Vol 78, No 1 (2023)

This review is devoted to endometriosis-associated immune cells and immune molecules, analysis of various databases, new insights, theories, biomarkers, reviews of research in this area. To date, many attempts have been made to establish a certain role of immune cells and the microenvironment in the development of endometriosis. Nevertheless, despite intensive studies of endometriosis, the role of inflammatory cells and molecules has not yet been fully studied. As we know, the pathobiology of endometriosis is not fully understood, and its progression is associated with a local and systemic inflammatory reaction. It is important to clarify the role of the immune system to better understand its significance in the pathogenesis of endometriosis, especially in the case of atypical and endometriosis-associated ovarian tumors. The above requires further study of this problem in order to optimize the pathogenetically justified modern therapy of endometriosis.

Background. An extremely small number of studies have been devoted to the study of differences in LIC (liver iron concentration) and MIC (myocardium iron concentration) indicators, as well as their correlation with each other and with ferritin levels in patients with various nosological forms. Aims to study the relationship of ferritin, LIC and MIC levels in patients with various causes of hemochromatosis (hereditary hemochromatosis (HH), aplastic anemia (AA), primary myelofibrosis (PMF), thalassemia (TL), myelodysplastic syndrome (MDS)). Methods. The design of the study is a single–stage observational one. The study included 91 patients with primary hemochromatosis and secondary transfusion-dependent hemochromatosis receiving regular blood transfusion and iron chelate therapy from 2015 to 2018. The studies were carried out on 1.5 T MR-scanner Magnetom Espree (Siemens, Germany), and myocardial iron concentration (MIC) was calculated using the formula MIC = 45 × (T2*) – 1.22. Liver iron concentration (LIC) was calculated using the formula LIC = 0.03 × R2* + 0.74. The ferritin level was determined by enzyme immunoassay. Statistical processing of the results obtained was carried out using the SPSS software package. Results. Connections between LIC and ferritin (r = 0.867; p < 0.001), MIC and ferritin (r = 0.759; p = 0.004) and LIC and MIC (r = 0.737; p = 0.006) were found in patients with primary hemochromatosis, while in patients with secondary hemochromatosis significant correlations were found only between LIC and MIC (r = 0.503; p < 0.001), while the relationship was average. Links between LIC and ferritin were found in patients with AA (r = 0.656; p = 0.040), an average relationship, in patients with TL (r = 0.714; p = 0.020), an average relationship. The relationship between MIC and ferritin was revealed in patients with AA (r = 0.703; p = 0.050), an average relationship, in patients with TL (r = 0.757; p = 0.018), an average relationship. At the same time, in patients with MDS and PMF in this study, there was no association between ferritin and LIC, ferritin and MIC. Conclusions. In patients with hereditary hemochromatosis, LIC and MIC are associated with ferritin, and MIC is also associated with LIC (medium bond). In patients with iron overload due to thalassemia, an average correlation between LIC and ferritin, MIC and ferritin was revealed. In patients with iron overload due to aplastic anemia, an average correlation between LIC and ferritin, MIC and ferritin was revealed.

Infectious diseases, due to their epidemic potential, are capable of global spread, they are unpredictable, and their effective control is possible only on a planetary scale. In no other field of medicine, such radical and often unpredictable changes occur in a short time in the form of the elimination of individual diseases, the identification of a large number of previously unknown and the return of already forgotten diseases, a significant change in the pathogenesis and clinical symptoms of a significant number of them. Under these conditions, these changes often create problems for the health authorities and the public, ahead of their ability to recognize and respond in a timely manner to the emergence of epidemics and the transformation of pathological manifestations. Significant recent scientific progress has only slightly clarified our knowledge of the biological and genetic diversity of pathogens. Until now, the entire spectrum of infectious pathology remains unclear, and its numerous manifestations often take even experienced specialists by surprise. Evidence of our limited knowledge and ability to control the situation is the ongoing COVID-19 pandemic for three years now, the increasingly frequent detection of “new” infections, the return of infections declared defeated, evidence of the role of infectious factors in the etiology of many other human diseases.

α-Isomer of Klotho Protein has been actively studied over the past 20 years. It has been found that α-Klotho is closely associated with aging and has anti-aging properties. Besides, it is involved in development of malignant tumor diseases. Its universal influence on many biological mechanisms leading to hyperplastic changes in cells and tissues has been proven experimentally. Recent studies demonstrated inhibitory effect of α-Klotho on the classical carcinogenic pathways such as insulin-like growth factor 1 (IGF1), fibroblast growth factor (FGFs), transforming growth factor β1 (TGFb1), Wnt, P53/p21, oxidative stress response pathways. Impeding effect of α-Klotho protein on the development of such types of malignant tumors as breast, pancreatic, lung, stomach, hepatocarcinoma, and others is proven in a number of cases. This review describes the role of α-Klotho in oncogenesis, its involvement and influence on the main signaling pathways known for their role in the development of malignant tumors, and the possibility of regulating its expression.

