Vol 74, No 3 (2019)


Evaluation of the lipid peroxidation reactions activity in middle-aged men with chronic gastritis on the background of H. pylori infection

Darenskaya M.A., Smirnova O.V., Kasparov E.V., Grebenkina L.A., Sinyakov A.A., Kolesnikova L.I., Kolesnikov S.I.


Background: There is not enough information about the course of the processes of lipid peroxidation-antioxidant defense in middle-aged men who are at risk of developing gastric cancer on the Correa cascade.

Aims: To analyze of the processes of lipid peroxidation activity and antioxidant defense in men with chronic gastritis and chronic atrophic gastritis in combination with and without the presence of Helicobacter pylori.

Materials and methods: 173 middle-aged men with an established diagnosis of chronic gastritis were examined, which were divided into 4 groups: group 1 ― patients with chronic gastritis without H. pylori (n=58), group 2 ― patients with chronic gastritis in combination with H. pylori (n=61), group 3 ― patients with chronic atrophic gastritis without H. pylori (n=28), group 4 ― patients with chronic atrophic gastritis in combination with H. pylori (n=26). Evaluation of the content of parameters of the lipid peroxidation system and the antioxidant components activity using spectrophotometric research methods was carried out. For statistical analysis, the software package Statistica 7.0 (Stat Soft, USA) was used. The study was conducted during 2013−2015.

Results: Infection H. pylori with chronic and chronic atrophic gastritis accompanied by significant changes in the system of lipid peroxidation, and antioxidant defense components in the form of primary and accumulation of end products, insufficient activity of antioxidant enzymes ― superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase and reducing content of reduced glutathione. The use of an integrating factor to assess the severity of prooxidant activity confirms the development of antioxidant deficiency in patients of these groups.

Conclusions: In patients with chronic and chronic atrophic gastritis, combined with H. Pylori infection, a more pronounced progression of oxidative stress reactions and a significant lack of antioxidant factors were found in comparison with patients with these forms of gastritis without H. pylori.


Annals of the Russian academy of medical sciences. 2019;74(3):149-156
pages 149-156 views

DERMATOLOGY and VENEROLOGY: current issues

Evaluation of the Effectiveness of Therapy for Stevens−Johnson Syndrome and Toxic Epidermal Necrolysis: A Review

Lepekhova A.A., Allenova A.S., Olisova O.Y., Teplyuk N.P., Kanareikina E.V.


39 original articles were analyzed. 8 of them were excluded due to the small sample of patients. The effectiveness of the intravenous Ig, systemic glucocorticosteroids, cyclosporin A, biological agents (etranecept, infliximab, thalidomide) on the basis of the SCORTEN scale and the number of lethal outcomes was evaluated. Information was searched for the following databases: PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Cochrane Library. The systemic glucocorticosteroid (GCs) pulse therapy using only in the phase of disease progression was the most appropriate. Some authors showed a high risk of sepsis development in patients treated with GCs. In patients who received high doses of IVIg (≥2 g/ kg), mortality was 2.5 times lower compared to the lower one. The number of lethal outcomes in the Cyclosporin A (3 mg/kg/day) group was 3.3 times lower. A high mortality rate was observed in patients receiving thalidomide. The effectiveness of a particular method of therapy, as well as the prognosis of the disease, largely depends on the process severity, the presence and type of concomitant pathology (for example, severe course and negative outcome in patients with cancer). There is no a single point of view regarding the therapy of SSJ and TEN. Thus, a large multicenter randomized studies are crucial.


Annals of the Russian academy of medical sciences. 2019;74(3):157-166
pages 157-166 views

The Value of Genetic and Non-Genetic Factors in the Emergence and in the Development of Androgenetic Alopecia in Men: Multifactor Analysis

Kondrakhina I.N., Verbenko D.A., Zatevalov A.M., Kubanov A.A., Deryabin D.G.


Background: Among pathological hair loss conditions in men the androgenic alopecia (L64 according to ICD-10) has been the most common diagnosed. However, the reasons of the occurrence and development of the disease remain incompletely clarified, that determines the difficulties of personalized therapy.

