Research Institute of Medical Problems of the North

Aim: to present clinical guidelines describing the clinical, laboratory, endoscopic and histological characteristics of autoimmune gastritis (AIG) and to provide information support for decision-making on diagnosis, prognosis assessment and choice of management tactics for patients with AIG. Key points. AIG is an organ-specific autoimmune disease characterized by the presence of antibodies to parietal cells and/or intrinsic factor, in which inflammation and atrophy are limited to the gastric mucosa, functionally manifesting as hypo- and achlorhydria. There is evidence of an increase in the incidence of AIG worldwide. AIG is often associated with autoimmune thyroiditis (up to 40 % of cases), type 1 diabetes mellitus, and autoimmune polyglandular syndrome. Data on laboratory diagnostic methods, esophagogastroduodenoscopy, and histological examination of biopsies are presented, with an analysis of the endoscopic and histological picture typical of AIG. When AIG is combined with H. pylori infection, eradication therapy is recommended. In addition to symptomatic treatment and treatment of anemia, long-term rebamipide therapy is recommended to potentiate the protective properties of the gastric mucosa. Endoscopic monitoring of patients with AIG is recommended at intervals of once every 3 years.

Rhinosinusitis is one of the most common diseases in otolaryngology which manifests itself as nasal congestion, headache, nasal discharge and other symptoms. Sometimes rhinosinusitis accompanies seasonal acute respiratory viral infections, being a manifestation of seasonal and year-round allergies, and develops with dysfunction of the immune response. Chronic rhinosinusitis (CRS) is diagnosed if the symptoms of rhinosinusitis last for >12 weeks. Comorbid conditions (curvature of the nasal septum, bronchial asthma, etc.) increase the manifestations of CRS. The purpose of our work was to study the features of cytokine regulation in CRS with comorbid diseases. 84 persons with rhinosinusitis and 100 healthy controls were involved. The study included patients with CRS (n = 29), CRS and deviated septum (n = 24), CRS with bronchial asthma (n = 31) and a control group (n = 100) consisting of practically healthy individuals. The case–control study was performed in Laboratory of Clinical Pathophysiology at the Research Institute of the Railway Ministry. The studied materials were venous blood and nasal discharge. The content of TNFα, IFNγ, IL-2, IL-6, IL-4, IL-10 was determined by ELISA technique using JSC "Vector-Best" reagents (Novosibirsk, Russia) and a Muitiskan FC spectrophotometer. Statistical processing was performed using the Statistica 10.0 program. To describe samples with a distribution different from normal, we used the median (Me) and interquartile range (IQR), defined as the difference between the 25 th (Q 0.25 ) and 75 th (Q 0.75 ) percentiles. This approach allows us to present the central tendency and measure of data dispersion, minimizing the impact of outliers (Wilcox, 2012). All patients with CRS and comorbid conditions systemically and locally show unidirectional changes manifesting as an increase in proand anti-inflammatory cytokines, thus suggesting the development of immune responses by Th1/Th2 mechanisms. The presence of comorbid conditions (curvature of the nasal septum, bronchial asthma) enhances the immune response. In comorbid conditions, the content of cytokines is statistically significantly increased relative to both control group and patients with CRS. Maximum concentrations of cytokines are detected when CRS was combined with bronchial asthma.

BACKGROUND: The functional state of neutrophils plays a key role in the pathogenesis of sepsis; however, the effect of lactate on their phagocytic activity and the production of reactive oxygen species (ROS) remains insufficiently studied. Current data are limited to general concepts regarding the impact of lactate on the immune system, whereas information on the response of neutrophils from patients with sepsis to in vitro lactate exposure is scarce. AIM: This work aimed to investigate the effect of in vitro lactate exposure on phagocytosis and ROS production by neutrophils in patients with sepsis. METHODS: The study included patients with confirmed sepsis (n = 28) and healthy volunteers (n = 18). Blood samples were collected on the first day after hospitalization and diagnostic confirmation. The phagocytic activity of immature and mature neutrophils was assessed by flow cytometry. ROS production was evaluated using chemiluminescence analysis. All experiments were performed under standard conditions (control) and with in vitro lactate exposure. RESULTS: Under control conditions, the phagocytic index of mature neutrophils did not differ between healthy donors and patients with sepsis; however, the mean fluorescence intensity was higher in septic patients. Lactate moderately increased the phagocytic index in patients without affecting control values, whereas the elevated fluorescence level persisted. Immature granulocytes demonstrated a similar pattern. Spontaneous and stimulated lucigenin- and luminol-dependent chemiluminescence in patients with sepsis were characterized by a prolonged time to peak, reduced intensity, and a smaller area under the curve, indicating suppression of neutrophil function. Lactate exposure further increased the time to peak. CONCLUSION: In sepsis, neutrophils preserve phagocytic activity (regardless of maturation stage), but the respiratory burst is delayed. In vitro lactate exposure enhances phagocytosis with virtually no effect on ROS generation, suggesting its selective modulation of neutrophil functions and potential to promote inflammatory activity while attenuating the mechanisms of completed phagocytosis.

