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Vol 18, No 3 (2018)


Diseases associated with complement system dysregulation and the prospects of their treatment

Umnyakova E.S., Pashinskaya L.D., Krenev I.A., Legkovoy S.V., Kokryakov V.N., Berlov M.N.


The lack of pharmaceutical agents that could modulate complement activation is one of the most serious problems in modern medical practice. Meanwhile, the complement system plays a significant role in the pathogenesis of numerous diseases such as age-related macular degeneration (degenerative eye disease, which is the main cause of blindness in the elderly), kidney diseases such as atypical hemolytic-uremic syndrome and membranoproliferative glomerulonephritis type II, paroxysmal nocturnal hemoglobinuria (Marchiafava-Micheli disease), and hereditary angioedema. The complement and its components are involved in the development and progression of autoimmune pathological processes, such as systemic lupus erythematosus, rheumatoid arthritis, and autoimmune hemolytic anemia; neurodegenerative and neoplastic diseases; and complications after heart attacks, strokes, and transplants. This review considers the involvement of complements in the pathological processes, existing methods of treatment, and the prospects for the development of drugs that can correct the work of complement - the most important component of innate immunity.
Medical academic journal. 2018;18(3):7-16
pages 7-16 views

Inflammatory disorders in the pathogenesis of Charcot-Marie-Tooth hereditary polyneuropathy

Voitenkov V.B., Ekusheva E.V., Skripchenko N.V., Klimkin A.V.


In our review, we discuss the inflammatory changes in the pathophysiology of Charcot-Marie-Tooth hereditary polyneuropathy, and this matter is still under further evaluation. Lipid oxidation, inflammatory changes, and blood inflammation agent (e.g., cytokines) concentration changes are important for the pathogenesis of this disorder. Several clinical cases of acute or chronic combination of hereditary and inflammatory polyneuropathies are identified. These clinical cases may be suspected when the typical course of Charcot-Marie-Tooth disease changed to rapid worsening of motor symptoms, inflammatory changes, and pain syndrome. Thus, anti-inflammatory treatment should be considered in these cases.
Medical academic journal. 2018;18(3):17-22
pages 17-22 views

Application of physical factors in complex treatment of puerperas with postpartum endometritis

Veres I.A.


This study aimed to investigate the effectiveness of the complex therapy of postpartum endometritis (PE) using percutaneous electrophoresis of metronidazole in the main group of puerperas (n = 43, mean age 27.6 ± 5.2 years). Patients from the comparison group (n = 42, mean age 26.3 ± 4.1 years) received only basic treatment according to the protocol. This study determined the severity of the main symptoms of PE in puerperas before and after the treatment using the clinical scale. The effectiveness of the treatment was evaluated quantitatively. Electrophoretic percutaneous administration of metronidazole combined with basic drug therapy exerted a pronounced anti-inflammatory effect at the local and systemic levels and reduced the risk of infection in endometritis. Compared with the basic therapy of PE, the high therapeutic effectiveness of electrophoresis with metronidazole was established.
Medical academic journal. 2018;18(3):23-31
pages 23-31 views

Intraportal therapy of autologous bone marrow mononuclear cells in patients on the waiting list for liver transplantation

Granov D.A., Sheraliev A.R., Gerasimova O.A., Polikarpov A.A.


This study was carried out to explore the methodology of intraportal infusion of autologous bone marrow mononuclear cells in patients in the waiting list for liver transplantation. The study included eight patients. The Model for End-Stage Liver Disease (MELD) score as a predictor of hepatic failure exceeds 10 points, i.e., 12-22 points. According to Child-Turcotte-Pugh (CTP) classification, the severity of cirrhosis ranged from class B to C. The bone marrow volume of 224-320 ml was harvested by bilateral aspiration from the posterior iliac crest. The total volume of the mononuclear cells (MNC) was 47.1-58.3 ml (median, 47 ml). The absolute viable count of isolated MNC was 1.24 · 109-5.84 · 109 and CD34+ cells 2.54 · 106-48.20 · 106. After portal vein catheterization, direct transhepatic portography was performed, and portosystemic collaterals were found in all cases. Portal flowmetry was performed to determine the optimal selective perfusion rate of the segmental branches of the portal vein. Portal vein infusion was performed at 0.3-1.5 ml/sec. Serious side effects were not detected during bone marrow harvesting and MNC infusion. All patients had stable condition (no deterioration was initially noticed) after MNC infusion according to the MELD score and CTP criteria during a 3-month observation. Moreover, improvement in physical health status was observed and obtained using the SF-36 questionnaire. This study confirmed the safety of using intraportal therapy of autologous bone marrow MNC in patients on the waiting list for liver transplantation. Herein, we presented the technique of target delivery of autologous bone marrow MNC to the liver to minimize their loss during intraportal infusion. Prolonged follow-up time and improvement of the present technique are needed for further evaluation of the efficiency of autologous bone marrow MNC.
Medical academic journal. 2018;18(3):32-40
pages 32-40 views

Cognitive function in patients with myasthenia gravis

Nalkin S.A., Lobzin S.V., Sokolova M.G.


