Modeling of bacterial lipopolysaccharide-induced endometritis in rats and the possibility of its therapy using plasma enriched with soluble platelet factors

We presents results of a study on endometritis modeling in rats with double intravaginal administration of bacterial lipopolysaccharide (LPS). The established endometrial inflammatory process was accompanied by a decrease in the weight of animals, an increase in the weight of the uterus, neutrophilic infiltration, edema, and overexpression of cyclooxygenase in endometrium on 30-45 days after the start of endometritis induction. Local intravaginal use of plasma enriched with soluble platelet factors/platelet-rich plasma (PORFT/PRP) caused a decrease in the intensity of the inflammatory process and the rate of neutrophil infiltration of the endometrium, a decrease in the intensity of cyclooxygenase, interleukin-6 and transforming growth factor-β expression, and an increase in the body weight of animals. The conclusion was made on the possibility of creating model of endometritis in rats by double administration of LPS and the ability of local administration of PORFT/PRP to have a therapeutic effect on the inflammatory process in the endometrium.

Chronic obstructive pulmonary disease and smoking in COVID-19.

COPD is a chronic disease that progressively worsens the patient's respiratory function. Infection with SARS-CoV-2 in a patient with COPD with initially low respiratory rates should theoretically lead to a more severe course and a high probability of lethal outcome. However, at present, no direct connection has been found between the presence of COPD, smoking and a high risk of being infected or severe course of SARS-CoV-2 infection. Of great importance in the study of these paradoxical facts is the interaction between the reninangiotensin and nicotinic cholinergic systems. In this review, we perform an extensive literature search for studies of the relationship between COPD, smoking, and SARS-CoV-2 infection.

Superficial fungal infections in a time of pandemi

Current challenges for healthcare systems worldwide should not overshadow global prevalence of contagious superficial fungal infections. Causative agents, patterns of their spread and clinical manifestations of cutaneous mycoses all change and so does our knowledge of fungal biology and genetics. Sooner or later, dermatologists would have to adapt or develop newer diagnostic and therapeutic modalities according to novelties im dermatophyte taxonomy and major epidemiologic shifts. Common management of tinea infections in most developed countries including Russia still relies on the same hundred years old mycological techniques and the same antifungals as decades ago. Emergence of resistant dermatophyte strains and reported series of recalcitrant tinea infections in some regions of the world raise awareness in Europe today and may be expected in Russia tomorrow. Learning from recent international experience and clinical trials, one may need reappraisal of different topical antifungals recommended in Russia.

Vitamin D and antimicrobial peptides in congenital pneumonia of premature newborns

Introduction. One of the leading causes of morbidity in newborns is the pathology of the respiratory tract. Among this group of patients, and especially premature newborns, congenital pneumonia takes the leading role among diseases of the respiratory system. The aim of the work was to identify the relationship between the level of vitamin D and endogenous antimicrobial peptides in congenital pneumonia of premature infants. Material and methods. We observed 2 groups of premature newborns: 32 newborns with congenital pneumonia, and the comparison group consisted of 20 "almost healthy" newborns without respiratory tract pathology. Results. In patients with pneumonia, the level of vitamin D was significantly lower (9,57 [6,57-17,25]) when compared with conventionally healthy newborns (21,1 [9,2-32,02]), p<0.01. However, in the group with congenital pneumonia, the levels of cathelicidin LL-37 and HBD-2 were significantly higher (2,87 [2,3-4,43] and 240,4 [132,4-406,7]) compared with another group (1,6 [0,8-2,5] and 156,7 [82,4-208,7]), p<0,01. Moreover, patients with severe congenital pneumonia had significantly lower concentration of vitamin D (7,6 [5,7-13,2]) and higher cathelicidin LL-37 (3,75 [2,8-4,26]) compared with patients with moderate pneumonia (13,7 [9,7-16,5] and 2,5 [2,1-3,7], respectively). But we did not observe such a relationship with HBD-2 (in severe congenital pneumonia, there was a decrease in HBD-2 (220,4 [142,6-401,6] and 278,2 [154,6-378,6], respectively). Conclusion. Lower vitamin D concentrations in serum may be have significant associatiation with congenital pneumonia. Also, vitamin D levels can predict the need for mechanical ventilation and the duration of hospitalization for congenital pneumonia in premature infants.

Features of local and systemic production of pro-inflammatory, chemoattractant mediators and vascular growth factors in high-risk corneal transplants.

