Vol 70, No 2 (2015)

PROCEEDINGS of the GENERAL MEETING of the Department of Medical Sciences, RAS

NOZOLOGICAL HETEROGENEITY, MOLECULAR GENETICS AND IMMUNOLOGY OF AUTOIMMUNE DIABETES MELLITUS

Dedov I.I., Shestakova M.V., Kuraeva T.L., Titovich E.V., Nikonova T.V.

Abstract

Article is devoted to the review of literature data, and also the analysis of results of own researches concerning genetics, molecular genetics and immunological violations at various forms of the autoimmune diabetes (DM) including classical T1DM, LADA type and an autoimmune polyglandular syndrome of 1 type (APS1). In case of T1DM more than 80% of patients are carriers of one or two strongest predisposing haplotypes: DRB1*O4-DQA1*O3O1-DQB1*O3O2 and DRB1*O3-DQA1*O5O1- DQB1*O201 designated as DQ2 and DQ8. HLA genes can model a clinical features of disease. In Russian population, the children with diabetes manifestation up to 5-year age has significantly often high risk genotypes (DQ2/DQ8) and significantly less the low risk genotypes in comparison with children, who had manifestation of T1DM in 10 years and later. The long-term
16-years family studies showed the maximum frequency of T1DM in high risk group, constantly accruing in process of increase in term of supervision, and in groups of an average and low risk lower and invariable. The highest risk of T1DM manifestation, reaching 90% at 10 years of supervision is defined by existence of HLA high risk genotypes and many antibodies, revealed from early age. LADA ― the hybrid form of autoimmune DM having signs of T1DM and T2DM in the basis. The development of autoimmune process against β-cells can be caused by only gene mutation (APS1). The part of T1DM cases which doesn't have the contributing HLA genes and autoimmune markers in process of studying of the importance of various genes and their biological value can be attributed to new, yet unknown forms of DM.

 

Annals of the Russian academy of medical sciences. 2015;70(2):132-138
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AUTOIMMUNE DISEASES OF DIGESTIVE SYSTEM

Ivashkin V.T., Sheptulina A.F., Raikhel'son K.L., Losik E.A., Ivashkin K.V., Okhlobystin A.V., Baranskaya E.K., Polyektova E.A., Shifrin O.S.

Abstract

Autoimmune diseases of digestive system refer to pathological conditions, caused by autoimmune mechanisms, and their etiology remains unknown. This is a group of relatively rare diseases, however, during the last years a marked tendency towards the raise in incidence and prevalence is observed, which led to an increase in number of clinical investigations on etiology, pathogenesis, and, accordingly, development of new diagnostic methods and therapies. Results of such trials shown, for example, that the pathogenesis of chronic cholestatic liver diseases is associated with nuclear receptors function, while the main etiological and pathogenic factor of inflammatory bowel diseases represents gut microbiota. Despite new achievements in autoimmune diseases of digestive system research, therapies are low effective and are accompanied by a huge number of adverse events. The fact that these diseases may lead to malignant tumors is also worth noting. For example, patients with primary sclerosing cholangitis have a 160 times higher risk of cholangiocellular carcinoma, while 10–14% of patients with celiac disease may develop malignancies of esophagus, small and large intestine. Thus, these diseases require further investigation with a purpose of more accurate diagnostic methods for the detection of disease at early stages and new effective and safe therapies development.

 

Annals of the Russian academy of medical sciences. 2015;70(2):139-151
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THE EXPERIMENTAL MODEL OF AUTOIMMUNE PROCESS: THE ROLE OF EPIGENETIC VARIATION IN THE POPULATION OF MICE HYBRIDS

Kolesnikova O.P., Kudaeva O.T., Vol'skii N.N., Goiman E.V., Gavrilova E.D., Perminova O.M., Demchenko E.N., Kozlov V.A.