Aims: To analyze both genetic and non-genetic factors involved in the pathogenesis of androgenic alopecia in men, and to create personalized multifactorial model for description of individual causes of the disease.

Materials and methods: The genetic predisposition to androgenic alopecia was estimated by the set of SNP rs929626, rs5919324, rs1998076, rs12565727 and rs756853, analyzed by mini-sequencing. The non-genetic factors included: hormones and metabolic markers, trace elements, and vitamins. Two-stage model creation of androgenic alopecia occurrence and development was carried out using a neural network (for genetic factors) followed by step-by-step linear discriminate analysis (for non-genetic factors).

Results: The case-control study included 50 men revealing I−IV stages of androgenic alopecia (according to Norwood-Hamilton classification) and 25 healthy volunteers relevant in their age and origin. The analysis of each SNP separately did not show significant differences between these groups, while SNP joint consideration in neural network model made it possible to assess the genetic predisposition to androgenic alopecia, as well as to divide the low and high genetic risk subgroups. A large number of significant non-genetic factors, including elevated levels of dihydrotestosterone, 17-OH-progesterone, insulin, and deficiency of Mg, Cu, Zn, Se, vitamins D, E, folic acid was shown in low genetic risk subgroup. In turn, in the high genetic risk subgroup the set of significant non-genetic factors was limited to metabolic and micronutrient disorders only. These data were used for the multifactorial model showing 81.2−85.1% accuracy being the most effective in early (I−II) stages of androgenic alopecia.

Conclusions: The different influence of non-genetic factors in patients with low and high genetic risk of androgenic alopecia has been revealed. The integral factors consideration in the proposed two-stage multifactorial model identifies individual causes of the disease and gives the chance for the development of personalized therapy of androgenic alopecia in men.

Annals of the Russian academy of medical sciences. 2019;74(3):167-175
pages 167-175 views


Urine-Derived Stem Cells: Differentiation Potential into Smooth-Muscle Cells and Urothelial Cell

Vasyutin I.A., Lyundup A.V., Kuznetsov S.L.


Background: Tissue engineering of low urinary tract organs requires biopsy of urinary bladder material. The current study describes non-invasive approach of obtaining autologous stem cells from urine of healthy adults. These cells were studied for potential to differentiate into epithelial cells and smooth muscle cells of the urinary bladder.

Aims: To describe properties of urine-derived stem cells (USCs) and investigate their differentiation potential for tissue engineering of low urinary tract organs.

Materials and Methods: USCs were isolated from urine of healthy volunteers with centrifugation and seeded in media to 24-well plates. Expression of stem cells markers (CD73, CD90, CD105, CD34, CD45, CD29, CD44, CD54, SSEA4) by USCs was assessed with flow cytometry. Expression of specific markers of smooth muscle cells and urothelial cells was assessed with fluorescence microscopy with following computational image analysis.

Results: Median number of USCs per 100 ml urine was 6. Doubling time for USC was 1.44±0.528 days (n=4) and there were 26.3±4.79 population doublings for USC cultures (n=4). Median expression of markers of postnatal stem cells was CD73 ― 79.8%, CD90 ― 56.6%, CD105 ― 40.7%, CD34 <1.0%, CD45 <2.0%, CD29 >99.0%, CD44 >99.0%, CD54 ― 97.7% and SSEA4 >99.0%. Treatment of cells with high concentration of EGF in media with low concentration of FBS for 10 days increased cytokeratin (CK) expression to 24.9% for CK AE1/AE3 and to 7.6% for CK 7. Treatment of USCs with media inducing smooth muscle differentiation for 10 days increased expression of α-smooth muscle actin to 79.6% and expression of calponin to 97.6%.

Conclusions: USCs are cells that can be found in urine in small quantities. They have high proliferative potential and express markers of postnatal stem cells. Under effect of PDGF-BB and TGF- β1 they differentiate into smooth muscle cells.

