Vol 76, No 1 (2021)

Background. In 2020, the pandemic caused by novel coronavirus infection has become one of the most critical global health challenges during the past century. The lack of a vaccine, as the most effective way to control the novel infection, has prompted the development of a large number of preventive products by the scientific community. We have developed a candidate vaccine (EpiVacCorona) against novel coronavirus infection caused by SARS-CoV-2 that is based on chemically synthesized peptides conjugated to a carrier protein and adsorbed on aluminum hydroxide and studied the specific activity of the developed vaccine.

Aims — study of the immunogenicity and protectivity of the peptide candidate vaccine EpiVacCorona.

Methods. The work was performed using standard molecular biological, virological and histological methods.

Results. It was demonstrated that EpiVacCorona, when administered twice, spaced 14 days apart, to hamsters, ferrets, and non-human primates (african green monkeys, rhesus macaques) at a dose of 260  μg, which is equal to one inoculation dose for humans, induces virus-specific antibodies in 100% of the animals. Experiments in hamsters showed this vaccine to be associated with the dose-dependent immunogenicity. The vaccine was shown to accelerate the elimination of the virus from the upper respiratory tract in ferrets and prevent the development of pneumonia in hamsters and non-human primates following a respiratory challenge with novel coronavirus.

Conclusions. The results of a preclinical specific activity study indicate that the use of EpiVacCorona has the potential for human vaccination.

Background: Pneumococcal disease is common cause of morbidity and mortality in adults and children worldwide. The severity of pneumococcal diseases determines their high socio-economic significance.

Aims: Estimate the burden of pneumococcal infection and vaccination coverage in Russia.

Methods: The data was obtained from federal surveillance system. The information obtained was analyzed using descriptive statistics methods.

Results: The annual incidence of community-acquired pneumonia in Russia was 491.7/100000 in 2011-2019. It ranges from 359.8/100000 among adults of working age to 1505.4/100000 among children 1-2 years old. The upward trend of incidence is observed throughout the period, most expressive among school-age children (7-17 years old). Total 29.2% of all pneumonia have an identified etiology. 94% of pneumonia with known etiology are bacterial, 8.4% among it are pneumococcal.

Pneumonia accounts for 57% of all deaths from respiratory diseases among children under five (3.7/100000) and 34% among elderly. The death rate from pneumonia in 2009-2018 tends to decrease. In 2018, 25.5 thousand deaths from pneumonia were registered (17.5/100000). The highest  rate is observed among children under one year (14.0 /100000) and elderly (41.2 /100000).

There is a downward trend in incidence of otitis media. The incidence in children under 14 was 2612.6/100 000 in 2018. The incidence of bacterial meningitis is 1.4/100 000. Every year 2-3 thousand cases are registered, 43-52% of which are among children (3.04/100000., maximally in children under one year old, 13.2/100000).

The level of vaccination against pneumococcal infection is increasing annually, but the proportion of children who have received a completed course of vaccination remains insufficient (64.6% in 2019). Coverage among the adult population was 2.3% (3.8% among those over 60). The main contingents of vaccinated adults are conscripts (coverage 67.4%) and people with chronic lung diseases (coverage 15.1%).

Conclusions: The socio-economic and epidemiological burden of diseases associated with pneumococcal infection in Russia remains high. Accurate assessment of morbidity and mortality rates caused by St. pneumoniae diseases isnt possible due to the insufficient level of their ethological identification. Further efforts are required to achieve high level of herd immunity against pneumococcal infection through vaccine prevention during COVID-19 pandemic.

In most cases, COVID-19 has a favorable outcome. However, the risk of developing critical forms of the disease, including secondary hemophagocytic lymphohistiocytosis – HLH (cytokine storm syndrome), remains high. This dictates the interest in studying pathogenetic mechanisms, features of the clinical picture, laboratory and instrumental criteria for covid-19 disease. The article analyzes the causes of acute respiratory distress syndrome and multiple organ failure as manifestations of HLH. The necessity of monitoring signs of hyperinflammation (ferritin, C-reactive protein, etc., biomarkers of inflammation) and activation of thrombosis is substantiated, in order to make timely decisions about the beginning of pathogenetic therapy. However, there are limitations for routine testing of the level of Pro-inflammatory cytokines. Information about the diagnostic criteria of HLH is summarized, and the expediency of these criteria for establishing secondary HLH, which has complicated the course of COVID-19, is emphasized.

