Molekulyarnaya Meditsina (Molecular medicine)

Peer-review medical journal.

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  • Publishing House «Russkiy Vrach»

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  • Publishing House «Russkiy Vrach»

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The journal «Molecular medicine » highlights research results in such areas as the investigation of the molecular and genetic bases of the etiology and pathogenesis of socially significant diseases with the aim to develop new diagnostic methods and Benches-to-bedside to the effective therapy of human diseases, including technology-based nuclear medicine.

Particular attention is given to the formation of principles of personalized medicine based on a fundamentally new approach both to the disease and the patient, in the context of an active introduction into the practice achievements of genomics, proteomics, metabolomics and bioinformatics, using modern knowledge and computer technologies, relying upon a wealth of international experience in this area.

The main efforts are focused as well on the creation of complex genetic cellular bioengineering medical technologies and highly effective drugs of new generation, including directional medicinal agents, drugs based on nanotechnology.

According to the Decision of the Presidium of the Higher Attestation Commission (HAC) the journal "Molecular Medicine" is included into the list of leading peer-reviewed scientific journals, in which the main results of the thesis for the degree of doctor and candidate of sciences should be published.

Journal "Molecular Medicine" is included in the Russian Science Citation Index.

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Vol 24, No 4 (2026)

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Original research

Molecular aspects of improving physical performance in conditions of short-term hypobaric hypoxia and pharmacological pseudohypoxia
Krytsyna U.V., Kharitonova O.V., Pozdnyakov D.I., Temirbulatova A.M., Skulte I.V.
Abstract

Background. Hypoxic training are actively used in both professional and amateur sports. Hypoxia triggers a number of adaptive mechanisms aimed at improving stamina. However, these compensatory and adaptive pathways can be activated through rational pharmacological exposure, inducing pseudohypoxia.

The aim of the study was to compare the molecular mechanisms of performance enhancement in short-term hypobaric hypoxia and pharmacological pseudohypoxia.

Material and methods. Hypobaric hypoxia was simulated in male C57BL/6 mice by placing the animals in a pressure chamber with 14% oxygen content and reduced atmospheric pressure (equivalent to 4000 m above sea level). Pseudohypoxia was reproduced by a course of administration of a succinate dehydrogenase inhibitor – sodium polydihydroxyphenylene thiosulfonate, orally at a dose of 2.1 mg/kg. A combined exposure option was also simulated in animals: hypoxia + pseudohypoxia. After 21 days, the level of physical activity of the animals was recorded in the forced swimming test. Next, the concentrations of Hif-1α, AMP-activated protein kinase, and insulin receptors in muscle tissue, as well as erythropoietin, insulin-like growth factor-1, and cortisol in blood serum were evaluated.

Results. It has been shown that both in conditions of hypobaric hypoxia and pharmacological pseudohypoxia, as well as their combined variants, there is an increase in the concentration of Hif-1α, AMP-activated protein kinase and insulin receptors in muscle tissue. An increase in serum erythropoietin concentration of 51.8% (p < 0.05) was noted in hypobaric hypoxia, which was not observed in the case of pseudohypoxia and combined exposure. It is also worth noting that the physical performance of the animals to which the combined treatment option was applied was significantly higher than in mice that were simulated hypoxia (by 41.8%; p < 0.05) and pseudohypoxia (by 64.1%; p < 0.05). Cortisol concentration are not change in all groups.

Conclusion. In order to increase the level of physical activity through the activation of Hif-1α and insulin-dependent cellular signaling mechanisms, it is advisable to combine hypobaric hypoxic effects and pharmacological pseudohypoxia.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):3-7
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Relationships between growth factors and clinical diagnostic parameters in patients with diabetic foot syndrome
Sycheva D.R., Lutsenko Y.G., Kyshenya M.S., Abramova Y.G., Yasinetskaya E.I.
Abstract

Aim of the study was to establish the relationships between vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF-BB), and transforming growth factor β1 (TGFβ1) and clinical diagnostic parameters in patients with diabetic foot syndrome (DFS) treated with various approaches.

