Vol 77, No 3 (2022)

GASTROENTEROLOGY: CURRENT ISSUES

Peculiarities of Microbiota in Patients with Inflammatory Intestinal Diseases

Sukhina M.A., Yudin S.M., Zagainova A.V., Makarov V.V., Veselov A.V., Anosov I.S., Lyagina I.A., Chistyakova D.A., Safin A.L., Shelygin Y.A.

Abstract

Background. The intestinal microbiota, on the one hand, protects a person from pathogens, on the other hand, it itself may be one of the triggers and/or mediators of progression in inflammatory bowel diseases. Inflammatory bowel disease (IBD) predominantly affects young people of working age. It noted a steady increase in the incidence of IBD in recent decades throughout the world and in Russia. Inflammatory bowel diseases significantly affect quality of life and lead to complications of having to perform surgery, which significantly reduces the quality of life. Aims — of the study was to investigate the composition of the microbiota of the colon, the search features of the microbial spectrum of patients with inflammatory bowel disease patients compared with control patients. Materials and methods. A prospective study was carried out between patients with inflammatory bowel disease and patients without inflammatory bowel disease for the period 2018–2019. The study included 157 IBD patients and 150 patients without IBD. All patients studied stool, which have been subjected to microbiological and metagenomic study. Results. Most often, facultative anaerobic microorganisms were present in the stool of patients with IBD (in 60%, 103–109 CFU/g) and in patients without IBD (69%, 103–109 CFU/g), the share of gram-negative bacteria accounted for 52%, in mostly represented by bacilli belonging to the order Enterobacteriales, only 7% of isolated gram-negative facultative aerobic microorganisms were gram-negative non-fermenting bacteria represented by 5 genera: Acinetobacter, Burkholderia, Pseudomonas, Stenotrophomonas, Ralstonia. Gram-positive facultative anaerobic microorganisms in 89% were represented by cocci of the genus Enterococcus, Streptococcus, Staphylococcus, Micrococcus, Gemella, Globicatella, Granulicatella. Conclusions. According to the results of our study, special attention should be paid to the presence of rare microaerophilic and obligate anaerobic microorganisms in the fecal microbiota of patients with IBD (Arcobacter butzleri, Gardnerella vaginalis, Aromatoleum aromaticum, Terrisporobacter glycolicus (Clostridium glycolicum), Solobacterium moorei, Alloscardovia omnicolens, Fusobacterium nucleatum, Fusobacterium ulcerans, Dialister micraerophilus), that have not been isolated from patients without IBD. A timely adequate assessment of the composition and functional characteristics of the microbiota in terms of key biomarkers will make it possible to carry out targeted diagnostics and prevention of the immediate and long-term consequences of inflammatory bowel diseases.

Annals of the Russian academy of medical sciences. 2022;77(3):165-171
pages 165-171 views

INFECTIOUS DISEASES: CURRENT ISSUES

The Analysis of Anti-Epidemic Measures Carried Out in the Russian Federation in the Context of the COVID-19 Pandemic

Onischenko G.G., Borisevich S.V.

Abstract

The outbreak of a new coronavirus disease,COVID-19, started in December 2019 in China continues to be one of the most important realities of our time influencing all spheres of human activity March 11, 2022 marks two years since the WHO declared a pandemic it is expected that the number of cases by this time may reach the mark 500 million. Taking into account the widespread spread of infection, spontaneous appearance during the natural evolution of the pathogen new highly pathogenic variants of the COVID-19 pathogen for humans the most important is the implementation of anti-epidemic measures representing a set of measures, aimed at preventing the importation and spread of infection. The purpose of the presented article is a analysis of the anti-epidemic measures carried out in the Russian Federation in the context of a COVID-19 pandemic. Anti-epidemic measures include the implementation of measures, directed towards all links of epidemic: on the source, on the transmission path and on the receptive collective. From a wide range of sanitary and anti-epidemic measures carried out nationwide (including organizational and administrative, socio-economic, isolation and quarantine and others) the development of various methods of detection and identification of the COVID-19 pathogen, methods of serodiagnostics with which you can predict indicator of herd immunity, means of prevention and treatment of the disease, means and methods of disinfection is considered. As such measures, the development of means for detecting and identifying the pathogen, means of prevention and treatment of the disease, methods of serodiagnostics, with the help of which it is possible to predict indicator of herd immunity, means and methods of disinfection are considered. An assessment of the effectiveness of the developed tools of diagnostics, prevention and treatment in relation to new variants of the SARS-CoV-2 virus was carried out. The creation of a laboratory model to study an experimental infection which increases efficiency and reliability of ongoing preclinical studies of medical protective equipment is also important.

