 íàáëþäàëàñü ñòàòèñòè åñêè çíà èìî áîëåå âûñîêàÿ àñòîòà àáåððàöèé õðîìîñîìíîãî òèïà ïî ñðàâíåíèþ ñ êîíòðîëüíîé ãðóïïîé. Íàïðîòèâ, àñòîòà àáåððàöèé õðîìàòèäíîãî òèïà íå îòëè àëàñü ñòàòèñòè åñêè çíà èìî ìåæäó îáñëåäîâàííûìè ãðóïïàìè, òî ñîãëàñóåòñÿ ñ èçâåñòíûìè ìåõàíèçìàìè õðîíè åñêîãî âîçäåéñòâèÿ èîíèçèðóþùåãî èçëó åíèÿ. Êðîìå òîãî, óðîâåíü ìèêðîÿäåð, ñîîòâåòñòâóþùèõ îòñòàâøèì ôðàãìåíòàì õðîìîñîì è öåëûì õðîìîñîìàì, ó ðàáîòíèêîâ ïëóòîíèåâîãî ïðîèçâîäñòâà áûë ñòàòèñòè åñêè çíà èìî âûøå, åì â êîíòðîëüíîé ãðóïïå. Íàêîíåö, ñóììàðíàÿ àñòîòà àíåóïëîèäèè ïî øåñòè èññëåäîâàííûì õðîìîñîìàì òàêæå îêàçàëàñü âûøå â ëèìôîöèòàõ ïåðèôåðè åñêîé êðîâè èíäèâèäîâ ñ èíêîðïîðèðîâàííûì ïëóòîíèåì-239 ïî ñðàâíåíèþ ñ êîíòðîëüíîé ãðóïïîé. Õàðàêòåðèñòèêà ñôîðìèðîâàííûõ äëÿ îáñëåäîâàíèÿ ãðóïï èíäèâèäîâ ñ èíêîðïîðèðîâàííûì ïëóòîíèåì è êîíòðîëüíûõ ëèö Òàá ëè öà 1 Ãðóïïà Îáî çíà å íèå ãðóïïû Êîí ò ðî ëü íàÿ ãðóï ïà "Ê" 24 70 (53,0±9,42) Ëè öà ñ èí êîð ïî ðè ðî âàí íûì ïëó òî íè åì-239 "Pu" 26,5 70 (56,7±9,5) Âîçðàñò, ëåò Àêòèâíîñòü ïëó òî íèÿ, íêè èñ ëî èí äè âè äîâ 74 10 188 71 20

ÌÅÄÈÖÈÍÑÊÀß ÃÅÍÅÒÈÊÀ. 2013. ¹4 Ïî ðå çó ëü òà òàì öè òî ãå íå òè å ñêî ãî èñ ñëå äî âà íèÿ áû ëè âû äå ëå íû ïîä ãðóï ïû èí äè âè äîâ ñ ðàç íûì óðîâ - íåì õðîìîñîìíûõ íàðóøåíèé: õðîìîñîìíûõ àáåððàöèé (ÕÀ), àíåóïëîèäèè (Àí), ìèêðîÿäåð (Ìß) (òàáë. 4). Ìåæäó ñôîðìèðîâàííûìè ãðóïïàìè ïðîâîäèëîñü ñðàâíå íèå à ñ òîò ïî ëè ìîð ô íûõ âà ðè àí òîâ ãå íîâ MLH1 (rs1799977), PMS2 (rs1805321), XRCC1 (rs25487), TP53 (rs1042522), Cyp2C19 (rs4244285), GSTT1 (del) è GSTM1 (del). Íè ïî îäíîìó èç èññëåäîâàííûõ ëîêóñîâ íå óñòàíîâëåíî ñòàòèñòè åñêè çíà èìûõ ðàçëè èé ïî àñòîòàì àëëåëåé è ãåíîòèïîâ ìåæäó ãðóïïîé êîíòðîëÿ è ãðóïïîé èíäèâèäîâ ñ èíêîðïîðèðîâàííûì ïëóòîíèåì-239, òî ïîçâîëèëî íàì â äàëüíåéøåì ôîðìèðîâàòü ïîäãðóïïû ñ ðàçíûì óðîâíåì Ãåí Ïîëèìîð - ôèçì Ëî êà ëè çà - öèÿ â ãå íå Ñòðóê òó ðà ïðàé ìå ðîâ, ïà ðà ìåò ðû ÏÖÐ è ðå ñò ðèê öèè äëÿ îïðå äå ëå íèÿ ãå íî òè ïîâ ïî èñ ñëå äî âàí íûì ìàðê ðàì Ïî ñëå äî âà òå ëü íîñòü ïðàé ìå ðîâ MLH1 rs1799977 Ýêçîí 8 F: 5`-ATAGTTTGCTGGTGGAGATA-3` R: 5`-ATGTGATGGAATGATAAACC-3` PMS2 rs1805321 Ýêçîí 11 F: 5`-AGAACAAGCCTCACAGCCCA-3` R: 5`-CCGTGTCTGGGATGCTGAAC-3` XRCC1 rs25487 Ýêçîí 10 F: 5'-TTGTGCTTTCTCTGTGTCCA-3' R: 5'-TCCTCCAGCCTTTTCTGATA-3' TP53 rs1042522 Ýêçîí 4 F: 5`-TTGCCGTCCCAAGCAATGGATGA-3` R: 5`-TCTGGGAAGGGACAGAAGATGAC-3` Cyp2C19 rs4244285 Ýêçîí 5 F: 5`-AATTACAACCAGAGCTTGGC-3` R: 5`-TATCACTTTCCATAAAAGCAAG-3` GSTT1 GSTM1 Ïðîòÿæ ííàÿ äåëåöèÿ 10 òûñ. ï.í. Ïðîòÿæ ííàÿ äåëåöèÿ 10 òûñ. ï.í. F: 5`-GGTCATTCTGAAGGCCAAGG-3` R: 5`-TTTGTGGACTGCTGAGGACG-3` F: 5`-TGCTTCACGTGTTATGGAGGTTC-3` R: 5`-GTTGGGCTCAAATATACGGTGG-3` Òåì ïå ðà òó ðà îò æè ãà ïðàé ìå ðîâ Ìå òîä äå òåê - öèè 56 C ÏÖÐ / ÏÄÐÔ BccI 64 C ÏÖÐ / ÏÄÐÔ Bst MA I 55 C ÏÖÐ / ÏÄÐÔ Msp I 63 C ÏÖÐ / ÏÄÐÔ Bst FN I 60 C ÏÖÐ / ÏÄÐÔ Sma I 65 C 61 C (ãðàäèåíò) Ìóëü òè ïëåê - ñ íàÿ ÏÖÐ In/Del Ïðîäóêòû ãèä ðî ëè çà, ï.