Introduction. To date, there are a number of relevant studies devoted to changes in the LPO-AOP system indicators in adolescents and young adults with migraine. However, specific quantitative data and relationships between LPO-AOP indicators and migraine require further study. The aim of the study was to evaluate migraine-specific LPO-AOZ indices in adolescents and their associations with age and gender of patients. Material and methods. The study included 104 adolescents aged 12–17 years (boys and girls), comprising 66 participants with migraine (index group) and 38 without migraine (comparison group). The diagnosis was verified using a standardized screening questionnaire in accordance with the International Classification of Headache Disorders, 3rd edition (ICHD-3), which allowed confirmation of migraine and exclusion of other primary headache disorders. Components of the lipid peroxidation–antioxidant defense (LPO–AOD) system were quantified by spectrophotometric methods. Data were processed in Statistica 12 (TIBCO/StatSoft). Results. Adolescents with migraine showed higher malondialdehyde (MDA) levels in both plasma and erythrocytes, alongside reduced erythrocyte superoxide dismutase (SOD) activity. Compared with controls, the migraine group contained a larger proportion of participants with elevated plasma and erythrocyte MDA and with diminished erythrocyte antioxidant enzyme activities, particularly SOD and catalase (CAT). Conclusion. Migraine in adolescents is associated with a higher concentration in plasma and red blood cells of the pro–oxidant component of oxidative stress – MDA and lower activity of the enzymatic link of antioxidant protection – SOD and CAT, which indicates a more pronounced intensity of oxidative stress in this contingent. Given the significant role of the imbalance of the POL-AOР system in the development of oxidative stress, the increase in MDA and decrease in SOD and CAT activity that we have identified can probably be regarded as metabolic markers of the presence and/or risk of migraine. This assumption can be confirmed by further research.

Purpose. To study the differences in the indicators of autonomic regulation in children and adolescents with recurrent headaches (RH). Materials and methods. 84 people aged 7–17 years were examined – patients of the pediatric department, of which 40 (47.6%) were boys and 44 (52.4%) were girls; the median age was 16 (15; 17)] years. The features of vegetative regulation were assessed by the method of cardiorhythmography with the orthostatic test and cardiovascular tests according to the method of R.M. Baevsky using the device "VNS-spectrum". The indicators were compared in groups with the presence of RН (n=68) and without RН (n=16), as well as in groups formed taking into account the presence/absence of RН, gender and age. Results. In patients with RН, a predominance of the sympathetic division of the autonomic nervous system (ANS) was revealed, confirmed by the presence of statistically significant differences in the quantitative values of the studied indicators of autonomic regulation. Discussion: Considering the significant role of the ANS in regulating the activity of organs and systems, the sympathicotonic orientation of the regulatory function of the ANS that we have identified, this can be regarded as a state of tension in the adaptive capabilities of the body of children and adolescents associated with the presence of RН. This assumption can be confirmed by further studies. As a medical correction, it is possible to use the sedative Nervo-Vit and the adaptogen Leveton P.

This article continues our series of works devoted to the diagnosis of immunopathological syndromes in various diseases. The analysis of these syndromes provides deeper insight into the pathogenetic mechanisms underlying disease development, which is critically important for timely diagnosis and effective therapy. The present study examines immunopathological syndromes associated with adaptive immunity. Systemic immunopathological reactions of the cellular and humoral components of the immune system are characterized, and syndromes typical of type I, II, and III cellular responses are identified. Manifestations associated with impaired immunosuppression are also described. In evaluating immunopathological syndromes of the humoral immune system, differentiation by immunoglobulin classes—A, M, E, and the four subclasses of immunoglobulin G—is proposed. In this discussion article, we aim to unify the definitions of immunopathological syndromes related to adaptive immunity. Our primary goal is to provide clinicians with conceptual foundations for understanding their mechanisms of formation, thereby opening new therapeutic opportunities. We also seek to standardize key approaches to the assessment, staging, and treatment of these syndromes.