Background. In order to achieve the technological sovereignty of the Russian Federation, the transformation of existing scientific reserves into in-demand technologies and technologically independent sectors of the economy, special attention is paid to the frontier areas of world science. At the same time, frontiers are understood as thematic areas on the basis of which Russian critical technologies will be developed in the import-saving paradigm. Aims — the purpose of the study is to identify the most promising niches of the global pharmaceutical market and research areas focused on their expansion. Methods. Analysis of the volume of R&D financing by the world’s leading pharmaceutical companies in the period 2015–2022, multi-criteria scientometric analysis and thematic mapping of the collection of the most highly cited reviews published in 2020–2022 and indexed in the Scopus database. Results. The analysis of the volume of R&D financing by the world’s leading pharmaceutical companies in the period 2015–2022, and their average annual growth rates, was carried out. It is shown that with an annual increase in the corporate R&D budget of 2.8%, by 2022 the total R&D expenditures of key players in the global pharmaceutical market reached $182 billion per year. At the same time, 60% of these funds ($109.4 billion) fell in 2022 to the top 20 global pharmaceutical companies investing in the development of new medicines. For comparison, the internal costs of research and development of the Russian Federation are given, which, taking into account the GDP deflator as of 08.04.2022, are estimated at $48 billion, of which the amount of budget funding provided in 2023 for the priority direction of the Strategy of Scientific and Technological Development of the Russian Federation “Transition to personalized medicine, high-tech healthcare and technologies health savings, including through the rational use of medicines (primarily antibacterial)”, will amount to 39.5 billion rubles. Given the relatively low level of funding for domestic research and development of new medicines (compared to the budgets for R&D of pharmaceutical companies in the world), it seemed important to identify the most promising niches of the global pharmaceutical market and research areas focused on their expansion. Conclusion. As a result of multi-criteria scientometric analysis and thematic mapping of the collection of the most highly cited reviews published in 2020–2022 and indexed in the Scopus database, 10 frontier research areas have been identified that have the potential to transform the structure of the global pharmaceutical market until 2030.

The development of original drugs is a complex, time-consuming, labor-intensive, costly, and risky process. The pharmaceutical industry is a critically important area of technological sovereignty of the country. Effective functioning of the drug supply system is impossible without original drug development process, which provide the foundation for progressive evolution of a number of branches of the socio-economic sector of the country’s economy. Domestic pharmacology faces several unresolved problems, many of which must be viewed through the prism of pharmacological disciplines, primarily theoretical and clinical pharmacology, and considering the evolution of approaches used in them. Pharmacology is a system of thought for pharmacologists and experts in drug development, aiming not only to improve the quality and quantity of drugs created, but also to accelerate this process. This article describes the essence of the pharmacological approach, briefly describing the main stages of the development of an original drug — from the idea to research conducted, after the widespread introduction of the drug into clinical practice. At the end of the article the authors presented the successful experience of pharmacological approach application by pharmacologists of Volgograd State Medical University on the example of the development of an original drug for the treatment of diabetes mellitus and its complications.

Background. Over the past 10 years, the incidence of benign prostatic hyperplasia (BPH) over 80 cm³ has increased 3–4 times. With indications for surgical treatment, transurethral methods are increasingly used today with the use of laser or plasma techniques for resection and enucleation of the prostate. The article presents a comparative analysis of the results of plasma transurethral enucleation of the prostate (P-TUEP) and open prostatectomy, methods of surgical and drug prevention of dysuric complications, which indicates the primacy of the choice of P-TUEP in large and giant BPH surgery. Aims — to prove the effectiveness of the use of plasma surgical methods and the scheme of complex medical postoperative prevention of late dysuric and cicatricial complications in the treatment of benign prostatic hyperplasia of large and giant sizes. Methods. The design of a retrospective cohort trial included several stages conducted at the urological center of the clinical hospital “RZD-Medicine”, Nizhny Novgorod in 2008–2019. The object of the study were patients with a confirmed diagnosis of large BPH (over 80 cm³) and giant (over 250 cm³) size, divided into the main and control groups according to the methods of surgical intervention and postoperative prevention of dysuric complications. The selection of patients was carried out by the method of “paired design” with an equal number of observations and maximum comparability of the initial parameters. Data analysis was carried out using the methods of parametric and nonparametric statistics, multivariate statistical analysis. Results. Comparison of the results of P-TUEP (n = 122) and open prostatectomy (n = 122) in groups of patients with large and giant BPH showed the possibility of reducing intraoperative blood loss by 1.5 times, the duration of bladder catheterization — by 3.8 times, the frequency of early postoperative complications — by 1.7 times and the duration of hospitalization — by 2.9 times, which significantly saves hospital costs. Modification of the initial stage of P-TUEP, which consists in creating access to the prostate using new anatomical landmarks to maximize the preservation of the anterior fibrostromal complex, reduces the risk of trauma to the external urethral sphincter, which was proven by a three-fold decrease in the frequency of stress incontinence after surgery. In order to prevent late dysuric and cicatricial complications of P-TUEP, a scheme of complex medical postoperative prophylaxis with the use of a hyaluronic acid preparation was developed. It has been histologically and clinically confirmed that instillations of a hyaluronic acid solution into the bladder in combination with standard postoperative therapy make it possible to accelerate reparative processes by 2–4 times and get rid of irritative symptoms at 6–12 postoperative weeks, depending on the volume of removed BPH. Conclusion. The validity of the use, clinical and economic efficiency, high safety profile and the primacy of the choice of P-TUEP in surgery of large and giant BPH, including its modified technique and a comprehensive scheme of drug prevention of late complications, have been proven.

On December 14, 2022, Yevgeny Lhamatsyrenovich Choinzonov, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Honored Scientist of the Russian Federation, Director of the Research Institute of Oncology of the Tomsk National Research Medical Center of the Russian Academy of Sciences, Head of the Department of Oncology of the Siberian State Medical University (Tomsk), turned 70 years old.