ANALYSIS OF MTHFR AND VDR GENE VARIANTS AND OXIDATIVE/NITROSATIVE STRESS MARKERS IN THE DEVELOPMENT AND COURSE OF COVID-19 IN CHILDREN FROM THE POLTAVA REGION: APPROACHES TO PERSONALIZED THERAPEUTIC AND PREVENTIVE STRATEGIES

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Abstract
Analysis of gene variants, oxidative and nitrosative stress markers, and their interrelationships may facilitate the development of personalized approaches to the prevention and treatment of coronavirus disease 2019 (COVID-19) and other infectious diseases, particularly in regions affected by environmental pollution. The present study was conducted to evaluate the influence of MTHFR (rs1801133, rs1801131) and VDR (rs731236) gene variants, as well as oxidative and nitrosative stress markers, on the course of COVID-19 in children residing in the Poltava region, with consideration of nitrate and fluoride pollution. Methods. The study included 40 children diagnosed with COVID-19 and 17 age-matched children in the comparison group. The following parameters were assessed: variants of the MTHFR and VDR genes; urinary concentrations of nitrates, nitrites, malondialdehyde (MDA), and sialic acids; and residence in territories with elevated fluoride and nitrate pollution. Results. In children with COVID-19, a significantly higher frequency of the AA genotype of the rs1801131 variant was observed. Elevated urinary levels of nitrites, MDA, and sialic acids were identified as significant pathogenic factors associated with the disease. Among children living in fluoride- and nitrate-polluted areas, correlations were found between MTHFR gene variants and serum concentrations of bilirubin, creatinine, and MDA. Betaine-arginine supplementation was identified as a potential strategy for personalized prevention and treatment in pediatric COVID-19. Conclusion. Associations were established between MTHFR gene variants and increased susceptibility to COVID-19. The influence of fluoride- and nitrate-polluted environments was confirmed, key pathogenic factors (nitrite, MDA, and sialic acid levels) were delineated, and betaine-arginine supplementation was proposed as a potential preventive and therapeutic intervention.

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