Material and methods. The study included 227 patients with DFS, divided into two groups. The study group included 114 (50.22%) patients who received laser therapy as part of their treatment regimen, while the comparison group included 113 (49.78%) patients who received standard treatment regimens. Blood levels of VEGF, PDGF-BB, and TGF1β were determined using enzyme-linked immunosorbent assay, and markers of carbohydrate and lipid metabolism were measured using a colorimetric method. The duration of diabetes, the time of ulcer formation and healing rate, and the degree of foot tissue damage according to Wagner were also assessed.

Results. Healing of diabetic wounds was more active with laser therapy and was associated with increased levels of PDGF-BB (p < 0.001) and TGF1β (p = 0.032), and a decrease in VEGF to control values (p = 0.014). In the comparison group, no relationship was found between TGF1β levels and wound healing (p = 0.252), indicating low fibroblastogenesis activity with traditional diabetic foot treatment. A relationship was found between the decrease in HbA1c in the study group and levels of VEGF (p = 0.001) and PDGF-BB (p < 0.001), but no relationship was found for TGF1β (p = 0.054), which is due to the influence of tissue glycation on the proliferative potential of fibroblasts in diabetic foot disease.

Conclusion. VEGFА and PDGF-BB growth factors were molecular predictors of the degree of tissue damage in the diabetic foot. Determining the role of growth factors in diabetic wound healing is important for developing a personalized approach to treating diabetic foot syndrome and predicting the risk of complications.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):8-14
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Modeling of metabolic syndrome in mice and its pharmacological correction
Solomina A.S., Kachalov K.S., Rodina A.V., Durnev A.D.
Abstract

Introduction. Metabolic syndrome is a cluster of interrelated disorders of carbohydrate and lipid metabolism and requires reproducible experimental models suitable for pharmacological screening. Long-term exposure of laboratory animals to high-calorie diets can reproduce individual features of metabolic syndrome but substantially limits the rapid search for potential pharmacological correctors.

Objective. To model metabolic syndrome in female and male CBA/lac mice using a high-calorie diet combined with repeated tyloxapol administration and to perform a screening evaluation of the ability of the nerve growth factor mimetic GK-2 to correct carbohydrate and lipid metabolism disorders in comparison with the reference drugs metformin and glimepiride.

Material and methods. The study was performed in male and female CBA/lac mice aged 8–9 weeks. Metabolic syndrome was modeled by maintaining the animals on a high-calorie diet for 2 months and 3 weeks; from the beginning of the third month, tyloxapol was administered intraperitoneally at a dose of 200 mg/kg once every 3 days for 3 weeks. Pharmacological correction consisted of daily oral administration of metformin at 250 mg/kg, glimepiride at 4 mg/kg, or GK-2 at 10 mg/kg. Body weight, fasting blood glucose, glucose tolerance, insulin concentration, the HOMA-IR insulin resistance index, total cholesterol, triacylglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were assessed.

Results. The combination of a high-calorie diet and repeated tyloxapol administration reproduced a cluster of metabolic syndrome-related abnormalities in mice of both sexes, including increased body weight, elevated fasting glucose, impaired glucose tolerance, and increased total and low-density lipoprotein cholesterol levels. Glimepiride predominantly corrected carbohydrate metabolism abnormalities. The effects of metformin depended on animal sex and the parameter assessed. GK-2 at a dose of 10 mg/kg reduced blood glucose levels in mice of both sexes, decreased HOMA-IR in females and males, and exerted favorable effects on lipid metabolism parameters. Among the pharmacological interventions studied, a statistically significant reduction in low-density lipoprotein cholesterol in male mice with metabolic syndrome was observed with GK-2 treatment.