Annals of the Russian academy of medical sciences. 2019;74(3):176-184
pages 176-184 views


The Effect of Cyp2d6 Gene Polymorphism on the Efficacy and Safety of Mirtazapine in Patients with Depressive Disorders Comorbid with Alcohol

Zastrozhin M.S., Smirnov V.V., Sorokin A.S., Grishina E.A., Ryzhikova K.A., Shipitsyn V.V., Savchenko L.M., Buzik O.Z., Koporov S.S., Bryun E.A., Sychev D.A.


Background: Alcohol dependence is often combined with affective disorders, in particular, depressive disorder, which adversely affects the prognosis of the course of both diseases. For the treatment of a depressive disorder, drugs from the group of tetracyclic antidepressants, of which mirtazapine is a representative, are used. Therapy with mirtazapine is associated with the risk of undesirable drug reactions and pharmacoresistance.

Aim: To study the effect of CYPD6 isoenzyme activity on the efficacy and safety of mirtazapine therapy in patients with depressive disorders comorbid with alcoholism.

Methods: The study was conducted on 109 Russian patients with a depressive disorder, comorbid with alcohol dependence. For the correction of depressive disorders within the framework of cyclothymia, mirtazapine was prescribed to patients at a dosage of 15−45 mg/day. CYP2D6*4 genotyping (1846G> A, rs3892097) was carried out using Real-time polymerase chain reaction with allele-specific hybridization. Efficacy and safety were assessed using validated psychometric scales and an assessment of the severity of adverse drug reactions.

Results: By the 9th day of the study, the severity of depressive symptoms on the HAMD scale was significantly different in patients with different genotypes: (GG) 7.0 [6.0; 8.0], (GA) 4.0 [3.8; 5.0] (p<0.001), safety indicator, estimated on a UKU scale: (GG) 3.0 [3.0; 3.0], (GA) 4.0 [4.0; 5.0] (p<0.001). The presence of differences persisted on the 16th day: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [0.8; 3.2] (p<0.001), safety indicator, estimated on a UKU scale: (GG) 6.0 [6.0; 7.0], (GA) 8.5 [8.0; 10.0] (p<0.001).

Conclusion: In this study, the effect of CYP2D6 gene polymorphism on the efficacy and safety of therapy with mirtazapine was demonstrated. Carrying a minor allele A is associated with an increased risk of adverse drug reactions, but improving performance profile performance.

Annals of the Russian academy of medical sciences. 2019;74(3):185-191
pages 185-191 views


Visual Acuity Charts: Analytical Review, Basic Terms

Gracheva M.A., Kazakova A.A., Pokrovskiy D.F., Medvedev I.B.


The review is dedicated to the visual acuity charts for assessment vision at far. The first part of the review provides definitions of basic terms:
optotypes, step of the chart (change in the sign size from line to line), chart design; also, termination rules for measurement procedure and the main
measuring units (logMAR, decimal units) are discussed. The second part of the paper provides historical review of charts development, starting
from the beginning of the XIX century. The most wide spread visual acuity charts are described: Snellen chart, Sivtsev-Golovin chart, ETDRS
chart, Lea chart, etc. The features of their structure and the optotypes used are discussed, taking into account their usefulness, practicality and
feasibility in children vision assessment. Charts compliance with the standard in view of recommendations about optotypes properties and optotypes
distribution on the chart field are reviewed. A special attention is drawn to the modern tendencies in optotypes development in order to obtain better
repeatability of visual acuity assessment.

Annals of the Russian academy of medical sciences. 2019;74(3):192-199
pages 192-199 views


The Role of the Endocannabinoid Signaling System in the Pathophysiology of Asthma and Obesity

Kytikovа O.Y., Novgorodtseva T.P., Denisenko Y.K., Antonyuk M.V., Gvozdenko T.A.