í. G: 243 À: 161+82 T: 243 C: 136+107 A: 615 G: 377+238 C: 199 G: 113+86 A: 169 G: 120+49 "+": 13 " ": "+": 114 " ": Ïðè ìå à íèå. * äëÿ êîí ñò ðó è ðî âà íèÿ ïî ñëå äî âà òå ëü íî ñòè ïðàé ìå ðîâ èñ ñëå äó å ìûõ îá ëà ñ òåé ãå íîâ èñ ïî ëü çî âà ëàñü ïðîãðàììà Vector NTI Òàá ëè öà 2 Èñ òî - íèê * * * * [8] [32] Òàá ëè öà 3 Ñðåäíèå çíà åíèÿ àñòîòû õðîìîñîìíûõ íàðóøåíèé â èññëåäîâàííûõ ãðóïïàõ (% ± ñò.îøèáêà) Òèï õðîìîñîìíûõ íàðóøåíèé Ãðóï ïà èí äè âè äîâ ñ èí êîð ïî ðè ðî âàí - íûì ïëóòîíèåì-239 Êîí ò ðî ëü íàÿ ãðóïïà Àáåð ðà öèè õðî ìî ñîì íî ãî òè ïà 0,86±0,10* 0,33±0,12 Àáåð ðà öèè õðî ìà òèä íî ãî òè ïà 0,75±0,08 0,55±0,11 Ñóììàðíàÿ àñòîòà àíåóïëîèäèè (õðîìîñîìû 2, 7, 8, 12, X, Y) 1,49±0,30* 0,73±0,23 Ìèê ðî ÿä ðà 0,78±0,07* 0,55±0,04 Ïðè ìå à íèå. * ñòà òè ñòè å ñêè çíà è ìî áî ëåå âû ñî êàÿ à ñ òî òà â ãðóï ïå èí äè âè äîâ ñ èí êîð ïî ðè ðî âàí íûì ïëó òî íè - åì-239 ïî ñðàâíåíèþ ñ êîíòðîëüíîé ãðóïïîé (p<0,05) Ãðóï ïà ñðàâ íå - íèÿ Õàðàêòåðèñòèêà ãðóïï, ñôîðìèðîâàííûõ íà îñíîâå óðîâíÿ õðîìîñîìíûõ íàðóøåíèé â ëèì ôî öè òàõ ïå ðè ôå ðè å ñêîé êðî âè Èñ õîä íûå ãðóï ïû ( èñ ëåí íîñòü) Êðè òå ðèé ôîð ìè ðî âà íèÿ Îáú ì âûáîðêè >ÕÀ "Pu" (15) + "Ê" (2) Óðîâåíü õðîìîñîìíûõ àáåððàöèé 17 <ÕÀ "Pu" (30) + "Ê" (3) âûøå (>) ëè áî íè æå (<) 2,5% 33 >Àí "Pu" (26) + "Ê" (5) Óðî âåíü àíå óï ëî è äèè 10 è 31 <Àí "Ê" (23) âûøå (>) ëè áî íè æå (<) 23 >Ìß "Pu" (26) + "Ê" (16) Óðîâåíü ìèêðîÿäåð âûøå 6 (>) 42 <Ìß "Pu" (12) + "Ê" (25) ëè áî íè æå (<) 37 Ïðè ìå à íèå. "Ê" è "Pu" ñì. òàáë. 1 Òàá ëè öà 4 ISSN 2073-7998 21

ÎÐÈ ÃÈ ÍÀ ËÜ ÍÛÅ ÈÑ ÑËÅ ÄÎ ÂÀ ÍÈß õðîìîñîìíûõ íàðóøåíèé èç îáåèõ èñõîäíûõ ãðóïï (òàáë. 4). Îòêëîíåíèÿ íàáëþäàåìîãî ðàñïðåäåëåíèÿ ãåíîòèïîâ îò îæèäàåìîãî ïðè ðàâíîâåñèè Õàðäè Âàéíáåðãà òå ñ òè ðî âà ëè êàê â èñ õîä íûõ ãðóï ïàõ («Pu» è «Ê»), òàê è â ïîäãðóïïàõ, ðàçëè àþùèõñÿ ïî óðîâíþ õðîìîñîìíûõ íàðóøåíèé. Â èñõîäíûõ ãðóïïàõ ïî âñåì èññëåäîâàííûì ëîêóñàì íàáëþäàëîñü ñîîòâåòñòâèå ðàâíîâåñèþ Õàðäè Âàéíáåðãà (òàáë. 5). Ñîîòâåòñòâèå íàáëþäàåìîãî ðàñïðåäåëåíèÿ ãåíîòèïîâ îæèäàåìîìó áûëî çàðåãèñòðèðîâàíî âî âñåõ ïîäãðóïïàõ ïî èçó åííûì ïîëèìîðôíûì âàðèàíòàì â ãåíàõ CYP2C19, XRCC1 è PMS2, â ïÿ òè èç øåñ òè ïîä ãðóïï ïî ãåíó ÒÐ53 è â òð õ èç øåñ òè ïîä ãðóïï ïî ãå íó MLH1. Â ïîä - ãðóïïàõ ñ âûñîêèìè óðîâíÿìè õðîìîñîìíûõ àáåððàöèé, àíåóïëîèäèè è ìèêðîÿäåð ïî ïîëèìîðôíîìó âàðèàíòó â ãåíå MLH1 è â ïîäãðóïïå ñ âûñîêèì óðîâíåì àíåóïëîèäèè ïî ïîëèìîðôíîìó âàðèàíòó â ãåíå TP53 ðàñïðåäåëåíèå ãåíîòèïîâ îòëè àëîñü îò ðàâíîâåñèÿ Õàðäè Âàéíáåðãà. Âî âñåõ ñëó à ÿõ (è äëÿ ãå íà TP53, è äëÿ ãå íà MLH1) îòêëîíåíèå áûëî îáóñëîâëåíî îòñóòñòâèåì ãîìîçèãîò ïî ðåäêîìó àëëåëþ è èçáûòêîì ãåòåðîçèãîò. Ïðè ýòîì, äëÿ ïîëèìîðôíîãî âàðèàíòà ãåíà MLH1 â ïà ðàõ ñðàâ íå íèé ñ âû ñî êèì è íèçêèì óðîâíåì õðîìîñîìíûõ íàðóøåíèé ñòàòèñòè åñêè çíà èìûå ðàçëè èÿ ïî ðàñïðåäåëåíèþ ãåíîòèïîâ áûëè óñòàíîâëåíû òîëüêî ìåæäó ãðóïïàìè ñ õðîìîñîìíûìè àáåððàöèÿìè âûøå 2,5% è íèæå 2,5%, òî ñîîòâåòñòâóåò ôîíîâîìó óðîâíþ ( 2 =6,097, p=0,047). Ïðåäðàñïîëàãàþùèì ê ïîâûøåííîìó óðîâíþ õðîìîñîìíûõ àáåððàöèé îêà - çàëñÿ ãåòåðîçèãîòíûé ãåíîòèï: OR=4,41 (CI: 1,14 14,29), 2 =3,95, p=0,047. Ìåæäó äðóãèìè ñðàâíèâàåìûìè ïîäãðóïïàìè (ðàçëè àþùèìèñÿ ïî óðîâíþ àíåóïëîèäèè è ìèêðîÿäåð) ïî àñòîòàì ãåíîòèïîâ rs1799977 â ãåíå MLH1 íå óñòàíîâëåíî ñòàòèñòè åñêè çíà èìûõ îòëè èé, êàê è ïî èññëåäîâàííîìó ëîêóñó â ãåíå TP53. Âìåñòå ñ òåì, ñèòóàöèÿ ïî «ñìåùåíèþ» ðàñïðåäåëåíèé àñòîò ãåíîòèïîâ (òàáë. 5) â ïîäãðóïïàõ ñ âûñîêèì óðîâíåì õðîìîñîìíûõ íàðóøåíèé íå ìî æåò áûòü ñëó àé íîé, òàê êàê äàí íûå ïîä ãðóï ïû áû ëè ñôîðìèðîâàíû èç äâóõ èñõîäíûõ ãðóïï (êîíòðîëüíîé è ãðóïïû ñ èíêîðïîðèðîâàííûì ïëóòîíèåì-239 òàáë. 5), â êîòîðûõ, ïî âñåì èññëåäîâàííûì ïîëèìîðôíûì âàðèàíòàì íàáëþäàëîñü ñîîòâåòñòâèå ðàâíîâåñèþ Õàðäè-Âàéíáåðãà, à ìåæäó ãðóïïàìè íå áûëî óñòàíîâëåíî ñòàòèñòè åñêè çíà- èìûõ ðàçëè èé ïî àñòîòàì ãåíîòèïîâ. Ïðè ïîïàðíîì ñðàâíåíèè ïîäãðóïï ñ ðàçíûì óðîâíåì õðîìîñîìíûõ íàðóøåíèé, ïîìèìî îòìå åííîãî âûøå ãåíà MLH1, åù òîëüêî â äâóõ ñëó àÿõ âûÿâëåííûå ðàçëè èÿ äîñòèãëè óðîâíÿ ñòàòèñòè åñêîé çíà èìîñòè: äëÿ rs25487 ãåíà XRCC1 ïðè ñðàâ íå íèè ïîä ãðóïï ñ âû ñî êèì è íèç êèì óðîâíåì õðîìîñîìíûõ àáåððàöèé è äëÿ ñî åòàíèé ãåíîòèïîâ GSTT1/GSTM1 ïðè ñðàâ íå íèè ïîä ãðóïï ñ âû ñî êèì è íèçêèì óðîâíåì àíåóïëîèäèè. Îäíàêî â îòäåëüíûõ ïàðàõ ñðàâíåíèé äëÿ âñåõ ëîêóñîâ íàáëþäàëèñü îïðåäåë ííûå îòëè èÿ â õàðàêòåðå ðàñïðåäåëåíèÿ àñòîò ãåíîòèïîâ è àëëåëåé, íå äîñòèãàâøèå, òåì íå ìåíåå, çíà èìîãî óðîâíÿ. Ñëåäóåò îòìåòèòü, òî èñëåííîñòè îáñëåäîâàííûõ ãðóïï íåâåëèêè, òî ìîæåò îòðàæàòüñÿ íà ñòàòèñòè åñêîé çíà èìîñòè ïîëó åííûõ ðåçóëüòàòîâ. Ïî ïîëèìîðôíîìó âàðèàíòó â ãåíå PMS2 ñòàòèñòè åñêè çíà èìûõ ðàçëè èé ïî àñòîòàì àëëåëåé è ãåíîòèïîâ â ïîäãðóïïàõ ñ ðàçíûì óðîâíåì õðîìîñîìíûõ íàðóøåíèé íå çàðåãèñòðèðîâàíî. Âìåñòå ñ òåì, íàáëþäàåòñÿ ñóùåñòâåííîå (â 1,59 ðàçà) ðàçëè èå ïî àñòîòå íîñèòåëüñòâà ãåòåðîçèãîò â ïîäãðóïïàõ ñ âûñîêèì è íèçêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé (35,29 è 56,25% ñîîòâåòñòâåííî) (òàáë. 5). Áåëêè PMS2 è MLH1 ÿâëÿþòñÿ êîìïîíåíòàìè ñèñòå - ìû ïîñò-ðåïëèêàòèâíîé ìèññ-ìàò ðåïàðàöèè (MMR). Îíè îáðàçóþò ãåòåðîäèìåð, íàçûâàåìûé MutL, ôóíêöèîíèðóþùèé ñîâìåñòíî ñ ãåòåðîäèìåðîì MutS èëè MutS ñóáúåäèíèöåé êîìïëåêñà, óçíàþùåãî íàðóøåíèÿ ñïàðèâàíèÿ äâîéíîé ñïèðàëè ÄÍÊ (ìèññ-ìàò è). PMS2 îáëàäàåò ýíäîíóêëåàçíîé àêòèâíîñòüþ, âíîñÿ îäíîöåïî å íûå ðàç ðû âû â íèòü ÄÍÊ ïî êðà ÿì ó à ñò êà ñ ìèññ-ìàò åì. Äåãðàäàöèþ ïîâðåæä ííîãî ó àñòêà îñóùåñòâëÿåò ýêçîíóêëåàçà EXO1. Ïîêàçàíû ôèçè åñêèå âçàèìîäåéñòâèÿ MutL ñ ÄÍÊ-ïîëèìåðàçîé III, òàêæå ïðèâëåêàåìîé ê ïðîöåññó ðåïàðàöèè. Ýíäîíóêëåàçà PMS2 íå ìîæåò ðàçðåçàòü ìåòèëèðîâàííóþ ÄÍÊ, ïîýòîìó òàêèì ïóòåì ìîãóò ðåïàðèðîâàòüñÿ òîëüêî íàðóøåíèÿ, âîçíèêøèå de no vo. Êðîìå òîãî, MutL ÿâëÿåòñÿ àñòüþ BRCA1-àññîöèèðî - âàííîãî êîìïëåêñà, êîíòðîëèðóþùåãî ñòàáèëüíîñòü ãåíîìà BASC (êî òî ðûé ñî äåð æèò áåë êè BRCA1, MSH2, MSH6, MLH1, ATM, BLM, PMS2), à òàê æå áåë êî âî ãî êîìïëåêñà RAD50-MRE11-NBS1. Ýòîò êîìïëåêñ äèíàìè - åí è èçìåíÿåòñÿ êàê íà ïðîòÿæåíèè êëåòî íîãî öèêëà, òàê è â ïðåäåëàõ ñóáêëåòî íûõ äîìåíîâ. MLH1 ìîæåò òàêæå ãåòåðîäèìåðèçîâàòüñÿ ñ MLH3 (MutL ) è èã ðàòü îïðå - äåë ííóþ ðîëü â ìåé î çå. Èç âå ñò íî òàê æå, òî PMS2 âî âëå - åí â ñèãíàëüíûé ïóòü, êîòîðûé ïðè ñèëüíûõ ïîâðåæäåíèÿõ ÄÍÊ âûçûâàåò îñòàíîâêó êëåòî íîãî öèêëà è âåäåò ê àïîï òî çó [19, 28]. Áåë êè PMS2 è MLH1 èã ðà þò âàæ íóþ ðîëü â ïîääåðæàíèè ñòàáèëüíîñòè ãåíîìà [22, 35]. Ìóòà - öèè â ãå íàõ PMS2 è MLH1 ìîãóò ïðèâîäèòü ê íåêîòîðûì íàñëåäñòâåííûì îíêîëîãè åñêèì çàáîëåâàíèÿì, òàêèì êàê ñèíäðîì Ëèí à è ñèíäðîì Òóðêîòà. Áîëüøèíñòâî ñåìåé ñ êëèíè åñêè âåðèôèöèðîâàííûì íàñëåäñòâåííûì íåïîëèïîçíûì êîëîðåêòàëüíûì ðàêîì èìååò ìóòàöèè â ãå íàõ MLH1 è MSH2. Êðîìå òîãî, ìóòàöèè â MLH1 ìî - ãóò âûçâàòü ñèíäðîì Ìüþ Òîððå, ëîáóëÿðíóþ êàðöèíîìó (LCIS), ðàê ýí äî ìåò ðèÿ [9, 20, 34]. Â íà ñòî ÿ ùåì èñ ñëå äî âà íèè äëÿ çà ìå íû â ãå íå XRCC1 (rs25487) òàê æå áû ëà âû ÿâ ëå íà íå êî òî ðàÿ ñïå öè ôè êà â ðàñïðåäåëåíèè àñòîò ãåíîòèïîâ â ðàçíûõ ïîäãðóïïàõ (òàáë. 5): à ñ òî òà ãî ìî çè ãîò íî ãî ãå íî òè ïà ïî ìà æîð íî ìó àë ëå ëþ âà ðü è ðî âà ëà â ïðå äå ëàõ 35 59%, à ãå òå ðî çè ãîò - íî ãî 40 60%. Òåì íå ìå íåå, ìåæ äó ñðàâ íè âà å ìû ìè ïàðàìè ïîäãðóïï ñòàòèñòè åñêè çíà èìûõ ðàçëè èé ïî à ñ òî òàì ãå íî òè ïîâ íå âû ÿâ ëå íî. Ïî à ñ òî òàì àë ëå ëåé ðàçëè èÿ ðåãèñòðèðîâàëèñü òîëüêî ïðè ñðàâíåíèè ïîä - ãðóïï ñ âûñîêèì è íèçêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé: àëëåëü A ÿâëÿåòñÿ ïðåäðàñïîëàãàþùèì ê ôîðìè - ðî âà íèþ ñòðóê òóð íûõ íà ðó øå íèé õðî ìî ñîì (OR=2,82 (CI: 1,05 7,66) 2 =4,26, p=0,039). 22

ÌÅÄÈÖÈÍÑÊÀß ÃÅÍÅÒÈÊÀ. 2013. ¹4 àñòîòû àëëåëåé è ãåíîòèïîâ èçó åííûõ ëîêóñîâ â èññëåäîâàííûõ ãðóïïàõ Ïîëèìîðôèçì Ãðóïïû MLH1 Òàá ëè öà 5 "Pu" "Ê" >ÕÀ <ÕÀ >Àí <Àí >Ìß <Ìß AA 39,44 37,84 23,53 42,42 26,67 35,71 26,19 29,73 AG 53,52 48,65 76,47 42,42 73,33 57,14 64,29 59,46 GG 7,04 13,51 0 15,15 0 7,14 9,52 10,81 A 66,2 62,16 61,76 63,64 63,33 63,04 58,33 59,46 ÐÕÂ: 2 (p) 2,725 0,086 6,515 (<0,01) 0,229 2 (p) ãå íî òè ïû 6,097 (0,047) PMS2 10,055 (<0,01) 1,043 4,367 (<0,05) 2,014 CC 21,43 22,22 29,41 18,75 30 26,09 28,57 18,92 CT 58,57 50 35,29 56,25 46,67 47,82 52,38 48,65 TT 20 27,78 35,29 25 23,33 26,09 19,05 32,43 C 50,71 47,22 47,06 46,88 53,33 50,00 54,76 43,24 ÐÕÂ: 2 (p) 2,063 XRCC1 0,001 0,487 1,446 0,536 0,117 0,138 0,003 GG 45,71 35,14 35,29 59,37 43,33 34,78 38,10 56,76 AG 42,86 55,41 41,18 37,5 46,67 60,87 52,38 40,54 AA 11,43 9,46 23,53 3,13 10 4,35 9,52 2,7 G 67,14 62,84 55,88 78,13 66,67 65,22 64,23 77,03 ÐÕÂ: 2 (p) 0,058 2,569 0,462 0,302 2 (p) àë ëå ëè 4,259 (0,039) TP53 0,075 (>0,05 2,685 0,832 0,783 GG 57,75 48,65 64,71 48,49 46,67 65,22 61,90 51,35 CG 36,62 44,59 35,29 39,39 53,33 30,43 38,10 43,24 CC 5,63 6,76 0 12,12 0 4,35 0 5,41 G 76,06 70,95 82,35 68,18 73,33 80,43 80,95 72,97 ÐÕÂ: 2 (p) 0,002 Cyp2C19 0,494 0,781 0,280 3,967 (<0,05) 0,025 2,325 0,343 GG 77,14 69,86 88,24 68,75 83,33 60,87 63,41 81,08 GA 20 28,77 11,76 28,12 13,33 39,13 34,15 18,92 AA 2,86 1,37 0 3,13 3,34 0 2,44 0 G 87,14 84,25 94,12 82,81 90 80,43 80,49 90,54 ÐÕÂ: 2 (p) 0,809 