Conclusion. A combination of a high-calorie diet and fractional tyloxapol administration reproduces, within a relatively short period, a cluster of abnormalities characteristic of metabolic syndrome in male and female CBA/lac mice and may be suitable for pharmacological screening. GK-2 at a dose of 10 mg/kg demonstrated an ability to correct carbohydrate metabolism disorders comparable to that of glimepiride and showed a potentially relevant effect on selected lipid profile parameters, supporting its further investigation as a possible pharmacological corrector of metabolic disorders.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):15-22
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Holistic multiprofile model of cardiometabolic risk: from preclinical phenotyping to structural and functional damage to the heart and blood vessels
Khabibulina M.M., Salikova S.P., Seliverstov P.V., Fedorets V.N., Tsurtsumiya D.B., Shamilov M.D., Alieva P.M., Chupanova A.T., Davydova D.R.
Abstract

Introduction. Non-communicable diseases develop long before clinical manifestation, and their subclinical signs may be missed by one-dimensional risk assessment. A holistic multiprofile approach combining somatic, psychoemotional and behavioural determinants may improve cardiometabolic risk stratification.

Objective: to validate the applicability of a holistic multiprofile model of cardiometabolic risk assessment at the preclinical and clinical stages of its development.

Material and methods. Block 1 included 177 women with oestrogen deficiency and grade I–II arterial hypertension: 85 with normal body weight and 92 with metabolically healthy abdominal obesity; the control group included 90 apparently healthy women. Echocardiography, brachial artery endothelium-dependent vasodilation testing, common carotid artery duplex scanning, Holter monitoring, ambulatory blood pressure monitoring, laboratory assessment and psychosomatic profiling were performed. Block 2 included remote multiprofile screening of 3155 students and cluster analysis of a prospective follow-up group of 157 participants.

Results. In women with metabolically healthy abdominal obesity, despite comparable blood pressure levels, more pronounced endothelial dysfunction, left ventricular remodelling, diastolic abnormalities and an unfavourable psychosomatic profile were revealed. In the preclinical block, 56.4% of young adults had medium or high risk in at least one non-communicable disease profile, and 75.7% had multiprofile risk. Cluster analysis identified 4 phenotypes with distinct psychosomatic patterns.

Conclusion. The holistic multiprofile approach detects clinically significant differences hidden by one-dimensional risk assessment and may serve as a basis for personalized cardiometabolic stratification.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):23-31
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The effect of GHK-PGP peptide and its analogues on the rat’s behavior in the forced swimming test
Alferova M.E., Bobyntsev I.I., Vorvul A.O., Tenkova A.N., Andreeva L.A., Myasoedov N.F.
Abstract

Introduction. The Gly-His-Lys (GHK) peptide, which is a fragment of type I collagen, has a wide range of biological effects, including neurotropic ones, and has an anxiolytic and analgesic effect. However, GHK is susceptible to proteases and various proline-containing amino acid sequences were added to the C-terminus to increase the duration of its effects.

Purpose of the study. Study of the behavior of rats in the forced swimming test using the GHK-PGP peptide and its structural analogs.

Material and methods. The experiments were performed on 200 male Wistar rats weighing 170–190 g. The work used peptides synthesized in the Laboratory of Molecular Pharmacology of Peptides of the National Research Center “Kurchatov Institute” (GHK, Pro-Gly-Pro (PGP), Gly-His-Lys-Pro-Gly-Pro (GHK-PGP), Gly-His-Lys-Gly-Pro (GHK-GP), Gly-His-Lys-Pro (GHK-P), Gly-His-Lys-Val-Glu-Pro (GHK-VEP)), which were administered intraperitoneally 15 min before the experiment at doses of 0,5; 5,0 and 50,0 μg/kg. Animal behavior was assessed using a forced swim test.

Results. GHK at a dose of 5,0 μg / kg caused a decrease in motor activity, and the PGP peptide at doses of 0,5 and 50,0 μg/kg had a pronounced antidepressant effect. GHK-PGP had an antidepressant effect only at a dose of 5,0 μg / kg. Thus, in the total GHK-PGP molecule, the PGP peptide neutralized the effect of GHK and was its structural part, determining this type of biological activity. GHK-GP had no effects at all doses. The GHK-VEP peptide had an antidepressant effect at a dose of 0,5 μg / kg.