Annals of the Russian academy of medical sciences. 2022;77(3):172-180
pages 172-180 views

Iron Metabolism Markers in Patients with Tuberculosis Combined with HIV Infection

Abdullaev R.Y., Komissarova O.G., Terentyeva O.R.

Abstract

Background. Changes of iron metabolism in patients with tuberculosis combined with HIV infection is an important task of phthisiology, since, on the one hand, iron deficiency can have a negative effect on the course of the tuberculous process. On the other hand, compensation for iron deficiency may be creating an iron overload situation, promoting replication of M. tuberculosis. Aims — to study in a comparative aspect, changes in iron metabolism markers in patients with tuberculosis combined with HIV infection and without it. Methods. The study included 284 tuberculosis patients who were divided into 2 groups. The first group included 141 patients with tuberculosis combined with HIV (TB/HIV group). The comparison group consisted of 143 tuberculosis patients without HIV (TB group). The assessment of the body’s iron supply was carried out in terms of the concentration of serum iron, transferrin (TF), and ferritin (FT). The study was conducted separately in men and women, since the indicators of iron metabolism in healthy men and women differ significantly. Results. It was found that in men with TB/HIV patients, the decrease in serum iron less than the lower limit of the norm took place in 47.6%, and in the TB group — in 27.3% of cases (p < 0.01). The concentration of TF in the blood serum in the group of TB/HIV patients in men decreased in 69.9%, and in the group of TB patients — in 31.2% of cases (p < 0.01). The level of FT in the TB/HIV group increased in 19.4%, and in the TB group — in 8.3% of cases (p < 0.05). In women, a decrease in iron levels in the group of TB/HIV patients was observed in 39.5%, and in the TB group — only in 2.2% of cases (p < 0.01), a decrease in the level of TF was observed in 55.2% and 24.3% (p < 0.01). A decrease in ferritin levels below 15 ng/ml was observed in 15.7% of women with TB/HIV and in 10.6% of TB patients. A negative relationship was found between iron content and CRP levels. Conclusion. The results of studied made it possible to conclude that in all cases the decrease in iron was caused not by a true deficiency of iron, but by its redistribution in the body. At the same time, a small number of women with tuberculosis combined with HIV infection and tuberculosis without HIV infection showed a significant decrease in ferritin levels, which indicated that they had a true iron deficiency.

Annals of the Russian academy of medical sciences. 2022;77(3):181-188
pages 181-188 views

Von Willebrand Factor and Myeloperoxidase as Laboratory Predictive Markers of In-Hospital Survival in Severe COVID-19 Patients

Makatsariya A.D., Khizroeva J.K., Schoenfeld Y., Tretyakova M.V., Slukhanchuk E.V., Shkoda A.S., Pankratyeva L.L., Petrovsky M.I., Mashechkin I.V., Blinov D.V., Gris J.R., Bitsadze V.O.

Abstract

Background. The severe acute respiratory syndrome of the SARS-CoV-2 virus-mediated coronavirus disease 2019 (COVID-19) highlighted the central role of immunothrombosis. Severe endothelial damage with the release of unusually large multimers of von Willebrand factor (vWF) and subsequent consumption of ADAMTS-13 is described during severe COVID-19. The activation of innate immune cells among which neutrophils contribute to the formation of extracellular neutrophil traps (NETs) and to the release of myeloperoxidase (MPO) potentially contributing to the spread of inflammation and microvascular thrombosis. Objective — to evaluate the ability of vWF, ADAMTS-13 and MPO to predict in-hospital mortality in severe COVID-19 patients needing mechanical ventilation. Methods. We performed a one-center observational study of 79 severe COVID-19 patients entering intensive care unit for mechanical ventilation, examining vWF, ADAMTS-13 and MPO among other potential predictors for in-hospital death. Results. After multivariate analysis, vWF antigen (vWF:Ag) and MPO antigen (MPO:Ag) were finally the single two parameters which increasing values were independently associated with non-survival; vWF:Ag (U/dL): adjusted OR 3.360, 95% CI 1.562–7.228, p = 0.0019; MPO:Ag (ng/ml): adjusted OR 1.062, 95% CI 1.024–1.101, p = 0.0011. From these results a simplified mortality score was derived and patients categorized as having a score value higher or lower that the median value of the score: a high score value was associated with a lower cumulative survival rate (p < 0.0001), 50% of the cases being dead at day 13 post-hospital admission. Conclusions. In severe COVID-19 necessitating mechanical ventilation, increasing values of MPO activity and of vWF antigen tested at admission are associated with poor survival.

Annals of the Russian academy of medical sciences. 2022;77(3):189-198
pages 189-198 views

COVID-19 in Russia: Evolution of Views on the Pandemic. Report I

Starodubov V.I., Beregovykh V.V., Akimkin V.G., Semenenko T.A., Ugleva S.V., Avdeev S.N., Zykov K.A., Trofimova T.N., Pogosova N.V., Perekhodov S.N., Kuzin S.N., Yacyshina S.В., Petrov V.V., Khafizov K.F., Dubodelov D.V., Gasanov G.A., Svanadze N.K., Cherkashina A.S., Sinitsyn E.A., Rvacheva A.V., Sergeeva N.V., Polosova T.A., Zykova A.A., Zelenin D.A., Gorbenko M.Y., Rodyukova I.S., Chaus N.I., Snitsar A.V.

Abstract

Over the two years of the novel coronavirus infection (COVID-19) pandemic, there has been an evolution of views in various fields of medicine, which has led to a powerful development of scientific research in the field of epidemiology, clinic, diagnosis and therapy of COVID-19. The article highlights the evolution of views and approaches to the study of the epidemiology and radiology of COVID-19. The data of molecular genetic studies are shown, which are the most important component of epidemiological surveillance. The study of the manifestations of the COVID-19 epidemic process made it possible to distinguish two stages in the development of the epidemiological situation in the Russian Federation. At the first stage of the epidemic, two rises in the incidence rate of the population were recorded, regulated by social and natural factors. The second stage of the epidemic was due to a change in the biological properties of the SARS-CoV-2 virus, followed by a change in the prevailing genovariants (Alpha, Delta and Omicron). At the second stage of the epidemic, three rises in the incidence of the population were recorded. The general principles for the use of radiodiagnosis methods, which are used primarily to detect lung damage in COVID-19, are given. With the accumulation of experience, a natural change in ideas about the algorithms for the use of visualization technologies has occurred.

Annals of the Russian academy of medical sciences. 2022;77(3):199-207
pages 199-207 views

NEUROLOGY AND NEUROSURGERY: CURRENT ISSUES

Рotential Laboratory Markers of Vincristine-Induced Peripheral Neuropathy

Kovtun O.P., Bazarnyi V.V., Koryakina O.V.

Abstract

New chemotherapy agents of haematological malignancies in children often lead to adverse drug reactions, including vincristine-induced peripheral neuropathy (VIPN). The incidence of this pathology ranges from 22 to 72%. The clinic and instrumental evaluation of children with VPN, including questionaries, scales, electrodiagnostic examinations, do not provide an opportunity for prognosis and early detection of chemotherapy-related neurologic complications. Consequently, identifying biomarkers associated with VIPN is urgently warranted that discussed in this review. PubMed and Scopus were browsed based on the keywords that allowed us to select 55 articles (4 systemic reviews, 14 scientific reviews, 37 original articles) between 2017 and 2021. Reports from the included studies clearly emphasize that vincristine-induced peripheral neuropathy is associated with changes in plasma and cerebrospinal fluid (CSF) levels of the nerve growth factor (NGF) light chains of neurofilaments (NfL) and brain derived neurotrophic factor (BDNF) that are biomarkers of axonal damage. However, none of them do have criterion validity — sensitivity and specificity. One of the most promising prognostic biomarkers is CХCL10 and CXCL12 that detect children with or without VIPN (sensitivity — 79%, specificity — 78%). The next task is finding an optimal profile of these cytokines. These cytokines together with axonal biomarkers can be used for the diagnosis and prevention of chemotherapy-induced neurotoxicity in children.

Annals of the Russian academy of medical sciences. 2022;77(3):208-213
pages 208-213 views

ONCOLOGY: CURRENT ISSUES

The Role of Molecular Genetic Studies in Current Oncology

Kit O.I., Maksimov A.Y., Jenkova E.A., Timoshkina N.N.