Abstract

Background: At the development of graft versus host disease in genetically homogeneous population of (C57Bl/6 x DBA/2) F1 mice two clinical phenotypes of SLE-like disease were revealed: lupus+ (immune complex glomerulonephritis and hemolytic anemia) and lupus – (hemolytic anemia). The GvHD phenotypic heterogeneity is determined by the Th1 /Th2-polarization: Th2 lymphocyte predominant activity, leads to the lupus+ development, or prevalence activity of Th1 cells, leads to the lupus– development. Objective: Our aim was to evaluate the possibility of using an experimental model of autoimmune disease for studying and testing of epigenetic modifications, shifting Th1 /Th2-
balance in vivo. Methods: Сhronic GVHD was induced in B6D2F1 mice by the transplantation of 130×10 6 parental DBA/2 splenocytes. Аnti-ds-DNA, total IgG and IgG1, IgG2а Abs were measured by ELISA. Results: Six- to 8-week-old female DBA/2 and B6D2F1 mice were obtained from Biological Research Laboratory (Novosibirsk). It was established that regular moderate physical activity (unladed swimming) shifted Th1 /Th2 balance towards Th1. This leads to a decrease in a population of recipients the lupus+ mice from 57 to 26% (p <0,001) with significantly reduced hypergammaglobulinemia (IgG from 2,8 to 2,0 mg/ml; p <0,047) and DNA antibodies titer from 0,18 to 0,12 OD (p =0,05). Administration of epigenetic modificator bisphenol A at low doses, which mimicking estrogen effects, enhances the proportion of lupus+ mice in experimental groups from 33 to 64% (p <0,001) and impairs their clinical status by the increasing the urine protein level from 2.8 to 4,2 mg/ml (p <0,001) in animals. Conclusion: Th1 /Th2 – balance presumably is determined by the immune system epigenetic modification in experimental mice, formed on the previous stages of ontogeny and defines the direction of immune processes development in individual animal.


Annals of the Russian academy of medical sciences. 2015;70(2):152-158
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FUTURE THERAPEUTIC TARGETS IN MANAGEMENT OF AUTOIMMUNE SKIN DISEASES

Kubanova A.A., Karamova A.E., Kubanov A.A.

Abstract

Pemphigus is a severe, potentially fatal bullous skin disease, caused by desmoglein autoantibody production and immune-mediated regulation of T-cells subsets. Conventional therapy including systemic corticosteroids with or without other immunosupressants causes numerous adverse effects and becomes inefficient in refractory patients. In this work, the authors showed a modern view on the pathogenesis of pemphigus. This article describes the detailed action mechanism of rituximab, a chimeric monoclonal antibody directed against CD20 antigen of B-cells. The authors conduct the results of meta-analyses of rituximab’s efficiency in pemphigus patients. Moreover, in this article, the authors consider new promising treatment options and potential targets for biological therapy of pemphigus diseases.

Annals of the Russian academy of medical sciences. 2015;70(2):159-164
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INNOVATIVE METHODS OF SOME SYSTEMIC AUTOIMMUNE DISEASES TREATMENT

Mazurov V.I., Trofimov E.A.

Abstract

In the present paper we consider the problem of innovative treatment of systemic autoimmune diseases for example, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The use of biological therapy is suitable for severe rheumatoid arthritis and promotes remission in 2530% of cases. Application biological therapy (as anti-B cell therapy) in cases of systemic lupus erythematosus severe forms can reduce the immuno activity level, and also leads to the regression of secondary vasculitis in lung tissue and renal parenchyma. The analysis of drugs and principles of treatment of rheumatoid arthritis and systemic lupus erythematosus was done. Particular attention is paid to the safety and efficacy of biological agents and synthetic base anti-inflammatory drugs.

 

Annals of the Russian academy of medical sciences. 2015;70(2):165-168
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AUTOIMMUNE RHEUMATIC DISEASES — PROBLEMS OF IMMUNOPATHOLOGY AND PERSONALIZED TREATMENT

Nasonov E.L., Aleksandrova E.N., Novikov A.A.