Conclusion. GHK-PGP and its structural modifications using proline-containing amino acid sequences affect behavior in the forced swim test in rats, while the anxiolytic effect of GHK is neutralized with the appearance of an antidepressant effect.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):32-35
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SNCA long 3’UTR transcripts in patients with synucleinopathy
Karan L.S., Abramycheva N.Y., Minaev I.V., Krutyakova T.A., Protopopova A.O., Protsenko A.R., Berdalina I.A., Fedotova E.Y., Illarioshkin S.N.
Abstract

Introduction. Post-transcriptional and post-translational modifications of the alpha-synuclein protein are considered important links in the pathogenesis of Parkinson’s disease (PD) and multiple system atrophy (MSA). Regulation of mRNA stability and translational activity is primarily provided by the 3’untranslated region (3’UTR). The proportion of long 3’UTRs (3’UTR-L) is currently considered as a risk factor for PD.

Aim of the study. To assess the proportion of 3’UTR-L SNCA transcripts with in patients with PD and MSA, and the influence of single nucleotide polymorphisms (SNPs) in this gene on the 3’UTR-L/total SNCA mRNA ratio.

Material and methods. The concentration of SNCA and 3’UTR-L mRNAs was determined in blood leukocytes of 84 patients (Russian population) with PD, 50 patients with MSA, and 49 healthy volunteers, by quantitative RT-PCR. The proportion of 3’UTR-L was expressed as a percentage of the total SNCA mRNA. SNP was determined by Sanger sequencing.

Results. Overall, the proportion of 3’UTR-L did not differ significantly between the PD, MSA, and control groups: in PD, the median proportion of 3’UTR-L was 30.9%, in MSA – 28.5%, in the control group – 29.8%, p = 0.21. A decrease in the proportion of 3’UTR-L by 15–21% relative to the median value for the group was detected in PD patients in association with the «risk» genotype GG at rs356168, rs356165, and rs3756063; in the MSA patient group, a decrease of 13–15% was also noted in relationship with the GG genotype at rs356168, rs356165, and the CC genotype at rs2737029. An increase in the proportion of 3’UTR-L by 17% was noted only in the PD group for “protective” genotype AA at rs356168 and rs356165.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):36-43
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Effect of phytocomposition based on B. vulgaris, C. bergamia, D. villosa and L. meyenii on the state of the germinal epithelium of rat testes on a high-fat diet
Sinyavskaya A.M., Deulin I.Y., Palchikova N.A., Selyatitskaya V.G., Voevoda M.I.
Abstract

Introduction. Plant biologically active compounds are considered as potential means of correcting reproductive function in obesity, but the molecular and cellular mechanisms of their action remain poorly understood.

The purpose of the study. To study the effect of a phytocomposition (PC) based on extracts of bergamot fruit (Citrus Bergamia), dioscorea rhizome (wild yam, Dioscorea Villosa), barberry fruit (Berberis Vulgaris) and Peruvian maca root (Lepidium Meyenii) on the state of the germinal epithelium of rats kept on a standard diet (SD) or a high-fat diet (HFD).

Material and methods. Male Wistar rats (n=63) were divided into 8 groups (Gr). During 4 and 7 weeks, animals Gr1 and G5, respectively, received SD (the proportion of fat in total calories was 11%), Gr2 and Gr6 – SD + PC, Gr3 and G7 – HFD (the proportion of fat in total calories was 36%), Gr4 and Gr8 – HFD + PC. After removing the animals from the experiment, histological sections were stained with hematoxylin and eosin to study the morphology of the testes. An indirect streptavidin peroxidase method was used for the immunohistochemical study.

Results. After 4 weeks of keeping rats on HFD, a decrease in Ki-67 and vimentin expression, a 60% increase in caspase 3 expression, a 22% decrease in the number of Leydig cells were found in the testes; after 7 weeks, the revealed shifts were joined by a decrease in tubule diameter by 18% and a decrease in the height of the germinal epithelium by 25%. Simultaneous administration of PC partially compensated for the revealed disorders in HFD, the most pronounced effect on the increase in expression was found for vimentin.