Ebstein anomaly is a congenital heart disease, which is characterized by the presence of atrialized portion of the right ventricle, formed as a result of displacement of the tricuspid valve leaflets into the right ventricle and their partial adherence to the underlying myocardium. Atrialized portion in the right ventricle occupies the space between the fibrous annulus of the right atrioventricular orifice and the functional annulus of tricuspid valve, which represents a zone of closure of free (non-adherent to the underlying myocardium) edges of its leaflets. Ebstein anomaly is very rarely isolated, and can be combined with a number of heart diseases and be an integral part of hereditary syndromes. Currently, the role of genetic research in the investigation of the etiology of human diseases as well as understanding of the relationship between different diseases is increasing. The review presents literature data on the combination of Ebstein anomaly with other heart diseases (congenital heart diseases, Wolf-Parkinson-White syndrome, cardiomyopathies, including left ventricular noncompaction), inter alia, within the scope of hereditary syndromes (Noonan syndrome, 8p deletion syndrome, 18q deletion syndrome, 1p36 deletion syndrome, Pierre Robin syndrome). Genetic factors (gene and chromosomal mutations) lying at the core of Ebstein anomaly, as well as heart diseases combined with it, are highlighted. The analysis of published data suggests that Ebstein anomaly is a monogenic disease, and is characterized by allelic and locus genetic heterogeneity. The combination of Ebstein anomaly with other heart diseases is based on their genetic linkage.

The prospects for the human embryos genome editing cause intense debates both in the scientific community and in general public. While the main attention of scientists is focused on the safety, effectiveness and clinical feasibility of the inherited genome editing, the public pays attention to the bioethical aspects of the issue - the prospects of a “baby design”, the development of new forms of social inequality and intervention in human evolution. The authors conducted an interdisciplinary analysis of medical genetics and bioethical issues of human embryo genome editing, revealed the possibilities and limitations of genome editing technology, and considered the specifics of ethical discussions. The conceptualization of the main approaches of natural and social sciences in a general theoretical framework made it possible not only to take into account the complex nature of the issues, but also to create the prerequisites for its further productive discussion.

The article presents the materials of systematization and scientific study of the main international and Russian normative documents in the field of healthcare and rights of children and adolescents aged 0-17, and of the practical implementation of an intersectoral/interdepartmental approach in relevant programs. A set of modern methods of socio-hygienic and medical-organizational research, including statistical, historical insights, expert evaluation, study of departments’ experience, and others was applied, with an emphasis on analysis.

Based on the model of the younger generation, the authors consider the current problems of implementing an interdepartmental approach to healthcare and protection of the rights of children and adolescents, recommended in recent years by leading international organizations, primarily The United Nations (UN): and the World Health Organization (WHO). The authors analyze the leading Russian normative documents based on international policy and illustrates the state of the approach in the Russian Federation, which is considered to be the leading, most effective mechanism for achieving the goals of strategies and integrated programs in this area, with an emphasis on preventive measures and the organization of primary healthcare as the most accessible and affordable to the public.

The results of a comprehensive analysis of federal and international official documents actualized the need for intersectoral activities in healthcare, education, social protection and other systems to strengthen the health promotion of the younger generation, which is considered to be the less protected group of population from the perspective of health and social well-being. The article shows the importance of further improvement of comprehensive research on the scientific justification of optimal, real and effective for the federal and territorial levels of organizational methods for interdepartmental healthcare of the younger generation in Russia.

Vitamin D-binding protein (DBP) was discovered more than half a century ago as a polymorphic serum protein and is currently characterized by a variety of physiological properties. First of all, DBP carries the bulk of vitamin D metabolites circulating in the bloodstream, while albumin is the second most important transport protein, especially in patients with a low concentration of DBP in serum. Since it was discovered that only 1–2% of the total circulating DBP have occupied steroid binding sites, a vigorous study of other potential biological roles of DBP was initiated: actin utilization, regulation of inflammation and innate immunity mechanisms, fatty acid binding, effects on bone metabolism and participation in the tumor pathogenesis. This review focuses on the main known biological functions of DBP.

The Hero of Labor of the Russian Federation Ivan Ivanovich Dedov turned 80 on February 12! The Department of Medical Sciences of the Russian Academy of Sciences congratulates RAS Academician Ivan Ivanovich Dedov!