Abstract

Genetic information, both inherited and tumor-specific, is becoming an increasingly important factor in the implementation of therapeutic strategies in oncology, providing an individual approach to each patient. Every year, an increasing number of achievements in medical genetics are introduced into oncological practice in the form of laboratory tests, diagnostic panels and practical recommendations. The article provides a brief overview of the results of genetic studies performed at the Federal National Medical Research Centre for Oncology of the Ministry of Health of the Russian Federation from the beginning of their implementation in 2013 to the present day. We have demonstrated not only testing data within the framework of clinical recommendations, but also an analysis of the search for new genetic, epigenetic and proteomic markers, which seem promising for the development of new target drugs, diagnostic and prognostic test systems. We believe that the model of interaction between a researcher and an oncologist used in our center allows us to shorten the path from a scientific hypothesis to the creation and implementation of innovative technologies.

Annals of the Russian academy of medical sciences. 2022;77(3):214-224
pages 214-224 views

Main Scientific Directions of Oncology Development in the Republic of Tatarstan

Hasanov R.S., Akhmedova G.M., Karpenko L.G., Gataullin I.G.

Abstract

The article is devoted to the main directions of oncology development in the Republic of Tatarstan. The results of comprehensive scientific research of the Kazan Scientific Oncology School are presented, the main scientific directions of the development of oncology in the Republic of Tatarstan are highlighted. Currently, the Oncological Service of the Republic of Tatarstan unites the Oncological Dispensary with branches, the Departments of Oncology, Radiology and Palliative Medicine, Obstetrics and Gynecology, Urology, Radiation Diagnostics of KSMA, the Department of Oncology, Radiation Diagnostics and Radiation Therapy of KSMU and other departments. Several important stages of the formation of the Kazan Scientific Oncological School are noted. The history of development is inextricably linked with the formation of the Department of Oncology at Kazan State Medical Academy. The main measures to reduce mortality from cancer are presented. The main tasks of the oncological service of the Republic of Tatarstan are described. Scientifically based complexes of measures for the rehabilitation of cancer patients have been implemented. Scientific knowledge has been translated into healthcare. Approaches to the organization of oncological services based on modern scientific achievements, developed methods of rehabilitation and palliative care, the implementation of these approaches into clinical practice contribute to improving the effectiveness of providing medical care to cancer patients, achieving the set targets.

Annals of the Russian academy of medical sciences. 2022;77(3):225-229
pages 225-229 views

EPIDEMIOLOGY: CURRENT ISSUES

Formation of Cross-Disciplinary Interaction of Epidemiology and Pathological Physiology during Post-Nonclassical Development of Science

Savilov E.D., Briko N.I., Krulikovsky A.I.

Abstract

In the submitted message the process of historical formation of epidemiology and the prospect of development of this preventive discipline in its cross-disciplinary interaction with a pathophysiology on new, post-nonclassical, a stage of formation of science is considered. These two fundamental medical sciences are engaged in any diseases (pathological states) irrespective of their origin and have identical approaches to their study which in the most generalized view can be reduced to identification of the causes, mechanisms of development and outcomes of pathological states at the level of generalizations. In both scientific disciplines also an object of researches — a disease of the person (sick organism) is identical. Fundamental differences take place only for the main subject of studying these sciences which pathological processes for a pathophysiology and population morbidity, including its consequences, for epidemiology are. But and these categories in many respects are an essence one and too, but only at various levels of the organization of live. Therefore, the nature of transformations of both scientific disciplines in philosophical and methodological sense completely keep within a framework of modern transformations of science during formation of its post-nonclassical stage. It in turn assists formation of the next (cross-disciplinary) period in epidemiology which continues and develops basic provisions of its third stage defining population approach when studying various pathology. Thus, in the period of post-nonclassical science there is a process of cross-disciplinary formation of epidemiology that brings her to higher level of development and generalizations.

Annals of the Russian academy of medical sciences. 2022;77(3):230-237
pages 230-237 views

ANNIVERSARIES, CONGRATULATIONS

To the 70th Anniversary of Academician of the Russian Academy of Sciences Vitaliy Vasil’evich Zverev

Svitich O.A.

Abstract

June 03, 2022 70th years have passed since the birth of Academician of the Russian Academy of Sciences, Doctor of Biological Sciences, Professor, Scientific Director of the Federal State Budgetary Scientific Institution Research “I. Mechnikov Institute of Vaccines and Serums”.

Annals of the Russian academy of medical sciences. 2022;77(3):238-239
pages 238-239 views

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