Involvement of detoxification system enzymes in pathogenesis of some common multifactorial diseases. Predictive genetic testing

The review summarizes the original data concerning involvement of some genes participating in Phase I and Phase 2 of detoxification systems in the origin, progression and treatment efficiency of such common multifactorial diseases as endometriosis, bronchial asthma, alcoholic cirrhosis, habitual miscarriages, gestosis, lung cancer, chronic bronchitis etc. Of special theoretical and practical value of these studies is an identification of highly nonrandom association of particular functionally inferior alleles of the genes belonging to glutathione-S- transferase super-gene family (GSTM1 (0), GSTT1 (0), GSTPi (s) as well as N-acetyl transferase - NAT-2 (s) with these diseases. Thus molecular testing of these alleles might be recommended as feasible predictive test for personal predisposition evaluation, for estimation of remote prognosis and for the treatment strategy in at least some of these diseases. Somewhat about 5-7% of all population in the North-West of Russia possess the most unfavorable combinations of GST genes genotypes (GSTM10/0; GSTTI0/0, GSTPi s/s). Early identification of these individuals by means of genetic screening supplemented with subsequent adequate social and medical care should be considered as feasible social program for efficient prevention of these diseases at the national level. Relying on these data as well as on the polymorphism studies and common mutation identification of other genes the idea of Genetic Form for the pregnant women is suggested and briefly discussed. Implementation of new sophisticated and highly productive molecular techniques amenable for the widespread population gene polymorphism screening becomes highly advisable.