The study presents the results of a complex neuropsychological examination of patients with myasthenia gravis, which revealed intellectual disorders in 36.6% of cases, i.e., violations of memory processes, decreasing short-term memory level, and rapid deterioration of attention. A study of patients with myasthenia gravis with thymoma (before thymectomy) and patients with disease duration of more than 10 years found more pronounced memory and attention disorders (р < 0.05).
Medical academic journal. 2018;18(3):41-45
pages 41-45 views

Immunohistochemical method of simultaneous detection of neurons and astrocytes in the rat brain

Kalinina Y.A., Sufieva D.A.


This study aimed to develop a method of simultaneous immunohistochemical detection of neurons and astrocytes using peroxidase labeling with subsequent analysis by light microscopy. A pair of antigens, each of which specifically identifies either neurons or astrocytes, was chosen (as markers neuronal nuclear antigen and glial fibrillary acidic protein were used, respectively). This method not only identifies the studied cells, but it also assesses their functional state under normal and pathological conditions. The proposed staining protocol allows significant simplification and optimization to simultaneously detect two antigens and to improve the quality of the slices obtained.
Medical academic journal. 2018;18(3):46-51
pages 46-51 views

Proliferative activity of colorectal adenocarcinoma: objectification of criteria of morphological evaluation

Kovtun D.P., Anichkov N.M., Polushin O.G., Ponomaryeva E.V., Lyubimov A.I., Kalinina E.Y.


Aim of the study. To analyze the correlation between proliferative activities determined on the basis of routine histological staining and immunohistochemical reaction to the nuclear antigen Ki-67 in colorectal adenocarcinomas. Methods. Thirty adenocarcinomas of the colon and rectum were retrospectively evaluated. Evaluation of proliferative activity was performed on serial histological preparations stained with hematoxylin and eosin and treated with antibodies to Ki-67. Calculation was carried out in the “hot spots” under four microscope high power fields (≈1 mm2). Results. An estimate of the Kendall rank correlation coefficient demonstrated a high degree of direct relationship between the number of mitoses counted by routine staining and proliferative activity estimated by the immunohistochemical method (τ = 0.708, p < 0.05). All observations on the dispersion diagram could be divided into three “cloud” clusters with similar values for Ki-67 with practically the same number of mitoses. Conclusions. On the basis of routine histological examination, it is possible to separate colorectal carcinomas from tumors with a low (1-2/mm2), moderate (3-5/mm2), and high (≥6/mm2) mitotic activity corresponding to the proliferation index values of Ki-67 <30%, 30%-50%, and >50%, respectively.
Medical academic journal. 2018;18(3):52-56
pages 52-56 views

Рathomorphological features of corneal regeneration in experimentally induced dystrophy against the background of intrastromal administration of autologous mononuclear leukocytes

Denisko M.S., Krivosheina O.I., Filippova E.O., Mustafina L.R.


The purpose of research is study the features of the flow of reparative regeneration of the cornea in an experiment in vivo with induced bullous keratopathy after the introduction of a suspension of autologous mononuclear leukocytes in the posterior third of the corneal stroma. Materials and methods. The experiment was performed on 27 chinchilla rabbits (27 eyes). At the first stage of the experiment all animals were reproduced the model of corneal bullous keratopathy by mechanical damage and removal of its endothelial layer. At the second stage, 2 weeks after the development of the disease, the animals were divided, depending on the planned treatment, into 2 groups: the main, 12 animals once in the back third of the corneal stroma were administered a suspension of autologous mononuclear leukocytes; comparisons, 12 animals were treated by conservative therapy. Results. Reproduction of in vivo bullous keratopathy of the cornea by mechanical damage and removal of its endothelial layer is accompanied by rapid (within 2 weeks) the development of the disease with diffuse hydropic degeneration of the anterior epithelium, marked edema of the stroma with the bundle of collagen fibers. On the experimental model of the bullous keratopathy of cornea it was found that the introduction of a suspension of autologous mononuclear leukocytes in the posterior third of the corneal stroma in the treatment of the disease provides rapid (1.5 times) dehydration of the stroma, reduces the number of dystrophic cells in the anterior epithelium by 1.2 times compared with conservative treatment. The period of restoration of the normal thickness of the corneal slice in animals of the main group is reduced by 1.4 times. The conclusion. The introduction of autologous mononuclear leukocytes suspension into the posterior third of the corneal stroma in the treatment of experimental bullous keratopathy of cornea induces reparative regeneration, accelerating the restoration of damaged corneal structures and preventing its neovascularization.
Medical academic journal. 2018;18(3):57-63
pages 57-63 views

Meteofactors and admittance of patients with atrial fibrillation for emergency medical care

Belyayeva V.A.