GSTT1/GSTM1 0,512 0,066 0,005 2,017 1,361 0,311 0,404 +/+ 46,48 39,19 47,06 45,46 56,67 30,43 47,62 43,24 +/- 36,62 47,3 47,06 39,39 36,67 43,48 33,33 43,24 -/+ 11,27 4,05 0 12,12 0 21,74 9,52 10,81 -/- 5,63 9,46 5,88 3,03 6,66 4,35 9,52 2,7 GSTT1 "+" 83,1 86,49 94,12 84,85 92 78,57 75,00 86,49 GSTM1 "+" 57,75 43,24 47,06 57,58 60 50 57,14 54,05 2 (p) ñî åòàíèÿ ãåíîòèïîâ 8,78 (0,032) Ïðè ìå à íèå. à ñ òî òû ïðè âå äå íû â ïðî öåí òàõ; ÐÕÂ ïî êà çà òå ëè ( 2 è p) îöåí êè ñî îò âåò ñò âèÿ à ñ òîò ãå íî òè ïîâ èñ ñëå - äî âàí íûõ ãðóïï ðàâ íî âå ñèþ Õàð äè Âàé íáåð ãà; ïðè âå äå íû òî ëü êî ñòà òè ñòè å ñêè çíà è ìûå ðàç ëè èÿ, ïî ëó åí íûå ïðè ñðàâ íå íèè à ñ òîò àë ëå ëåé ( 2 (p) àëëåëè) è ãåíîòèïîâ ( 2 (p) ãå íî òè ïû) ìåæ äó ãðóï ïà ìè ISSN 2073-7998 23

ÎÐÈ ÃÈ ÍÀ ËÜ ÍÛÅ ÈÑ ÑËÅ ÄÎ ÂÀ ÍÈß Íå èñê ëþ å íî âëè ÿ íèå ýòîé íóê ëå î òèä íîé çà ìå íû íà ðå ïà ðà öèþ õðî ìî ñîì íûõ àáåð ðà öèé, òî ñî ãëà ñó åò ñÿ ñ äàí íû ìè ëè òå ðà òó ðû. Â ðÿ äå ðà áîò ïî êà çà íî, òî âû ñî - êàÿ àñòîòà àëëåëÿ A àññîöèèðîâàíà ñ ïîâûøåíèåì óðîâíÿ ðàçëè íûõ õðîìîñîìíûõ íàðóøåíèé [14, 18, 23]. Â íàñòîÿ - ùåì èññëåäîâàíèè àñòîòà ðåäêîãî àëëåëÿ A ó èíäèâèäîâ ñ âûñîêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé ñîñòàâëÿåò 44,12%, â òî âðåìÿ êàê â ãðóï ïå ñ íèç êèì óðîâ íåì â äâà ðàçà íèæå (21,88%); â îñòàëüíûõ ãðóïïàõ àñòîòà äàííîãî àëëåëÿ íàõîäèòñÿ â ïðåäåëàõ 23 36%. Áåëîê XRCC1 ïðèíèìàåò ó àñòèå â ýêñöèçèîííîé ðå - ïàðàöèè îñíîâàíèé ÄÍÊ (BER), âçàèìîäåéñòâóÿ ñ äðóãèìè ôåðìåíòàìè ýòîé ñèñòåìû. Ïîëèìîðôèçì â ãåíå XRCC1 ÿâëÿåòñÿ ôàêòîðîì ðèñêà ðàçâèòèÿ ðàçíûõ ôîðì îíêîïàòîëîãèè. Îäíàêî äàæå ïðè ìåòààíàëèçàõ àññîöèàöèè ïîëèìîðôíûõ âàðèàíòîâ ýòîãî ãåíà ñ îíêîëîãè åñêè - ìè çàáîëåâàíèÿìè â îäíèõ ñëó àÿõ ïîäòâåðæäàþòñÿ [17], â äðó ãèõ íåò [16]. Ïî êà çà íî, òî àë ëåëü 399Gln (àë ëåëü A) ãåíà XRCC1 àññîöèèðîâàí ñ âûñîêèì óðîâíåì ìèêðîÿäåð [14] è ïî âû øåí íûì óðîâ íåì ðàç ðû âîâ ÄÍÊ, ò.å. ñíè æå - íèåì ñïîñîáíîñòè ôåðìåíòà ðåïàðèðîâàòü ïîâðåæäåíèÿ ÄÍÊ [18, 23]. Â íàøåì èññëåäîâàíèè íå óñòàíîâëåíî âëèÿíèå äàííîé çàìåíû íà óðîâåíü ìèêðîÿäåð. Ïî SNP rs1042522 â ãå íå TP53 â ïîä ãðóï ïàõ ñ âû ñî - êèìè óðîâíÿìè õðîìîñîìíûõ àáåððàöèé, àíåóïëîèäèè, ìèê ðî ÿäåð ãî ìî çè ãî òû ÑÑ íå âû ÿâ ëå íû. Â äðó ãèõ ïîä - ãðóïïàõ èíäèâèäîâ èõ àñòîòà íå ïðåâûøàåò 12,12%. Â ðàç íûõ ïîä ãðóï ïàõ ðàç áðîñ à ñ òîò àëü òåð íà òèâ íûõ ãî - ìî çè ãîò è ãå òî ðî çè ãîò ñî ñòàâ ëÿ åò îêî ëî 20% (òàáë. 5). Ñòàòèñòè åñêè çíà èìûõ ðàçëè èé ìåæäó ñðàâíèâàåìû - ìè ïîä ãðóï ïà ìè íå âû ÿâ ëå íî. Áåëîê p53, êîäèðóåìûé ãåíîì TP53, ÿâëÿåòñÿ îïóõîëåâûì ñóïðåññîðîì, èíäóöèðóþùèì îñòàíîâêó êëåòî íîãî ðîñòà èëè àïîïòîç â çàâèñèìîñòè îò ôèçèîëîãè åñêèõ îáñòî ÿ òåëüñòâ è òè ïà êëå òîê. Êðî ìå òî ãî, îí âî âëå í â êîí ò - ðîëü êëåòî íîãî öèêëà êàê òðàíñ-àêòèâàòîð ìíîæåñòâà ãåíîâ, ó àñòâóþùèõ â êëåòî íîì äåëåíèè, àïîïòîçå è ðåïàðàöèè ÄÍÊ [6]. Êîëè åñòâî p53 âîçðàñòàåò â òðàíñôîðìèðîâàííûõ êëåòêàõ ðàçíûõ òèïîâ. Ãåðìèíàòèâíîå íîñèòåëüñòâî ìó òà öèé â ãå íå ÒP53 â 80% ñëó à åâ ïðè âî