Abstract

By current standards autoimmunity is a complex pathological process based on a violation of tolerance and, consequently, the pathological immune response against its own tissues components (autoantigens) leading to the development of a wide range of autoimmune diseases in humans. In recent years, multiple immune disorders both acquired and / or congenital (associated with polymorphisms of genes that regulate immune response) have been transcribed. These disorders occur at the cellular and humoral levels: thymus, intestines, peripheral blood immune cells, including T and B lymphocytes, macrophages, dendritic cells, Treg-cells (Treg), components of complement system, cytokines and others. The interaction between the development of autoimmune rheumatic (ARD) and autoinflammatory diseases and syndromes is detected; a classification of immune-inflammatory diseases is designed. The article describes the results of our studies on the treatment of ARD using innovative genetically engineered biological agents and on the research of pathogenetic mechanisms and diagnostics of ARD based on immunological and molecular biological diagnostic techniques of a wide range of molecular and cellular biomarkers (autoantibodies, inflammatory acute phase proteins, cytokines, chemokines, markers of activation of the vascular endothelium, the components of the complement system, lymphocyte subpopulations, products of metabolism of bone and cartilage tissue, genetic, epigenetic, transcriptomic markers). The approaches to personalized treatment of ARD are presented.

 

 

Annals of the Russian academy of medical sciences. 2015;70(2):169-182
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AUTOIMMUNE DISEASES OF THE NERVOUS SYSTEM: PROBLEM STATEMENT AND PROSPECTS

Piradov M.A., Suponeva N.A.

Abstract

This review highlights the achievements in the field of autoimmune diseases of the nervous system over the last 15 years. It became possible to deepen the understanding of medical and social significance of these diseases, form the concept of nosologic unit heterogeneity, describe new and atypical forms of demyelinating diseases of the central and peripheral nervous system, autoimmune diseases of the neuromuscular synapse. Also, it is important to mention, that the new antigens were identified, the diagnostic panel of autoantibodies was developed and put into practice. Furthermore, the clinical practice guidelines for the diagnosis and management of patients were developed, the new drugs were tested and included in these guidelines. The scientists of the biggest Russian neurological centre, Research Centre of Neurology (Moscow), developed a vaccine for immunotherapy of multiple sclerosis, studied pathomorphosis of Guillain–Barre syndrome, specified the components of its pathogenesis, improved the programs of pathogenetic therapy, which led to the decrease in mortality from 30 to 3%, helped to decrease the AVL period by 2 times, hasten the recovery of independent walking by 2.5 times. Nowadays different biomarkers of diseases of the central and peripheral nervous system are studied and modern technologies in neurorehabilitation are applied.

 

Annals of the Russian academy of medical sciences. 2015;70(2):183-187
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CARDIOLOGY: CURRENT ISSUES

ROLE OF BRADIKYNIN IN THE MECHANISM OF ISCHEMIC PRECONDITIONING OF THE HEART. PROSPECTS OF BRADYKININ APPLICATION IN CARDIOSURGICAL PRAXIS

Maslov L.N., Naryzhnaya N.V., Podoksenov Y.K., Gorbunov A.S., Zhang Y., Pei J.

Abstract

Bradykinin level is increased in myocardium in response to short-term ischemia/reperfusion that is one of the evidences of its trigger role in ischemic preconditioning (IP). Pharmacological induced increase of endogenous bradykinin and kallidin-like peptide levels in myocardium enhances cardiac tolerance to impact of ischemia / reperfusion. Experiments with genetically modified mice indicate that kinins are involved in preconditioning but they are not the only trigger of IP. The B2-receptor blocking abolishes antiarrhythmic, infarct reducing effects of preconditioning, eliminates IP-induced cardiac tolerance to oxidative stress. Exogenous bradykinin mimics inotropic and cardioprotective effects of IP but does not mimic antiarrhythmic effect of preconditioning. The intracoronary or intravenous bradykinin infusion enhances human heart resistance to ischemia/reperfusion. Implementation of the cardioprotective effect of IP is provided by the activation of multiple signaling pathways that involve: B2-receptor, calcitonin gene-related peptide, NO-synthase, guanylyl cyclase, cGMP, protein kinase G, mitochondrial KATP channels, reactive oxygen species, kinases C, ERK and Akt. To increase of the human heart tolerance to ischemia/reperfusion is necessary to develop B2-receptor agonists devoid hypotensive and pro-inflammatory properties.