Conclusion. HFD causes degeneration of the testes, disrupting the balance of proliferation and apoptosis, FC has a protective effect, increasing proliferation and reducing apoptosis, preserving the structure of tubules and cellular composition.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):44-51
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Artificial intelligence and multimodal phenotyping of obesity: a path toward personalized molecular medicine
Grinevich V.B., Zakrevsky V.V., Kravchuk Y.A., Seliverstov P.V., Auzina A.A., Russkova A.I., Chernova E.S., Salikova S.P.
Abstract

Introduction. Body mass index remains a convenient screening tool but fails to capture fat distribution, body composition, molecular inflammatory status, psychobehavioral features, or obesity-related end-organ dysfunction.

Objective. To develop and substantiate the methodological architecture of a multimodal obesity phenotyping platform using machine-learning algorithms; to define the analytical toolkit for each clinical-biological domain; and to demonstrate the diagnostic capacity of the platform to discriminate clinically similar but molecularly distinct obesity phenotypes using modelled clinical scenarios.

Material and methods. An analytical, conceptual-modelling study was performed. A systematic review of PubMed/MEDLINE and Scopus publications (2021–2026) was conducted. An eight-domain phenotyping matrix, ML-algorithm stack, and two-tier CDSS architecture were developed in compliance with TRIPOD+AI, DECIDE-AI, CONSORT-AI, and SPIRIT-AI standards. Diagnostic value was demonstrated through two simulation-based clinical scenarios built on published ranges of real clinical parameters.

Results. A hierarchical two-tier system is proposed: an Authors’ Integral Obesity Index as a first-line screening tool (a metabolic modification of previously developed and registered risk-stratification algorithms) and a multimodal AI platform as a second-line precision diagnostic ecosystem. The simulation scenarios confirmed the platform’s ability to discriminate clinically meaningful molecular differences between patients sharing identical BMI values.

Conclusion. Multimodal obesity phenotyping with AI enables a shift from BMI-centric assessment to personalized clinical stratification. Interpretable algorithms implementing CDSS show the highest practical potential. Prospective clinical validation is the next essential step.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):52-59
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Reviews

Spatial analysis of tissue microenvironment functional morphology: multidimensional visualization techniques and artificial intelligence
Atiakshin D.A., Poddubsky A.A., Demyashkin G.A., Rezaian N., Saridis M.R., Prikhodko A.T., Alekhnovich A.V., Kostin A.A., Paltseva E.М.
Abstract

Objective. To systematically categorize contemporary approaches and technologies for visualizing structural components of the tissue microenvironment (TME), with a focus on the advantages, limitations, and data analysis strategies of multiplex immunohistochemistry.

Material and Methods. A comprehensive literature analysis was conducted using the PubMed, Scopus, and Web of Science databases. The search was restricted to publications from the last 5–7 years.

Results. The integration of multidimensional histology with spatial context and AI-driven analysis establishes a new paradigm of informativeness in functional morphology. Current spatial profiling techniques – including macro- and microdissection, barcoding, optical imaging, and mass spectrometry imaging - differ substantially in resolution, multiplexing capacity, and the types of molecular markers they can analyze. Among optical imaging methods, multiplex immunofluorescence (mIF) offers distinct advantages: high sensitivity, preservation of tissue structural and biological integrity, reliable objectivity in cell detection within the histoarchitectural context, and robust validation of results through accessible quality control of immunolabeling at each stage of the staining design. mIF-based spatial proteomics is technologically accessible and cost-effective compared to other omics technologies, positioning it as a promising tool of choice for functional morphology in both normal and pathological states. The integration of artificial intelligence into whole-slide image analysis enables automated cell segmentation, classification, and subsequent statistical evaluation.

Conclusion. The convergence of visualization technologies and spatial analysis of the tissue microenvironment provides unprecedented opportunities to uncover fundamental principles of biological organization at the tissue, cellular, and molecular levels. This creates a novel informational framework for the development of translational biomarkers, enhances the informativeness of diagnostic and prognostic algorithms, and improves therapeutic efficacy within the paradigm of personalized medicine.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):60-70
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Absence of muscle atrophy in some rheumatic diseases: fundamental and applied aspects of paradoxical preservation of inflammatory muscles
de Carvalho J.F., Churilov L.P., de Araujo R.C.
Abstract

Introduction. Although chronic inflammation is typically associated with tissue catabolism and wasting, most autoimmune rheumatic diseases, including polymyositis, dermatomyositis, lupus myositis, and overlap myopathies, as a rule paradoxically display preserved muscle trophism, despite significant weakness and pathohistological signs of inflammation. Only inclusion body myositis (IBM) typically exhibits progressive and irreversible muscle atrophy.