äÿò ê ôîð ìè ðî - âàíèþ åòûðåõ òèïîâ ðàêîâûõ íîâîîáðàçîâàíèé: ýòî ðàê ìîëî íîé æåëåçû, ñàðêîìà ìÿãêèõ òêàíåé è êîñòåé, îïóõîëè ãîëîâíîãî ìîçãà è àäðåíîêîðòèêàëüíûå êàðöèíîìû [13, 24, 27]. Íà îñòàâøèåñÿ 20% ïðèõîäèòñÿ ìíîæåñòâî áîëåå ðåä êèõ îïó õî ëåé. Â öå ëîì æå, ïðè ìåð íî â 60% âñåõ ðà êî - âûõ îáðàçîâàíèé âûÿâëÿþòñÿ ìóòàöèè â ãåíå TP53, ïðè âî - äÿùèå ëèáî ê èíàêòèâàöèè ãåíà, ëèáî ê íàðóøåíèþ ôóíêöèé êîäèðóåìîãî èì áåëêà p53. Êîäîí 72 ðàñïîëîæåí â ïðîëèí-áîãàòîì ðåãèîíå áåëêà è çàìåíà àìèíîêèñëîòû ìîæåò ìåíÿòü ñòðóêòóðó SH3-ñâÿçûâàþùåãî äîìåíà [10]. Ýòîò êîäîí ÿâëÿåòñÿ ðåçâû àéíî âàðèàáåëüíûì, â íåì îïèñàíî 5 íåñèíîíèìè íûõ íóêëåîòèäíûõ çàìåí, è òîëüêî çàìåíà Arg (äèêèé òèï) íà Pro ÿâëÿåòñÿ ïîëèìîðôíûì âàðèàíòîì, îñòà ëü íûå (çà ìå íû íà Cys, Gly, His, Leu) ïðåä ñòàâ ëÿ þò ñî - áîé ìóòàöèè [15]. Èìåþòñÿ äàííûå, òî ïîëèìîðôíûé âàðèàíò TP53 Pro72 (ïî ñðàâ íå íèþ ñ äè êèì òè ïîì Arg72) ñíèæàåò àïîïòîòè åñêóþ ôóíêöèþ áåëêà, à òàêæå ñâÿçàí ñ óâåëè åíèåì ðàäèî óâñòâèòåëüíîñòè êëåòêè [10]. Ïî çà ìå íå â ãå íå Cyp2C19 (rs4244285) â ïîä ãðóï ïàõ ñ íèçêèìè óðîâíÿìè àíåóïëîèäèè è ìèêðîÿäåð, à òàêæå â ïîäãðóïïå ñ âûñîêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé íå áûë çàðåãèñòðèðîâàí ãåíîòèï AA (òàáë. 5). Îäíàêî àñòîòû ãåòåðîçèãîò è àëüòåðíàòèâíûõ ãîìîçèãîò â ýòèõ ãðóïïàõ íåîäèíàêîâû è âàðüèðóþò äëÿ GA îò 11,76% (âûñîêèé óðîâåíü õðîìîñîìíûõ àáåððàöèé) äî 39,13% (íèçêèé óðîâåíü àíåóïëîèäèè). Â ãåíå Cyp2C19 àñòîòà ìàæîðíîãî àëëåëÿ w íàõîäèëàñü â ãðàíèöàõ îò 80,43% (ïîäãðóïïà ñ íèçêèì óðîâíåì àíåóïëîèäèè) äî 94,12% (ïîä - ãðóïïà ñ âûñîêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé). Ñòàòèñòè åñêè çíà èìûå ðàçëè èÿ ìåæäó ñðàâíèâàåìû - ìè ïîäãðóïïàìè íå çàðåãèñòðèðîâàíû. Ãåíû äåòîêñèêàöèè êñåíîáèîòèêîâ, êîòîðûå èãðàþò âàæíóþ ðîëü â èíäèâèäóàëüíîé óâñòâèòåëüíîñòè ê âîçäåéñòâèþ ðàçëè íûõ òîêñè åñêèõ àãåíòîâ îêðóæàþùåé ñðåäû, ïðåäñòàâëÿþò áîëüøîé èíòåðåñ ñ òî êè çðåíèÿ ôåíîìåíà èíäèâèäóàëüíîé ðàäèî óâñòâèòåëüíîñòè. Ãðóïïà ôåðìåíòîâ I ôàçû äåòîêñèêàöèè êñåíîáèîòèêîâ ïðåäñòàâ - ëåíà ñåìåéñòâîì öèòîõðîìîâ Ð-450, êîòîðîå âêëþ àåò â ñå áÿ áî ëåå 60 ãå íîâ [21, 25]. Ôåð ìåíò CYP2C19 ìå òà áî - ëèçèðóåò øèðîêèé ñïåêòð ëåêàðñòâåííûõ ïðåïàðàòîâ [33]. Îñíîâíîé ãåíåòè åñêèé äåôåêò, íàéäåííûé ó òàê íàçûâàåìûõ «ìåäëåííûõ» ìåòàáîëèçåðîâ (S)-ìåôåíèòîèíà ýòî òî êîâàÿ çàìåíà G íà A â ïÿòîì ýêçîíå â ïîëîæåíèè 681 ãåíà CYP2C19 (CYP2C19*2), ïðèâîäÿùàÿ ê ïîÿâëåíèþ àáåððàíòíîãî ñàéòà ñïëàéñèíãà [8]. Ýòîò ïîëèìîðôèçì îáóñëîâëèâàåò íàðóøåíèå ñïîñîáíîñòè öèòîõðîìà Ð450 ìåòàáîëèçèðîâàòü àíòèýïèëåïòè åñêèé ïðåïàðàò (S)-ìå - ôåíèòîèí, îìåïðàçîë, ïðîãóàíèë, íåêîòîðûå áàðáèòóðàòû è ðÿä äðóãèõ ñîåäèíåíèé [31, 38]. Äåëåöèîííûé ãåíîòèï () â ãå íå GSTT1 (òàáë. 5) â ñðàâíèâàåìûõ ïîäãðóïïàõ âñòðå àëñÿ ñ àñòîòàìè â èíòåðâàëå îò 5,88% (ïîäãðóïïà ñ âûñîêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé) äî 25,00% (ïîäãðóïïà ñ âûñîêèì óðîâíåì ìèêðîÿäåð). Ãåíîòèï ñ äåëåöèåé â ãåíå GSTM1 ðåãèñòðèðîâàëñÿ ñ âû ñî êîé à ñ òî òîé (îò 40 äî 