Vol 17, No 4 (2019)

Dendritic cells (DC), as professional antigen-presenting cells with functional plasticity, are widely studied in preclinical and clinical research of vaccines against various types of malignant tumors. Some of the studies DС have proved their efficiency. However, all over the world, there is no officially approved DC vaccine for the treatment of breast cancer. Knowledge and understanding of fundamental functions of DC, as well as the development of methods enhancing the effect of such vaccines, may contribute to the progress in this direction. In this review, we consider the features of the main types of DC and their role in the pathogenesis of breast cancer. Also, we describe the mechanisms of antigen uptake, processing, and presentation. In addition, considerable attention is paid to the current research of DC-based treatment of breast adenocarcinoma as DC are studied both as monotherapy or in combination with other therapeutic strategies.

Introduction. Type 2 diabetes mellitus (DM) is a metabolic disease characterized by prolonged hyperglycemia, which can cause various complications. Some studies have reported on the relationship between changes in cerebral metabolism and glucose levels. The aim of the study. Assessment of the content of brain metabolites in patients with type 2 diabetes. Methods. The study was an observational, one-stage, one-time, selective. Objects - patients with type 2 diabetes aged 45-65 years. All subjects were sampled to determine fasting plasma glucose, glycated hemoglobin (HbA1c), and tau protein. To assess the variability of glycemia was assessed using continuous monitoring for 14 days. Neuropsychological testing was performed using the Montreal cognitive dysfunction scale (MoCA test). Neurochemical changes in the brain were studied using proton spectroscopy (1HMRS) and the analysis of the following metabolites: N-acetylaspartate (NAA), choline (Cho), creatine (Cr), creatine phosphate (Cr2). The main indicators that were determined during this study were fasting glucose levels, HbA1c, glycemic variability coefficients, tau protein levels, MoCA test results, and the content of brain metabolites in the hippocampus. Results. As a result, 48 patients with type 2 diabetes were examined. The level of tau protein in serum was increased in the presence of cognitive disorders and amounted to 44,6 pg/ml, its increase is associated with age, high HbA1c (r=0,211, p=0,034; r=0,342, p=0,006). Anincrease in glycemia variability coefficients is recorded. Patients with type 2 diabetes have cognitive impairment, the MoCA test was 20 points on average. There is an increase in NAA and Cho of the hippocampal region. It has been found that elevated NAA levels are found in patients with high tau protein content, and high HbA1c levels, glycemia lability index and average glucose value in patients with type 2 diabetes with a reduced Cr level in the hippocampus region. Conclusion. Type 2 diabetes occurs with cognitive impairment, changes in brain metabolism and increased tau protein. The model for predicting cognitive impairment according to 1HMRS in patients with type 2 diabetes is 79%

Aim. To study the intergenic interaction and estimate the contribution of polymorphic loci p.K23E (rs5219, KCNJ11), g.15661G>T (rs1501299, ADIPOQ), p.V109D (rs2274907, ITLN1), g.2453G>A (rs7799039, LEP), g.53341C>T (rs7903146, TCF7L2), and p.P12A (rs1801282, PPARG) in the gain of the risk of DM2 using bioinformatics method of multifactor dimensionality reduction (MDR). Material and methods. A study conducted by the «case-control», included 114 patients (61 male (53,5%), 53 females (46,5%)) with DM2 (main group) and 109 patients (61 male (56%), 48 females (44%)) without DM2 (control group). Genotyping was performed by the PCR-RFLP. Analysis of intergenic interactions bioinformatics was conducted by the method of multifactor dimensionality reduction (Multifactor Dimensionality Reduction, MDR). Results. Among studied polymorphic variants the largest contribution to the gain in the risk of DM2 in persons of Kyrgyz nationality is contributee by g.15661G>T (ADIPOQ), and p.K23E (KCNJ11). Genetic markers of the elevated risk of DM2 include: allele T (OR=1,68; 95% CI=[1,09-2,60], p=0,025), the heterozygous genotype GT (OR=1,79, 95% CI=[1,05-3,05], p=0,037) of the polymorphism g.15661G>T (ADIPOQ), and allele A of the polymorphism p.K23E (KCNJ11) - OR=1,62 (95% CI=[1,10-2,38], p=0,019). Polymorphic loci p.V109D (ITLN1), g.2453G>A (LEP), g.53341C>T (TCF7L2) and p.P12A (PPARG) in the progress of DM2 do not have a significant impact individually, but the implementation in phenotypic DM2 they can take place due to the effect of intergenic interactions. In the presence of a genetic profile «CC (g.53341C>T, TCF7L2) / AG (g.2453G>A, LEP) / AA (p.K23E, KCNJ11)» and «CT (g.5341C>T, TCF7L2) / AA (g.2453G>A, LEP) / AG (p.K23E, KCNJ11)» the risk of developing DM2 increases by 5-8 times. Conclusion. For persons of Kyrgyz nationality polymorphic loci p.K23E (KCNJ11) and g.15661G>T (ADIPOQ) are associated with the increased risk of DM2. The loci g.2453G>A (LEP), p.V109D (ITLN1), g.53341C>T (TCF7L2) and p.P12A (PPARG) can affect the phenotypic realization of DM2 in combination with pathogenetically significant genotypes of the genes KCNJ11 and ADIPOQ.

Introduction. Giant cell tumors (GCT) of bones are benign tumors with the potential for the aggressive course and ability to metastasize. GCT accounts for approximately 5% of all primary bone tumors. Materials and methods. The clinical case of the patient L., 35 years old, with a giant cell tumor of the sacrum is presented. During the preoperative examination according to ultrasound, MSCT and MRI, the patient showed the destruction of the cortical sacrum along the internal contour; a large, extra organized in the form of a rounded shape with clear, uneven contours, cystic-solid structure proceeded from this zone. The lesion was hypervascular, with large lacunae filled with blood. The difficulties in the diagnosis of this lesion and the possibilities of surgical treatment are shown. Establishing diagnosis was possible only according to histological and immunohistochemical studies. Results and discussion. The histogenesis of GCT is still unknown and in the International Histological Classification of Bone Tumors is referred to as an independent rubric - tumors of unknown origin. The GCT tissue is represented by 3 cell lines: stromal fibroblast-like, mononuclear macrophages, giant multinucleated cells. Truly tumorous of them are only stromal fibroblast-like cells, the cells of other lines play an important role in the manifestation of the characteristic properties of GCT. Thus, histological examination reveals a complex of characteristic pathological changes in GCT, which, however, can be differently combined and have different severity even in within one large focus, which often makes differential histological diagnosis difficult, especially with a small unrepresentative histo- or cytobioptate. Therefore, it is necessary to perform an immunohistochemical study. Conclusion. Localization of GCT in the pelvis and in the sacrum is extremely rare. However, although only 6% of GCTs are found in the sacrum, these tumors are the second most common type of primary tumor of the sacrum. Due to the extremely rare occurrence of this tumor, despite the criteria for identifying them according to MSCT and MRI, which are quite clearly described in the literature, erroneous preoperative differentiation of this tumor is possible due to the lack of general surgeons, gynecologists and urologists in these departments, with a larger share the chances of such patients getting wary of detecting of GCT of the sacrum