Aim. This article proposes the hypothesis that a unique immunometabolic equilibrium in rheumatic myopathies maintains muscle mass despite inflammation and provides a review of data supporting it.

Material and methods. PubMed/MEDLINE, EMBASE, elibrary.ru and Scielo bibliographic databases were screened for articles on “Rheumatic diseases” AND “Muscle preservation” as well as on “Muscle preservation” AND “Organokines” OR “Cytokines” between 1965 and 2025, without any language restrictions.

We discuss possible mechanisms involving mitochondrial biogenesis, satellite cell activation, myokine and other cytokines modulation and effects of autoantibodies. The interplay of these links may counteract proteolysis and autophagy-related muscle degeneration. The phenomenon is interpreted in the context of I.I. Mechnikov’s idea of the struggle for existence between the cells of the same multi-cellular organism, and in comparison with other examples of organokine-mediated influences on the logistics of the body, when locally produced autacoids serve for re-distribution of resources.

Conclusion. Muscle preservation in some rheumatic autoimmunopathies may result from conflict of local and systemic defensive programs altering metabolic logistics. Understanding this paradox may reveal novel therapeutic insights into tissue preservation, muscle regeneration, and the interplay between immunity and metabolism in chronic autoimmune diseases.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):71-80
pages 71-80 views
Metabolic pathways and systemic significance of iron-regulating molecules in microorganisms
Boiko O.V., Terentiev A.A., Nikolaev A.A., Kozak D.M., Kriventsev Y.A., Bisalieva R.A., Mukhamedzyanova R.I., Akhmineeva A.K., Ivanova M.P., Medina M.Y., Kriventsev M.Y.
Abstract

The review aims at analyzing the present-day knowledge of iron-regulating molecules in microorganisms: their synthesis, secretion, the transport systems that facilitate iron uptake into the cell, the role of these molecules in the development of pathological processes in the human body, and the prospects for their use in developing a new generation of antimicrobial agents.

Material and Methods. The authors analyzed full-text articles published in PubMed/Medline from 2021 to 2026. The analysis included full-length articles only. A search for the term “iron-regulating molecules of microorganisms” yielded 78 articles for the specified period. 43 articles that did not correspond to the target topic were excluded from the total list. In total, the analysis included 34 publications found through electronic searching and 16 manually-retrieved articles.

Results. Iron is a mineral essential for the normal functioning of almost all forms of life, and pathogenic microorganisms are no exception. Acting as a cofactor, iron ions are involved in various biochemical processes: the synthesis of nucleic acids and proteins, the regulation of virulence factor expression, the metabolism of reactive oxygen species; therefore, its bioavailability is crucial for the metabolism of bacteria and fungi. In the human body, the level of free iron ions is extremely low, since most of it is either in a stored state or bound to metabolic and transport molecules. Thus, despite the abundance of iron in the human body, the amount available to potential pathogens is negligible. To address this deficiency, many microorganisms have developed systems that allow them to thrive under the deficiency of this chemical element in the host organism. Conclusion. The main functions of iron-regulating molecules consist in converting iron bound to proteins or water-soluble compounds into an ionic form accessible to microorganisms. The loss of the ability to synthesize these molecules correlates with a loss of virulence in microorganisms.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):81-88
pages 81-88 views
Alpha-Synuclein: from structural biology and conformational dynamics to molecular mechanisms of neurotoxicity
Kolotieva N.A., Salmina V.V., Guk P.V., Voronina V.S., Rossokhin A.V., Salmina I.V., Tregub P.P., Kudlay D.A., Illarioshkin S.N.
Abstract

Objective. To systematize current knowledge on the structural organization, conformational dynamics, and mechanisms of membrane toxicity of alpha-synuclein, as well as to analyze the role of age-associated impairment of proteostasis systems in the pathogenesis of synucleinopathies.