 

Annals of the Russian academy of medical sciences. 2015;70(2):188-195
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CHARACTERISTICS OF LEFT VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS BEFORE AND AFTER CORONARY ARTERY BYPASS GRAFTING

Khlopina I.A., Shatsova E.N., Lupachev V.V., Pakuev A.N., Chernozemova A.V., Kubasov R.V.

Abstract

Diastolic heart dysfunction occurs essentially in patients who suffer from chronic heart failure. In this context an investigation and application of different methods for diastolic function improvement remain a priority in the therapy of cardiovascular diseases. Objective: Our aim was to estimate coronary artery bypass grafting effect on the left ventricular functionality in patients with coronary heart disease. Methods: Patients (30 men without myocardial infarction and 44 — with myocardial infarction) were investigated by Doppler Echocardiography before and after coronary artery bypass grafting for left ventricular diastolic function assessment. In addition, during the year after operation examinations were carried out. Analysis of the data allowed detecting two types of disorders of transmitral flow: rigid and pseudonormal. Results: Our investigation showed that transmitral parameters improved in patients after operation. Patients without myocardial infarction in anamnesis had a myocardium cell relaxation improvement (IVRT decreasing; p =0,046), but an active myocardium relaxation turned for the better (increasing of Е/А (p <0,001) by component А lowering (p =0,003). Changes of pulmonary veins parameters were followed by the improvement of left heart ventricle relaxation: active — PVD decreasing, p =0,051; and passive — PVА decreasing, p =0,028. Patients with myocardial infarction in anamnesis had an IVRT decreasing (p =0,040) and А decreasing (p =0,041). In addition, in this group left atrial function improved (PVS decreasing; p =0,037). Conclusion: Coronary artery bypass grafting is effective in left ventricular diastolic function improvement and Doppler Echocardiography method can become an important criterion to estimate the treatment adequacy.

 

 

Annals of the Russian academy of medical sciences. 2015;70(2):196-202
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PEDIATRICS: CURRENT ISSUES

THE RELATIONSHIP OF THE DEGREE OF IMPAIRMENT OF THE STRUCTURE AND FUNCTION OF THE LIVER WITH ITS CHRONIC ILLNESSES IN CHILDREN

Volynets G.V., Evlukhina N.N., Filin A.V., Potapov A.S., Dvoryakovskii I.V., Dvoryakovskaya G.M., Surkov A.N., Shavrov A.A., Pakhomovskaya N.L., Skvortsova T.A.

Abstract

Objective: Our aim was to on the basis of determining the degree of violation of the structure and function of the liver establish their relationships and to assess the dynamics of liver disease in its chronic illnesses in children. Methods: With the help of the developed scoring systems were used to assess the degree of liver dysfunction and the degree of disruption of the structure of the liver and the severity of portal hypertension. Results: The results of the diagnostic methods 252 children aged 1 to 17 years (mean age of 11.8±3,5) with Wilson disease (WD), autoimmune hepatitis (AIH), chronic hepatitis C (CHC) were analyzed; 48 patients underwent liver transplantation. In children with WD, AIH and CHC liver function reduced by 41.3±12.9 % to 28.8±12.5% and 19.1±7.8% respectively. Structure of the liver in children with WD, AIH and CHC was disturbed by 25.0±8.1% to 20.4±9.2% and 6.8±4.4% respectively. The function and structure violations of the liver more pronounced in liver cirrhosis. The use of the developed scoring systems to monitor the severity of liver damage in the dynamics and evaluation of the effectiveness of the therapy is demonstrated. The degree of liver dysfunction is directly dependent on the degree of its structure. Abnormal liver function ≥40% and ≥40% of its structure with treatment failure can be used as a criterion of indications for elective liver transplantation with its chronic diseases in children. Conclusion: Developed a point system to determine liver function and a point system to determine disruption of the structure of the liver and the severity of portal hypertension in children can serve as an objective criterion for assessing the severity of liver disease, monitoring their changes in the dynamics with the assessment of the effectiveness of the therapy and making decisions about the need for routine liver transplantation in its chronic illnesses in children.