The relevance of the analysis of functional disorders of the gastrointestinal tract in children is largely due to the possibility of early prevention of severe forms of its pathology. The aim of the study was to determine changes in the activity of Helicobacter pylori-associated gastritis in schoolchildren with gastroesophageal reflux disease (GERD). Materials and methods. One thousand seventy nine children aged of 7–17 years were examined. Clinical manifestations of gastrointestinal pathology were identified in all children. An endoscopic examination of the upper gastrointestinal tract with a biopsy of the gastric mucosa was performed in 115 schoolchildren with gastroenterological complaints. Morphological diagnosis of gastritis and H. pylori infection was GERD (34 schoolchildren with GERD and 81 child without pathology), which was diagnosed in accordance with the children’s consensus. The significance of the feature differences was analyzed using the Pearson χ2 criterion. The differences were considered to be significant at p < 0.05. Results. The examined schoolchildren had gastritis of the 1st degree of activity, both in the antrum and even more often in the mucous membrane of the stomach body. At the same time, there were no changes in the activity of gastritis in both parts of the stomach in children, depending on the presence of GERD. Gastritis associated with H. pylori infection was detected in 53.8% of GERD children and 58.7% of cases without GERD (p = 0.672). In H. pylori-positive children, an increase in gastritis activity was detected. In infected with H. pylori children with GERD, there was no significant increase in the activity of the inflammatory process in both parts of the stomach. However, in H. pylori-positive schoolchildren without GERD, both in the antrum and in the stomach, increased gastritis activity was observed (p = 0.038), primarily expressed in younger schoolchildren (p = 0.044) and Tuvinians (p = 0.039). Conclusion. An increase in the activity of inflammation in the gastric mucosa in schoolchildren, regardless of the presence of clinical manifestations of GERD, is observed in gastritis associated with H. pylori infection.

The problem of ulcerative colitis (UC) is becoming increasingly relevant due to its prevalence and combination with psychological disorders. UC is associated with alterations in the intestinal microbiocenosis as one of the factors reducing tolerance to self-antigens. In addition, patients with UC often experience anxiety, depression and other negative emotional and psychological factors aggravating the course of the underlying disease. The study presented by Wang et al shows that the traditional Chinese medicine Wuling can exert its therapeutic effect by reversing the aberrant precursor of brain-derived neurotrophic factor (BDNF)/ BDNF signaling in mice with UC and depression. The combination of Wuling powder with mesalazine can exhibit an antidepressant effect and reduce intestinal inflammation. Undoubtedly, the study by Chinese authors deserves attention, and changes in the balance of precursor of BDNF/p75 neurotrophin receptor/sortilin and BDNF/tropomyosin receptor kinase B signaling may become a novel therapeutic target for clinical treatment and further development of research.

Back pain (dorsalgia) in adolescents associated with bronchial asthma is an urgent interdisciplinary problem in modern medicine that attracts the attention of scientists and practitioners. The aim of the work was to study the frequency and structure of back pain in adolescents with bronchial asthma, substantiating the need for their correction to improve the controllability of the disease. The article analyzes differences in the frequency and structure of back pain of various localization (in the cervical, thoracic, lumbar spine and their combinations) in adolescent patients of the pulmonary allergy center with bronchial asthma (controlled, partially controlled and uncontrolled). The results of our own research revealed the features of asthma in patients, depending on the severity, phase of the disease and severity of respiratory failure. Comparability of the frequency of recurrent dorsalgia among patients with and without asthma has been established, a high incidence of cervical and combined pain localization in patients with uncontrolled asthma, pain in the thoracic spine in patients with controlled asthma, and lumbar pain localization in patients with partially controlled asthma. Conclusion. The authors conclude that it is necessary to continue scientific research on the prevalence and structure of dorsalgia in adolescents with asthma, and the validity of their pharmacological correction to increase disease control, improve treatment effectiveness, and improve prognosis in this pathology.

Objective. To analyze the potential risks and technological limitations of using genome editing methods in neurodegenerative diseases, as well as to assess the prospects for their implementation in clinical practice. Material and methods. A systematic analysis of the literature for the period 2014–2024 in the databases PubMed, Cochrane Library, ClinicalTrials.gov, SAGE Premier, Springer and Wiley Journals. The key risks of using genome editing technologies are considered, including inappropriate effects, immunological reactions, and long-term consequences of changes in the DNA of nervous tissue. Results. The main technological limitations are analyzed, including problems of delivery across the blood-brain barrier, low editing efficiency in postmitotic neurons, and the complexity of long-term expression of components of editing systems. The prospects of introducing technologies into clinical practice are assessed, taking into account the current regulatory landscape in various countries. Conclusion. Despite significant technological challenges and potential risks, the development of genome editing techniques opens up prospects for the creation of effective treatments for neurodegenerative diseases. Key areas of further research include improving the safety and specificity of editing, optimizing delivery systems, and developing methods for long-term monitoring of the effects of genetic modifications in the nervous system.