Bronchial asthma (BA) and obesity are one of the major modern problem, requiring the development of an effective therapeutic strategy. The frequent combination of these diseases in one patient indicates the general pathophysiological mechanisms and future study for targeted drug exposure are needed. The endocannabinoid system is involved in a variety of physiological and pathological processes and can be considered as a general mechanism and a potential therapeutic target in asthma and obesity, the receptors of the system are expressed in many central and peripheral tissues. This signal system modulates the functions of the autonomic nervous system, immune system and microcirculation, plays an important role in the regulation of energy balance, metabolism of carbohydrates and lipids. The main research aimed at studying the functioning of this system was focused on neurology and psychiatry, while numerous scientific data demonstrate the importance of the participation of this system in the pathogenesis of other diseases. In particular, this system is involved in the mechanisms of obesity. The role of the endocannabinoid system in the pathogenesis of asthma is actively studied. The wide prevalence of the endocannabinoid signaling system and its regulatory role in the body opens up prospects for therapeutic effects in the treatment of asthma and obesity, as well as the possible phenotype of asthma, combined with obesity. The review is devoted to modern ideas about endocannabinoids, their receptors, mechanisms of action and their role in the pathophysiology of asthma and obesity. The therapeutic prospects and difficulties associated with the use of endocannabinoids and phytocannabinoids in medicine are discussed.

Annals of the Russian academy of medical sciences. 2019;74(3):200-209
pages 200-209 views


Diagnosis and Choice of a Method of Treatment of Intraabdominal Hypertension and Abdominal Compartment Syndrome

Timerbulatov V.M., Timerbulatov S.V., Fayazov R.R., Timerbulatov M.V., Gaynullina E.N., Smir R.A.


BACKGROUND: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) remain a complex problem of abdominal surgery. To date, the pathophysiological mechanisms, methods for determining intra-abdominal pressure (IAP) the frequency of its measurement, and the methods of conservative and surgical more and more researchers consider surgical decompression as a treatment.

AIMS: Аnalysis of the results of the implementation of monitoring of intra-abdominal pressure and its impact on the outcomes of treatment of patients with severe acute pancreatitis and acute colon obstruction.

MATERIALS AND METHODS: A study of 397 patients with emergency abdominal pathology including 197 with acute obstructive obstruction of the colon (AOOC), 200 severe acute pancreatitis (SAP) was performed. Patients (n=201) were included in the I (main) group, which was carried out using IAP as the main criterion for assessing the patient`s condition and when choosing a method of treatment, in II ― without taking then into account and monitoring. Measurement of IAP, blood lactate was determined primarily, then alternatively 4 to 6 hours. The survey included the study of biochemical indicators, endoscopic methods, visualization (ultrasound scanning, CT of the abdominal cavity organs).

RESULTS: In the I group of IAH patients, I and II degrees were in 73.13%, in the II group — in 79.5% IAH III and IV degrees, respectively, in 26.87% and 21.5% (p>0.05). Measurement of IAP was carried out according to the I.L. Kron method, repeated measurement depending on the degree of IAH after 4−6 hours, simultaneously, as a predictor of internal ischemia, determined the level of lactate in blood and perfusion abdominal pressure. An algorithm for early diagnosis is suggested excess intraabdominal pressure. For I and II, the degree of IAH was treated with aggressive conservative therapy, with failure of intensive therapy III of IAH degree — surgical treatment, with IV degree IAH — emergency decompressive laparotomy. In the I group, the mortality was significantly lower than in the II group: IAH at III, with AOOC 27.7% and 50%, respectively (p>0.05), at SAP — 37.5% and 80% (p<0.01), respectively, at IV degree IAH — for AOOC — 75% and 90% (p>0.05), with SAP — 75% and 88,8% (p>0.05) respectively.

CONCLUSIONS: The results of treatment of patients with IAH can be improved by its early diagnosis, intensive, aggressive therapy of IAH I−III degrees. At IAH I, II degrees conservative treatment is shown, persistent aggressive conservative treatment should be performed at IAH III degree, if it is unsuccessful and IV degree of IAH, an emergency decompressive laparotomy should be performed.

Annals of the Russian academy of medical sciences. 2019;74(3):210-215
pages 210-215 views

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