 

Annals of the Russian academy of medical sciences. 2015;70(2):203-213
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HYGIENIC ASSESMENT OF EDUCATIONAL TEXTS: METHODICAL APPROACHES AND EVALUATION OF DIFFICULTIES FOR CHILDREN OF SECONDARY TEXTBOOKS

Kuchma V.R., Tkachuk E.A.

Abstract

Background: The understandability and readability of the text are significant indicators of evaluation of textbooks. Objective: The aim of the study — rationale of improving the readability and understandability of textbooks. Methods: 60 modern textbooks for 5–11th classes on History, Physics, Biology and 23 textbooks of 1960–1980’s edition. Flesch index was used to assess the readability, Fogh index — to evaluate understandability. Results: The readability and understandability of texts in textbooks of 1960–1980’s and modern editions have no differences and show the same complexity of old and modern textbooks for students. The indicator of understandability of textbooks for primary classes corresponds to age norm and is 4.4±0.2 points. The indicator of readability for these books is less age norm and is 53.8±2.9 points, which increases the physiological cost of educational activities of children of primary school age. Children’s readability and understandability of school textbooks are a significant factor of intensity of training activities and can be objectively assessed by Flesch and Fogh indices, that it is appropriate for an objective hygienic assessment of the tension of the educational activities for children. Conclusion: The main direction of optimization of the tension of educational activity is to reduce the intellectual and emotional loads in children by increasing the easiness of reading textbooks due to their compliance with the age peculiarities of students.

 

 

Annals of the Russian academy of medical sciences. 2015;70(2):214-221
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FEATURES OF AUTONOMIC RESPONSE IN CHILDREN WITH BRONCHIAL ASTHMA IN THE PERIOD OF EXACERBATION

Lebedenko A.A., Semernik O.E.

Abstract

Background: Asthma is one of the urgent problems of modern pediatrics, but neuroregulation mechanisms underlying this disease have not been fully disclosed so far. The autonomic interactions assessment in patients with bronchial asthma is important to understand the pathogenesis and prognosis of the disease. Objective: The aim of the study was to investigate features of autonomic response in children with asthma in the period of exacerbation. Methods: The autonomic nervous system (ANS) of 82 children aged 6 to 18 years old with asthma in the period of exacerbation were investigated. The spectral analysis of the heart rate variability and the correlation rhythmography method (skaterography) were used to assess the ANS state. Investigations were carried out at rest and after clinoorthostatic test. Results: Non-respiratory (slow) waves reflecting the degree of activity of humoral and neural canals of heart rate central regulation were dominated at the spectrogram of 72 (87.80%) children experiencing asthma attack; more than half of patients (58.53%) had predominantly very low-frequency component (VLF%) in the range of fluctuation rate that indicated the influence of neurohumoral regulation. A significant increase in vagosympathetic balance coefficient (LF / HF) was recorded after clinoorthostatic test indicating the activation of the sympathetic nervous system. According to the correlation rhythmography data, a considerable scattering of scattergram points was detected in patients in the baseline state that indicated the predominant influence of parasympathetic nervous system. After the clinoorthostatic test, on the contrary, we observed the «tightness» of the scattergram cloud that could indicate sympathicotonia. Conclusion: The imbalance of the autonomic nervous system in the form of activation of the sympathetic and neurohumoral regulation department was found in children with asthma.

