Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Shepelkova GS, Chernyh NA, Kosiakova VK, Sadovnikova SS, Ergeshov A, Yeremeev VV

Given the fact, that adaptive immune response is important for control and elimination of viral infections causing human diseases, estimation of adaptive response to SARS-CoV-2 is extremely important. The neutralizing antibodies and CD4+/CD8+ T cells contribute to the SARS-CoV-2 control. Tuberculosis remains the leading cause of mortality among bacterial infections all over the world. Currently, treatment of tuberculosis is complicated by the COVID-19 co-infection. The aim of the study was to investigate the formation of neutralizing antibodies against SARS-CoV-2 and CD4+ and CD8+ T cells specific for SARS-CoV-2 in patients with pulmonary TB. The levels of neutralizing antibodies against SARS-CoV-2 and the amount of T cells specific for SARS-CoV-2 were estimated at two time points (3 and 6 months after COVID-19) in patients diagnosed with pulmonary tuberculosis (69 individuals: 33 females and 36 males aged 18–70 years). Patients without tuberculosis (35 individuals: 25 females and 10 males aged 18–70 years) who had undergone COVID-19 served as the control group. The study showed equal levels of SARS-CoV-2 neutralizing antibodies in both groups 3 months after COVID-19. The levels of antibodies decreased 6 months after COVID-19 compared to the levels reported 3 months after the disease in both groups. The antibody levels were significantly lower in the group of patients with TB (p = 0.01). The amount of SARS-CoV-2 specific T cells was lower in TB patients 6 months after COVID-19 (p < 0.001) compared to the control group. Thus, TB co-infection reduces the specific immune response to SARS-CoV-2 6 months after COVID-19.

Received: 2024-04-03

Published online: 2024-06-17

DOI: 10.24075/brsmu.2024.023

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VIEWS 1170

Dobronos MA, Osipova ZM, Myshkina NM

Production of biotherapeutic drugs in mammalian cells, recombinant proteins in particular, may be handicapped by the limitations imposed on the cultures by metabolic burden. An alternative solution is to produce proteins in cells of other animals (e.g., Sf9, S2 and High Five insect cell lines, Caenorhabditis elegans and Schistosoma mansoni cell line) or orthogonal cell systems, including plant-based. In our opinion, non-traditional cell cultures may become promising tool for production of affordable and effective biotherapeutic drugs.

Received: 2024-04-20

Published online: 2024-06-13

DOI: 10.24075/brsmu.2024.022

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VIEWS 1287

Smirnov SV, Kuznetsova OYu, Postnikov MA

The lens (lens cristalina) is part of the light conducting and light refracting system of the eye. Transparency and light refraction are the main properties of the lens. Nutrients are supplied to the lens through the capsule by diffusion and active transport. The energy needs of the avascular epithelial structure are 10–20 lower compared to that of other organs and tissues. Such needs are satisfied through anaerobic glycolysis. Currently, there is insufficient information about the fundamental chemical mechanism underlying the existence of the lens in the healthy body, the mechanisms of its functional “survival” against the background of somatic disorder, such as diabetes. The paper reports the authors’ view of certain chemical aspects clarifying pathochemical alterations of the lens with the possible mechanisms underlying its “adaptation”/”protection” associated with the systemic disorder at the molecular level. In particular, the view of the involvement of glucose-6-phosphate dehydrogenase/ transketolase, the enzymes of the oxidative and non-oxidative phases of the pentose phosphate pathway belonging to the native crystalline fraction protein family, in the mechanisms underlying protection of the lens against the oxidative and osmotic stress, involvement of aldo-keto reductases in pathochemical alterations of the lens, as well as the role the NO, NO3-, B6, PQQ small molecules having an antioxidant cytoprotective effect is reported.