Material and methods. A literature review was conducted covering publications indexed in PubMed, Scopus, Web of Science, and eLibrary databases for the period 2010 – 2026.

Key Findings. Soluble prefibrillar oligomers, capable of integrating into the lipid bilayer and forming annular pores, possess the greatest damaging potential in synucleinopathies. An original hypothesis is proposed for the formation of a transmembrane pore based on the parallel stacking of NAC domains without register shifting and lateral association of subunits forming a hydrophobic interface, geometrically classified as a composite prismatoid or scutoid.

Conclusion. Understanding the molecular mechanisms of oligomer membrane toxicity and age-related proteostasis failure opens new horizons for the development of pathogenetic therapies and substantiates the implementation of highly sensitive methods for early preclinical diagnosis.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):89-95
pages 89-95 views
Transformation of spiral arteries during pregnancy: pathogenic parallels between preeclampsia and placenta accrete spectrum
Nizyaeva N.V., Milyutina E.R., Makhmutova M.R., Plakhotina E.N., Fokina T.V., Gabitova N.A., Adamov Y.I., Belousova T.N.
Abstract

Introduction. Spiral artery transformation is a key physiological process of pregnancy that establishes low-resistance uteroplacental blood flow. It involves trophoblast invasion of the vascular wall, replacement of the endothelium, and disruption of the smooth muscle layer, resulting in dilated vessels that lose vasomotor control. Abnormalities of this process have traditionally been associated with preeclampsia; however, current evidence indicates a more complex and heterogeneous pathogenesis. Altered pathways of trophoblast invasion and its interactions with vessels of the uteroplacental region are also of major importance in placenta accreta spectrum (PAS).

Objective. To analyze and compare current evidence on the mechanisms of spiral artery transformation, patterns of trophoblast invasion, and shared pathogenetic pathways in preeclampsia and PAS.

Material and methods. An analytical review of published scientific data on physiological and pathological spiral artery remodeling, molecular mechanisms of trophoblast invasion, angiogenic imbalance, hypoxia, inflammatory responses, matrix metalloproteinase expression, and cell adhesion molecules in preeclampsia and PAS was performed. Morphological, molecular, and pathogenetic findings were comparatively synthesized.

Results. Impaired spiral artery transformation is an important but non-universal mechanism of preeclampsia and appears to be predominantly associated with specific disease phenotypes. In PAS, the absence or deficiency of decidual cells plays a key role, disrupting the physiological regulation of trophoblast invasion and altering the direction of trophoblast cell spread. Under these conditions, trophoblast cells may spread through the myometrium and invade the vascular wall from the adventitial side. Preeclampsia and PAS share several pathogenetic pathways, including hypoxia, disturbances in angiogenic balance, altered expression of matrix metalloproteinases and cell adhesion molecules, and activation of proinflammatory responses. However, trophoblast functional status differs between these conditions: preeclampsia is associated with trophoblast dysfunction, injury, and shedding, whereas in PAS a relatively preserved trophoblast, in the setting of absent or deficient decidual cells, may spread in an unregulated manner into the myometrium.

Conclusion. Preeclampsia and PAS represent distinct clinical and morphological patterns of disturbed interactions among trophoblast, decidual cells, and vessels of the uteroplacental region. Despite differences in the direction and morphological manifestations of invasion, shared molecular and pathogenetic mechanisms support consideration of these conditions within a broader concept of abnormal trophoblast invasion. Further investigation of spiral artery transformation and trophoblast phenotypic plasticity may improve understanding of disease mechanisms and contribute to more accurate diagnosis of placenta-associated pregnancy complications.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):96-103
pages 96-103 views
Antigen-specific skin tests for detecting tuberculosis infection before biologic and targeted therapy: molecular and immunological foundations and clinical interpretation
Kudlay D.A., Borodulina E.A., Amosova E.A., Lvova M.A.
Abstract

Introduction. The expanding use of biologic agents, targeted synthetic drugs, and other immunosuppressive treatments has increased the importance of testing for tuberculosis infection in patients at risk of developing tuberculosis disease. Mycobacterium tuberculosis antigen-based skin tests using ESAT-6 and CFP-10 constitute a new class of immunological tests that combine a specific antigenic platform with the operational format of a skin test.