 

Annals of the Russian academy of medical sciences. 2015;70(2):222-226
pages 222-226 views

MODERN VIEWS ON СHILDREN'S INTERSTITIAL LUNG DISEASE

Boitsova E.V., Belyashova M.A., Ovsyannikov D.Y.

Abstract

Interstitial lung diseases (ILD, diffuse lung diseases) are a heterogeneous group of diseases in which a pathological process primarily involved alveoli and perialveolar interstitium, resulting in impaired gas exchange, restrictive changes of lung ventilation function and diffuse interstitial changes detectable by X-ray. Сhildren’s interstitial lung diseases is an topical problem of pediatric pulmonology. The article presents current information about classification, epidemiology, clinical presentation, diagnostics, treatment and prognosis of these rare diseases. The article describes the differences in the structure, pathogenesis, detection of various histological changes in children’s ILD compared with adult patients with ILD. Authors cite an instance of registers pediatric patients with ILD. The clinical semiotics of ILD, the possible results of objective research, the frequency of symptoms, the features of medical history, the changes detected on chest X-rays, CT semiotics described in detail. Particular attention was paid to interstitial lung diseases, occurring mainly in newborns and children during the first two years of life, such as  congenital deficiencies of surfactant proteins, neuroendocrine cell hyperplasia of infancy, pulmonary interstitial glycogenosis. The diagnostic program for children’s ILD, therapy options are presented in this article.

 

Annals of the Russian academy of medical sciences. 2015;70(2):227-236
pages 227-236 views

SHORT MESSAGES

HYDROGEN SULFIDE AS A THIRD ESSENTIAL GAS MOLECULE IN LIVING TISSUES

Kolesnikov S.I., Vlasov B.Y., Kolesnikova L.I.

Abstract

The data of foreign studies over the last 15 years devoted to endogenous synthesis and biological role of hydrogen sulfide in micromolar quantities which complemented the already two well-known gas transmitters — OH and NO are presented in this review. Despite the short period since the physiological properties of hydrogen sulfide were opened (about 20 years) it was found that this gas transmitter plays a key role in the regulation of nerve (neural signal transmission), cardiovascular (relaxation of smooth muscles), immune (anti-inflammatory and cytoprotective agent) sensory, gastrointestinal (output of insulin) systems and in the metabolism of various organs. Currently the role of H2S in the pathogenesis of different diseases, neurodegenerative diseases, diabetes, heart failure) is being studying. The developments of drugs that act as either exogenous donors H2S or blockers of the biosynthesis of H2S are promising. With consideration the fact that H2S is a representative of non-synaptic way of intercellular communication based on diffusion of molecules of inorganic compounds in the intercellular space in all directions and effect on distant from their place of formation non- synaptic receptors it is suggested to use exogenous H2S in strict proportion for the treatment of a number of human diseases.

 

Annals of the Russian academy of medical sciences. 2015;70(2):237-241
pages 237-241 views

LIVER AND ITS LYMPH REGION AT BENZO[A]PYRENE EFFECTS IN AN EXPERIMENT

Michurina S.V., Borodin Y.I., Kolesnikov S.I., Ishchenko I.Y., Konenkov V.I.