Received: 2024-02-28

Published online: 2024-05-29

DOI: 10.24075/brsmu.2024.019

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VIEWS 1367

Gavisova AA, Shevtsova MA, Lvova PO, Biryukova DA, Ibragimova MH, Novoselova AV, Yushina MN, Chagovets VV, Frankevich VE

Diminished ovarian reserve (DOR) represents a relevant issue of reproductive medicine that is often associated with infertility and reduced efficacy of IVF programs. The changes in amino acid metabolism can play a role in the DOR pathogenesis as manifestations of the folliculogenesis and oogenesis epigenetic alterations. The study was aimed to assess alterations of amino acid metabolic pathways in blood plasma and follicular fluid and estimate their clinical significance in DOR. A total of 115 infertile women aged 25–42 years were included in the study. Groups were formed based on the ovarian reserve and age. Amino acid levels in blood plasma and follicular fluid were assessed by high performance liquid chromatography–mass spectrometry (HPLC-MS); bioinformatics analysis of amino acid metabolic pathways was performed. We revealed significant changes in the phenylalanine, tyrosine and tryptophan biosynthesis (effect = 0.5; p = 0.026), alanine, aspartate and glutamate metabolism (effect = 0.114; p = 0.013), and arginine biosynthesis (effect = 0.289; p < 0.001) pathways playing a role in folliculogenesis, oogenesis, and embryogenesis. The detected differences in the amino acid levels in various body fluids made it possible to construct the logistic regression models confirming DOR with the 88% probability based on the amino acid levels in follicular fluid (sensitivity 88%, specificity 84%) and 82% probability based on plasma levels (sensitivity 65%, specificity 91%). The findings can be used for further research focused on the pathogenesis of infertility associated with DOR and for selection of the most optimal diagnostic and treatment tactics.

Received: 2024-03-27

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.016

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VIEWS 1656

Borisova OYu, Andrievskaya IYu, Pimenova AS, Gadua NT, Chagina IA, Borisova AB, Chaplin AV, Alekseeva IA, Kafarskaya LI

Vaccination is an effective means of preventing pertussis infection. The purpose of this work was to improve vaccines available in the Russian Federation in general and actualize vaccine strains used for the production thereof in particular. We studied B. pertussis strains isolated in Moscow, Voronezh, Novosibirsk, Ulyanovsk and Chelyabinsk regions, and eight production strains part of the adsorbed diphtheria-pertussis-tetanus (DPT) vaccine. Multilocus antigenic sequence typing (MAST) and whole genome multilocus sequence typing (wgMLST) were used for genotyping. We studied cultural morphological, enzymatic, serological, and genotypic properties of the candidate B. pertussis strains, and compared their genotypic properties to those of B. pertussis vaccine strains from the current composition of the DPT vaccine. Candidate strains belong to four genotypes: ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-2/prn2, ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-2/prn9, ptxА1/ptxВ2/ptxС2/ptxР3/fim2-1/fim3-1/prn1 and ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-1/prn2. Current vaccine strains were from other six genotypes: ptxА2/ptxВ1/ptxС1/ptxР1/fim2-1/fim3-1/prn1, ptxА2/ptxВ2/ptxС1/ptxР2/fim2-1/fim3-1/prn1, ptxА4/ptxВ1/ptxС1/ptxР2/fim2-1/fim3-1/prn1, ptxА2/ptxВ2/ptxС1/ptxР1/fim2-1/fim3-1/prn1, ptxА4/ptxВ2/ptxС1/ptxР2/fim2-1/fim3-1/prn1 and ptxА1/ptxВ2/ptxС1/ptxР1/fim2-1/fim3-1/prn1. With the help of wgMLST, we established affiliation of all candidate strains of B. pertussis to ST2.