Objective. To summarize the molecular and immunological basis, diagnostic capabilities and limitations of Mycobacterium tuberculosis antigen-based skin tests and to define their place in the comprehensive assessment of patients before biological, targeted, and immunosuppressive therapy.

Material and methods. A narrative review of publications indexed in PubMed, Scopus, Web of Science, and eLibrary was conducted, together with an analysis of World Health Organization documents and professional clinical recommendations. Studies addressing the molecular properties of ESAT-6 and CFP-10, the diagnostic performance of the tuberculin skin test, interferon-gamma release assays, and antigen-based skin tests, as well as the risk of tuberculosis associated with drug-induced immunosuppression, were considered. The principal search period was 2015 – 2026; earlier fundamental studies were also included.

Results. ESAT-6 and CFP-10 are encoded within the RD1 region and secreted through the ESX-1 system, which is associated with the virulence of the M. tuberculosis complex. The absence of a functional RD1 region in Mycobacterium bovis (BCG) vaccine strains increases the specificity of ESAT-6/CFP-10-based tests compared with the tuberculin skin test. The TBST products evaluated by WHO include Cy-Tb, previously studied as C-Tb, C-TST, and the ESAT-6/CFP-10 recombinant antigen-based skin test used in the Russian Federation. TBSTs detect an antigen-specific cell-mediated immune response but cannot independently distinguish tuberculosis infection from active tuberculosis disease. In patients with severe immunosuppression, a negative skin test may result from impaired T-cell responsiveness. TBST results should therefore be interpreted together with clinical, epidemiological, radiological, and laboratory findings.

Conclusion. Antigen-based skin tests may be used as one component of the comprehensive assessment of patients before biological, targeted, and immunosuppressive therapy. Test selection and interpretation should take into account the clinical and epidemiological risk, the degree of immune impairment, the class of planned treatment, and applicable national clinical algorithms.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):104-110
pages 104-110 views
Interferon signature as a tool for stratifying response to immunomodulatory complexes of yeast RNA and ascorbic acid: molecular markers and prospects for personalized application
Potupchik T.V., Ermolaev V.V., Generalov S.V., Alikin Y.S., Evert L.S., Fedotova T.S., Grishina K.N., Vladimirova D.S.
Abstract

Introduction. Immunomodulatory complexes based on yeast RNA and ascorbic acid are regarded as a natural multitarget platform capable of affecting innate immune receptors, interferon signaling and cellular redox balance. However, variability of the interferon response to such compositions and the reasons for differences between experimental models, batches and potential patient groups remain insufficiently understood.

Objective. To systematize current concepts of the interferon signature as a tool for assessing and stratifying response to yeast RNA and ascorbic acid complexes, to identify key molecular markers of efficacy and to propose a conceptual framework for their application.

Material and methods. An analytical review of Russian and international publications devoted to innate immunity, receptors recognizing exogenous RNA, interferon response, interferon-stimulated genes, redox regulation, immunomodulatory effects of ascorbic acid and critical quality attributes of RNA-containing compositions was performed.

Basic provisions. The interferon signature may be considered an integrated molecular profile reflecting interactions between the characteristics of the complex, the baseline state of target cells and parameters of innate immune response. The most promising components of this signature include TLR3, TLR7, TLR8, DDX58, IFIH1, MAVS, IRF3, IRF7, IFN-α/β, ISG15, MX1, OAS1, IFIT1 and CXCL10. Cellular redox status represents an important modifying contour.

Conclusion. The interferon signature is the most promising tool for the molecular stratification of the effectiveness of immunomodulatory complexes of yeast RNA and ascorbic acid. Its use makes it possible to move from a general description of immunotropic activity to a predictive assessment of response and to the development of personalized application schemes. The most promising area of further research is the integration of quality control of RNA compositions with a panel of laboratory markers that characterize the readiness of cells for an interferon response and its early implementation.

Molekulyarnaya Meditsina (Molecular medicine). 2026;24(4):111-118
pages 111-118 views