Abstract

Background: Benzo[a]pyrene (BaP) is the widespread environmental toxicant with carcinogenic activity. BaP undergoes metabolic activation in the liver microsomal monooxygenase system, and its regional lymph nodes act as peripheral filters, purifying lymph formed in the liver. It remains an open question about the significance of the integral liver and lymphatic system work in supporting processes of adaptation and resistance to the BaP effects. Objective: The purpose of our investigation was to study structural and metabolic changes in the liver and its lymph region in males Wistar rats weighing 180–220 g. Methods: Animals of the experimental group (n =20) daily for 3 days was performed BaP injections: intraperitoneally with 2 mg per 100 g of body weight in 0.2–0.3 ml of olive oil. Rats in the control group (n =20) received in the same mode of injection of olive oil. The light and electron microscopy morphometric study of the liver and its regional lymph nodes morphometric analysis were performed. The intensity of lipid peroxidation in the liver was measured by the number of diene conjugates (DC), ketotriene conjugates (KC) and malondialdehyde (MDA). Results: Simultaneous increase of the hepatic sinusoids relative area and the specific area of the regional lymph nodes sinus system was discovered under the BaP effect. At ultrastructural level dilatation of the Disse spaces, filling of cell detritus and collagen fibers bundles of these spaces were noted. Damage of nuclear apparatus, balloonie expansion of granular endoplasmic reticulum profiles were found in hepatocytes, condensation of the mitochondrial matrix was observed. The relative squares of B-dependent zones increased and T-dependent paracortical zone reduced in the regional lymph nodes. The increase in the content of KC and MDA in liver was dentified. Conclusion: benzo[a]pyrene causes interrelated cascade of reactions in the liver and in its lymphatic region: a disturbance of the blood-lymph barrier morphological organization, the difficulty of lymph drainage from the organ. These promotes development of tissue hypoxia and apoptosis, protein synthesizing and energy cell apparatus disruptions, formation of lymphoid tissue temporary groups in the liver.

 

Annals of the Russian academy of medical sciences. 2015;70(2):242-248
pages 242-248 views

EPIDEMIOLOGICAL SURVEILLANCE OF CHOLERA IN RUSSIA DURING THE PERIOD OF THE SEVENTH PANDEMIC

Onishchenko G.G., Moskvitina E.A., Kruglikov V.D., Titova S.V., Adamenko O.L., Vodop'yanov A.S., Vodop'yanov S.O.

Abstract

In this work basic stages of formation of the epidemiological surveillance of cholera in Russia are described. In 1990-s for the first time zoning by epidemic manifestations of cholera was carried out at the level of subjects forming parts of Russia and other Republics of the Soviet Union with the introduction of differential tactics of epidemiological surveillance. Improvement of epidemiological surveillance of cholera was aimed at harmonization with the IHR (2005), integration of epidemiological surveillance of cholera and social-hygienic monitoring of water objects of I and II categories. Characterization of isolated Vibrio cholerae strains (1990−2014) on the genomic basis determined the emergence of new VNTR-genotypes of V. cholerae O1 ctxAB+ tcpA+, responsible for outbreaks, simultaneously with isolation of V. cholerae O1 ctxAB-tcpA- strains during monitoring of environmental objects for cholera. A viewpoint is considered of the beginning of the eighth cholera pandemic in the context of emergence of V. cholerae-torstrains with CTXφ prophage carrying ctxB gene of cholera toxin of classical biovar. Main directions of further enhancement of epidemiological surveillance include the study of basic data structures used in the epidemiological surveillance system, the use of zoning of municipal units of federal subjects with corresponding surveillance tactics and expected economic effect.

 

Annals of the Russian academy of medical sciences. 2015;70(2):249-256
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CURRENT CONCEPTS OF HUMAN MICROSPORIDIOSIS

Timofeev S.A.

Abstract

Microsporidiosis is an ubiquitous opportunistic disease that usually appears in immunocompromised patients: AIDS patients or organ-transplant recipients. The infectious agents of disease are fungi-related obligate intracellular parasites – microsporidia. Alongside with Cryptosporidium and Cytomegalovirus, these parasites are the most common causative agents of diarrhea in HIV-infected patients. Intestinal form of microsporidiosis has been most frequently observed, but microsporidia can affect almost any organs of the human body, eyes, lungs, muscles, organs of the nervous system. The present paper overviews the current data on the etiology, pathogenesis, epidemiology, clinical presentation, diagnosis and treatment methods of microsporidiosis.

 

 

Annals of the Russian academy of medical sciences. 2015;70(2):257-263
pages 257-263 views

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