This study presents the results of a retrospective analysis of the challenges of patients with atrial fibrillation (AF) for ambulance medical care depending on weather conditions and season. Aim. This study aimed to evaluate the effect of meteorological factors on addressing of patients with AF for emergency medical care in the context of seasonal dynamics. Materials. Archival cards of ambulance calls in the winter, spring, and summer 2012 and the corresponding databases of average daily meteorological parameters, day-to-day changes (∆), and pathogenicity indices were used: air temperature (it), atmospheric pressure (iр), humidity (ih), wind speed (iv), cloudiness (in), and general weather pathogenicity index (IWP). Results. In winter, the most significant negative effect is caused by fluctuations in meteo-factors: average daily air temperature and atmospheric pressure, it, ∆p, IWP; in spring were the average daily air temperature and atmospheric pressure, it, i∆t; in summer was i∆t. The response of the population to AF for medical care in the winter (6.7 ± 0.5 person/day) and spring (6.9 ± 0.4 person/day) is higher than that in summer (5.2 ± 0.5 person/day). Conclusion. The maximum number of correlation links between the frequency of ambulance medical care calls and meteorological factors is present in the winter and spring and has gender and season specifics. Seasonality factor affects the treatment of patients with AF for emergency medical care.
Medical academic journal. 2018;18(3):64-68
pages 64-68 views

Localization and activity of recombinant streptavidin in cell fractions of Escherichia coli

Zotova D.V., Grudinina N.A., Antimonova O.I., Shavlovsky M.M., Polyakov D.S.


The authors provide a genetic construct for obtaining recombinant biologically active wild type streptavidin with high yield. Addition of leader peptide and oligohistidine sequence to the streptavidin sequence makes it possible to isolate soluble streptavidin from the culture medium and from the soluble fraction. Temperature conditions for inducing of protein synthesis were found to have a significant effect on the distribution profile of streptavidin between fractions. The obtained protein product is not contaminated with endogenous biotin. The provided method excludes denaturation and renaturation steps which are necessary for isolation of the desired product from inclusion bodies but substantially reduce the yield. Thus, the provided approach allows to increase the yield of biologically highly active strepatividin which is capable of binding biotin and biotin-containing compounds and can be used for various practical purposes.
Medical academic journal. 2018;18(3):69-76
pages 69-76 views

Evaluation of the radioprotective properties of recombinant flagellin when used alone or in combination with interleukin-1 beta

Murzina E.V., Sofronov G.A., Simbirtsev A.S., Aksenova N.V., Veselova O.M., Ischenko A.M.


Research objective. To evaluate the radioprotective effectiveness of recombinant flagellin when used alone or in combination with interleukin-1 beta for prophylactic or therapeutic effect on animals. Materials and methods. The effect of hybrid flagellin FliC Salmonella typhimurium and human interleukin-1β (Institute of Highly Pure Biopreparations, Saint Petersburg, Russia) on the 30-day survival of male mice exposed to lethal doses of X-ray radiation was studied. Survival of irradiated animals was analyzed by Kaplan-Meier method. Results. The preventive use of flagellin had a protective effect on the 30-day survival of mice irradiated with lethal doses of X-rays. Compared with the irradiated control, the administration of flagellin (1 mg/kg or 2 mg/kg) prior to X-ray exposure (7.5 Gy, 8.0 Gy or 8.5 Gy) increased the animal survival rate to 67-87%. Complex preventive administration of flagellin (1 mg/kg) and interleukin-1 beta (50 μg/kg) provided a 100% survival rate of the irradiated mice. Separate use of drugs was also effective; 92.8% of mice survived when flagellin was administered prior to irradiation and interleukin after. Conclusion. Recombinant flagellin is a promising candidate product for designing new generation of domestic radiation countermeasures, including combinations with interleukin-1 beta.
Medical academic journal. 2018;18(3):77-84
pages 77-84 views

Molecular-genetic characteristics of strain Escherichia coli serogroup O26 causing diarrheal diseases in children

Makarova M.A., Dmitriev A.V., Matveeva Z.N., Kaftyreva K.A.


Aim. To determine the serotype and virulence factors of the E. coli serogroup O26 isolated from children with diarrheal syndrome. Materials and methods. Fifty-three strains of E. coli O26 isolated in 2014-2016 from the stool of children with clinical manifestations of acute intestinal infection in Saint Petersburg were studied. Phenotypic (enzymatic and antigenic properties), molecular genetic [detection of virulence genes of enteropathogenic (EPEC - eae, bfp, hlyA), and enterohemorrhagic (EHEC - eae, stx1, stx2, ehxA), genes encoding O- and H-antigens (rfb and fliC), genes, defining phylogenetic group (chuA, yjaA и TspE)] methods were used. The phylogenetic group and the production Shiga toxins were determined. Results. All strains were identical to the antigen characteristics of serotype O26:H11 and phylogenetic group B1. Two pathogroups were created based on the set of virulence genes: a-EPEC (64.2%) and EHEC (35.8%). Strains EHEC produced Shiga-toxin 1, encoding gen stx1. No differences in enzymatic activities were found between the strains of E. coli О26:H11 for EPEC and EHEC strains. Conclusion. In the population of E. coli O26:H11, which caused acute intestinal infection in children in Saint Petersburg, more than 30% of the strains belonged to the highly virulent group EHEC. Molecular-genetic methods should be used for reliable detection of pathogens.
Medical academic journal. 2018;18(3):85-90
pages 85-90 views

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