Received: 2024-04-09

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.017

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VIEWS 1833

Vlasova AV, Kulichenko TV, Smirnova EV

The POPI criteria (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions) for assessment of treatment of comorbidities, complications and underlying conditions in children that are accepted as the only existing instrument for detection of potentially inappropriate prescriptions, make it possible to evaluate prescriptions in children at the inpatient and outpatients stages of care provision, similar to the Beers criteria for adults. The study was aimed to assess the structure and rate of potentially inappropriate prescribing in the pediatric anesthesiology and resuscitation department of the multidisciplinary children's hospital based on the adapted version of POPI criteria for non-antibiotic concomitant therapy of nosocomial infections. We analyzed 305 cases of non-antibiotic medication prescription per 100 patients included. The rate of potentially inappropriate prescribing was 31 cases (10.5%), among which potentially inappropriate medication was prescribed in 29 cases (9.5%), and potentially missed medication took place in three cases (1%). The highest rate of potentially inappropriate prescribing was reported for respiratory diseases. Assessment of concomitant therapy in the critically ill children with infections revealed no significant effects on the rate of adverse reactions to antibiotics in children. In the context of implementing medical information systems (MIS) and prescription sheets, integration of the adapted POPI criteria is topical in terms of maintaining the quality and safety of drug therapy for treatment of concomitant diseases, conditions, and complications in children.

Received: 2024-02-21

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.018

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VIEWS 1767

Nikishina VB, Petrash EA, Engel EYa, Simonenko IA, Shagina ED

Functional assessment of higher mental functions in case of intoxication or during treatment will make it possible to identify predictors of the symptoms of hepatic encephalopathy associated with portal hypertension. The study was aimed to determine the diagnostic predictors of the emergence of the earliest symptoms of hepatic encephalopathy in adolescents with portal hypertension. The study involved 60 adolescents aged 13–17 years: 28 males, 32 females. The experimental group included 30 adolescents with the diagnosis К76.6 Portal hypertension, unspecified form. The control group included 30 adolescents with normal somatic status, who had no mental disorders, traumatic brain injuries or severe infectious diseases of the brain (based on the records of the annual check-up). The studied groups were matched by sex, age, and social status. The proprietary method, Tobii EyeX hardware and software system (GazeControl software), and Cambridge Face Memory Test for Children (CFMT-C) were used. It has been found that recognition of single face images, multiple face images, and multiple face images camouflaged with noise by adolescents with portal hypertension is associated with the greater efforts (manifested in the increased number and duration of gaze fixations), than recognition of the above by adolescents with normal somatic status. The accuracy of recognition of single face images, multiple face images, and multiple face images camouflaged with noise shown by adolescents with portal hypertension experiencing the toxic effects associated with manifestations of hepatic encephalopathy is significantly reduced compared to that shown by adolescents with normal somatic status. The results obtained can be considered as the diagnostic predictors allowing one to trace the changes in the hepatic encephalopathy severity at various stages of treatment (including after surgical intervention).

Received: 2024-03-11

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.015

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VIEWS 1676

Kolomiets KV, Afashagova ZR, Erendzhenova DE, Bashirova AS, Falchari VV, Babayeva NE, Aliyeva AD, Kurmalieva RZ, Fedoseyev YB

Breast cancer (BC) remains the main oncological pathology in the female population. Liver metastases in such cases mean an extremely unfavorable prognosis of the course of the disease. The key predictor of clinical outcome of metastatic BC is the molecular biological subtype of the tumor. The main goals of treatment of metastatic BC are to increase life expectancy, alleviate tumor-related symptoms, and maintain or improve patients' quality of life. Transarterial chemoembolization (TACE) enables new ways of liver metastases control. This article presents a case of application of TACE in combination with hormone therapy and selective inhibitors of CDK4/6 in a patient with unresectable liver metastases seeded by hormone-receptor positive (ER+/PR‒) breast carcinoma with an unknown Her2 status (2+). The approach allowed achieving regression of the oncological process in the liver to the point of unclear CT visualizations of metastatic foci, and proper disease control in the course of 28 months.

Received: 2024-02-19

Published online: 2024-04-29

DOI: 10.24075/brsmu.2024.014

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VIEWS 1690