57% â ðàç íûõ ïîä ãðóï ïàõ). Ïî ñî åòàíèþ ãåíîòèïîâ GSTT1/GSTM1 ðåäêèìè ÿâëÿþòñÿ «-/+» è «-/-». àñòîòà ñî åòàíèÿ «-/+» âàðüèðóåò îò 0% (â ïîäãðóïïàõ ñ âûñîêèìè óðîâíÿìè õðîìîñîìíûõ àáåððàöèé è àíå óï ëî è äèè) äî 21,74% (â ïîä ãðóï ïå ñ íèç êèì óðîâ íåì àíåóïëîèäèè). àñòîòà ñî åòàíèÿ «-/-» íàõîäèòñÿ â ïåðåäåëàõ 3,03 9,52%. Â áîëüøèíñòâå ñëó àåâ ïðåîáëàäàþùèì ÿâ ëÿ åò ñÿ ñî å òà íèå «+/+» (îò 30,43 äî 56,67%). Ìåæ äó ãðóïïàìè ñ âûñîêèì è íèçêèì óðîâíåì àíåóïëîèäèè âûÿâëÿþòñÿ ñòàòèñòè åñêè çíà èìûå ðàçëè èÿ ïî ãåíîòèïè åñêèì êîìáèíàöèÿì GSTT1/GSTM1: 2 =8,78, p=0,032. Ãëóòàòèîí-S-òðàíñôåðàçû GSTT1 è GSTM1 îòíîñÿòñÿ ê ãðóïïå ôåðìåíòîâ âòîðîé ôàçû áèîòðàíñôîðìàöèè êñåíîáèîòèêîâ, íà êîòîðîé ðàçëè íûìè ãèäðîëàçàìè è òðàíñôåðàçàìè ïðîâîäèòñÿ íåéòðàëèçàöèÿ òîêñè íûõ ïðîäóêòîâ ïåðâîé ôàçû äåòîêñèêàöèè. Ãëóòàòèîí-S-òðàíñôåðàçû èãðàþò îñíîâíóþ ðîëü â îáåñïå åíèè ðåçèñòåíòíîñòè êëåòîê ê ïåðåêèñíîìó îêèñëåíèþ ëèïèäîâ, àëêèëèðîâàíèþ áåë- 24

ÌÅÄÈÖÈÍÑÊÀß ÃÅÍÅÒÈÊÀ. 2013. ¹4 êîâ, íåãàòèâíîìó âîçäåéñòâèþ ñâîáîäíûõ ðàäèêàëîâ, ïðèâîäÿùèõ ê ïðåäîòâðàùåíèþ ïîâðåæäåíèé ÄÍÊ [1]. Ìóòàöèè ãåíîâ ñåìåéñòâà GST âîâëå åíû â ïàòîãåíåç ðàçëè íûõ ôîðì ðàêà è ÿâëÿþòñÿ ôàêòîðàìè ðèñêà ðàçâèòèÿ ðÿäà çàáîëåâàíèé. «Íóëåâûå» ãåíîòèïû GSTM1 èëè GSTT1 (ïîë - íàÿ äåëåöèÿ ãåíà), êàê ïðàâèëî, àññîöèèðîâàíû ñ ïîâûøåííîé àñòîòîé ñåñòðèíñêèõ õðîìàòèäíûõ îáìåíîâ (ÑÕÎ), ïî ñðàâíåíèþ ñ íîðìàëüíûì ãåíîòèïîì ïðè âîçäåéñòâèè òàêèõ õèìè åñêèõ ñîåäèíåíèé, êàê 1,2-ýïîêñè-3-áóòåí è äèýïîêñèáóòàí [11]. «Íóëåâîé» GSTM1 ãå íî - òèï îáóñëîâëèâàåò òàêæå óâåëè åíèå àñòîòû õðîìîñîìíûõ àáåððàöèé õðîìàòèäíîãî òèïà [30]. Ó èíäèâèäîâ ñ ñî åòàíèåì ãîìîçèãîò ïî «íóëåâûì» àëëåëÿì ãåíîâ GSTM1 è GSTT1 îïèñàíà ïîâûøåííàÿ àñòîòà àáåððàöèé õðîìîñîìíîãî òèïà ïðè âîçäåéñòâèè òåõ æå ñîåäèíåíèé. Äëÿ ãîìîçèãîòíûõ ïî «íóëåâîìó» àëëåëþ ãåíîâ GSTM1 è GSTT1 èí äè - âèäîâ ïðè êóðåíèè õàðàêòåðíû ïîâûøåííàÿ àñòîòà õðîìîñîìíûõ àáåððàöèé è âûñîêèé ðèñê ðàçâèòèÿ ðàêà ëåãêîãî [5, 7]. Â òî æå âðåìÿ, â ðÿ äå äðó ãèõ èñ ñëå äî âà íèé îò ìå à - þòñÿ ïðîòèâîïîëîæíûå ðåçóëüòàòû: íå ïîäòâåðæäàþòñÿ àññîöèàöèè ðàññìîòðåííûõ ãåíîòèïîâ ñ õðîìîñîìíûìè àáåððàöèÿìè è ðèñêîì ðàçâèòèÿ êàêîé-ëèáî ôîðìû ðàêà [26, 37], â íåêîòîðûõ èññëåäîâàíèÿõ [39] óêàçûâàåòñÿ äàæå ïðîòåêòèâíàÿ â îòíîøåíèè îíêîïàòîëîãèè ðîëü «íóëåâîãî» ãåíîòèïà ïî GSTM1. Òàêèì îáðàçîì, â õîäå âûïîëíåíèÿ íàñòîÿùåãî èññëåäîâàíèÿ áûëè èçó åíû ïîëèìîðôíûå âàðèàíòû â ñåìè ãåíàõ. Âûáðàííûå äëÿ èññëåäîâàíèÿ ãåíû êîäèðóþò áåëêè, îòíîñÿùèåñÿ ê ñèñòåìàì ðåïàðàöèè ÄÍÊ, ìåòàáîëèçìà êñåíîáèîòèêîâ, ðåãóëÿöèè êëåòî íîãî öèêëà è ïðîëèôåðàöèè. Äëÿ áîëüøèíñòâà èññëåäîâàííûõ ëîêóñîâ íàáëþäàëèñü îòëè èÿ ïî ðàñïðîñòðàí ííîñòè ãåíîòèïîâ ìåæäó ñðàâíèâàåìûìè ïîäãðóïïàìè, ðàçëè àþùèìèñÿ ïî àñòîòå âñòðå àåìîñòè õðîìîñîìíûõ íàðóøåíèé ðàçíûõ òèïîâ. Îäíàêî ñòàòèñòè åñêè çíà èìûå îòëè èÿ áûëè âûÿâëåíû òîëüêî äëÿ ïîëèìîðôíîãî âàðèàíòà â ãåíå MLH1 (ïðè ñðàâ - íåíèè ïîäãðóïï ñ âûñîêèì è íèçêèì óðîâíåì õðîìîñîìíûõ àáåððàöèé), à òàêæå äëÿ êîìáèíàöèé ãåíîòèïîâ GSTT1/GSTM1 (ìåæäó ïîäãðóïïàìè ñ ðàçíûì óðîâíåì àíåóïëîèäèè). àñòîòû àëëåëåé ìåæäó ñðàâíèâàåìûìè ãðóïïàìè âàðüèðóþò â ìåíüøåé ñòåïåíè; ñòàòèñòè åñêè çíà èìûå ðàçëè èÿ çàðåãèñòðèðîâàíû òîëüêî ìåæäó ïîäãðóïïàìè ñ ðàçíûì óðîâíåì õðîìîñîìíûõ àáåððàöèé (ïîëèìîðôíûé âàðèàíò â ãåíå XRCC1). Ñïåöèôèêà ôîðìèðîâàíèÿ âûáîðîê äëÿ íàñòîÿùåãî èññëåäîâàíèÿ, à èìåííî òðóäîåìêîñòü ïðåäâàðèòåëüíîãî äåòàëüíîãî öèòîãåíåòè åñêîãî è ìîëåêóëÿðíî-öèòîãåíåòè- åñêîãî èññëåäîâàíèÿ, îáóñëîâèëà, â êîíå íîì èòîãå, òîò ôàêò, òî áîëüøèíñòâî âûäåëåííûõ ãðóïï ñ ðàçëè íûìè ãåíîòèïàìè îêàçàëèñü ìàëî èñëåííûìè. Ýòî ñóùåñòâåííî ñíèæàåò âåðîÿòíîñòü ïîëó åíèÿ ñòàòèñòè åñêè çíà èìûõ îòëè èé ìåæäó îáñëåäîâàííûìè ãðóïïàìè è íå ïîçâîëÿåò îäíîçíà íî îöåíèòü ðîëü êàê îòäåëüíî âçÿòûõ àëëåëåé è ãåíîòèïîâ, òàê è èõ ñî åòàíèé â ôîðìèðîâàíèè òåõ èëè èíûõ õðîìîñîìíûõ íàðóøåíèé. Òåì íå ìåíåå, ïîëó åííûå äàííûå óêàçûâàþò íà âîçìîæíîñòü âîâëå åíèÿ îòäåëüíûõ ëîêóñîâ ãåíîìà â ôîðìèðîâàíèå èíäèâèäóàëüíîé óâñòâèòåëüíîñòè îðãàíèçìà ê âîçäåéñòâèþ ïëîòíî-èîíèçèðóþùå - ãî èçëó åíèÿ. Äëÿ ïîäòâåðæäåíèÿ ïîëó åííûõ ðåçóëüòàòîâ îá àññîöèàöèè íåêîòîðûõ èçó åííûõ ïîëèìîðôíûõ âàðèàíòîâ ñ óðîâíåì õðîìîñîìíûõ íàðóøåíèé è âûñêàçàííûõ ïðåäïîëîæåíèé î âîçìîæíîé âîâëå ííîñòè äðóãèõ ïîëèìîðôèçìîâ â ðèñê âîçíèêíîâåíèÿ öèòîãåíåòè åñêèõ íàðóøåíèé íåîáõîäèìî ïðîäîëæåíèå èññëåäîâàíèé êàê íà áîëåå îáøèðíûõ âûáîðêàõ, òàê è ó ïðåäñòàâèòåëåé äðóãèõ ýòíè åñêèõ ãðóïï. Ñïèñîê ëèòåðàòóðû 1. Áà ðà íîâ Â.Ñ., Áà ðà íî âà Å.Â., Èâà ùåí êî Ò.Ý. è äð. Ãå íîì å ëî âå êà è ãå íû «ïðåä ðàñ ïî ëî æåí íî ñòè». (Ââå äå íèå â ïðå äèê - òèâíóþ ìåäèöèíó). 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(3822) 513146, fax (3822) 513744, e-mail: nad.babushkina@medgenetics.ru We pres ent data con cern ing fre quen cies of poly mor phic vari ants of DNA re pair (MLH1 (rs1799977), PMS2 (rs1805321), XRCC1 (rs25487)), cell cy cle con trol (TP53 (rs1042522)) and me tab o lism of xenobiotics (Cyp2C19 (rs4244285), GSTT1 (del) è GSTM1 (del)) genes in co hort of plu to nium work ers and con trol group. Also, sub groups with var i ous lev els of chro mo some ab nor mal i ties are con - sid ered (with high and low lev els of chro mo some ab er ra tions, aneuploidy and micronuclei). There were no sig nif i cant dif fer ences of allele and genotype frequencies between group of plutonium workers and control group. However, significant differences of rs1799977 MLH1 genotype frequencies was observed between subgroups with different levels of chromosome aberrations (p=0.047) and GSTT1/GSTM1 ge no type fre quen cies be tween sub groups with high and low lev els of aneuploidy (p=0.032). There were also dif - ferences between subgroups regarding to genotype frequencies at other loci, but insignificant. Allele frequencies differences were registered only in XRCC1 (rs25487) between subgroups with different levels of chromosome aberrations (p=0.039). Key words: individual radiosensitivity, gene polymorphism, DNA repair, chromosome aberrations, micronuclei 26