Purpose: to study the composition and content of proinflammatory cytokines, chemoattractant mediators, vascular growth factors in blood serum (SB) and lacrimal fluid (LF) in patients with KPHR. Materials and methods. A total of 106 patients with postinflammatory corneal spots and turbid transplant were examined. The control group consisted of 20 practically healthy donors. Cytokines: IL-2, IL-18, MCP-1 / CCL2, MIP-1β / CCL4, RANTES / CCL5, Eotaxin / CCL11, IP-10 / CXCL10, SDF-1α / CXCL12, VEGF-A, VEGF-D, PIGF-1, HGF / SF. Results. The study of the levels of systemic production of immunomodiators in the groups of patients revealed significant changes in the concentrations of MCP-1 / CCL2, RANTES / CCL5, Eotaxin / CCL11, IP-10 / CXCL10, SDF-1α / CXCL12, as well as angiogenic factors VEGF-A and HGF / SF compared to controls. In the group of primary KPHR in the presence of vascularization, an increase in the production of IL-18, RANTES / CCL5, Eotaxin / CCL11 was observed. 1 / CCL2, VEGF-A, PIGF-1 and HGF / SF (p<0.05). Graft vascularization in repeated (2 and higher) corneal transplants (group II) was associated with significant increases in SC IL-2, PIGF-1, and HGF/SF (p<0.05). Analysis of cytokine content in the LF of patients with repeated KPHR and vascularized graft showed a statistically significant increase in IP-10 / CXCL10, MIP-1β / CCL4, SDF-1α / CXCL12, and VEGF-A. A retrospective analysis of the content of cytokines in the SB, depending on the outcomes of keratoplasty, showed a significant increase in the concentration of 7 out of 11 studied cytokines in patients of the KPHR group with various complications in the postoperative period, including those with a developed graft rejection reaction. Conclusions. It has been shown that the formation of vascularized corneal spots is associated with a significant increase in systemic production of IL-18, an increase in the concentration of chemokines with angiogenic activity RANTES / CCL5 and Eotaxin / CCL11 in the blood of patients with KPHR. During vascularization of the graft with repeated KPHR in the SB and LF, a unidirectional increase in the levels of IL-2, MCP-1 / CCL2, growth of VEGF-A and HGF / SF is observed. A factor in the development of graft rejection is the initially high concentrations in the SB of patients with KPHR IL-2, IL-18, chemokines RANTES / CCL5, MIP1β / CCL4, VEGF-A, PLGF, HGF / SF (p<0.05), indicating about the activation of pathological angiogenesis against the background of inflammation and an activated adaptive immune response.

Comorbidity of atopic bronchial asthma and food allergy in adults

Adult patients with atopic bronchial asthma are susceptible to food allergy, in more than one third of cases, while asthma is a risk factor for severe life-threatening factors. The aim of the study was to determine the prevalence and relationship of food allergies with atopic bronchial asthma in adults living in Chelyabinsk. Materials and methods. An analysis of 313 outpatient case histories of patients with atopic bronchial asthma over the age of 18 was performed. Results. The presence of food allergy was a factor in the earlier onset of atopic bronchial asthma, which is consistent with the concept of comorbidity of these diseases. Patients with seasonal allergic rhinitis and pollen sensitization have an increased risk of developing food allergies (OR – 2.075 [1.27- 3.39]), p=0,004. The overall incidence of oral allergic syndrome among all patients with atopic asthma and plant sensitization was 33% [28; 37]. Plant products (fruits, honey, nuts) were the cause of food allergic reactions in 87% [80; 92] of adult cases. The main clinical manifestations were: oral allergic syndrome, urticaria, angioedema, shortness of breath. Sensitization to pollen of trees, grasses and weeds approximately equally increases the risk of developing an oral allergic syndrome, upon sensitization to tree pollen (OR – 3.08 [2.32-4.25]), to grass pollen (OR – 3.5 [2.23-5.61]), to weed pollen (OR – 2.86 [2.02-4.03]). The combination of several types of pollen sensitization increases by 4 times the risk of developing oral allergic syndrome to a wide range of foods. Conclusion. Data on the causes and clinical manifestations of food allergies in combination with bronchial asthma have been obtained. The notion of a significant risk of developing dangerous clinical manifestations of food allergy in patients with atopic bronchial asthma will make it possible to reasonably prescribe emergency drugs for independent use.

Activity of hydrolytic enzymes of innate immunity in bacterial and coronaviral pneumonia.

The aim of this work was to study the enzymatic activities of hydrolases in the blood serum of patients with bacterial pneumonia, pneumonia caused by SARS-CoV-2 and practically healthy volunteers who made up the comparison group. A number of blood serum enzymes related to innate immunity were determined: lysozyme, elastase, BAPNAamidase and deoxyribonuclease activity. Results: it was shown that blood serum in pneumonia caused by SARS-CoV-2 has the highest level of elastase and lysozyme activities, which significantly (p<0,001) exceeded the corresponding activities of sera amongst patients with bacterial pneumonia and in the comparison group. It was also found that trypsin-like activity of blood serum was increased in bacterial pneumonia in comparison with pneumonia caused by SARS-CoV-2 (p <0,001). There were no statistically significant differences in the level of deoxyribonuclease activity of blood serum among analyzed groups.

The relationship of the level of β-defensin-1 in the saliva of patients with oral candidiasis after CoVID-19 infection

Aim: to determine the level and clinical significance of β-defensin-1 in the saliva in patients with Candida stomatitis after a previous coronavirus infection. The object of the study was 67 patients with Candida stomatitis (of which 31 patients had a PCR-confirmed diagnosis of coronavirus infection) and 23 patients of the control group without candidal stomatitis. Research methods: taking smears from the oral mucosa to confirm the diagnosis with a microbiological method, ELISA to assess the level of β-defensin 1 in the saliva. Аccording to the results of the study, in the group of patients with oral candidiasis (ОС) after COVID-19 (n=31), the most frequent was the chronic hyperplastic form of candidiasis (64,5%), in terms of localization – Candida glossitis (77,4%, p<0,05). It was found that the primary ОС in the group of patients after COVID-19 (n=31) was 74,2% of cases (p<0,05), and in the group of patients with ОС without a history of COVID-19 (n=36) this indicator amounted to 41,7%. Moreover, in patients in the group with ОС after COVID-19, the level of β-defensin-1 strongly positively correlated with the incidence of primary episodes of ОС (RSpearman=0,76, p<0,001). It was also found that the lowest β-defensin-1 level in saliva was in patients with ОС after COVID-19 (2,1±0,8 ng/ml, p<0,001). It was significantly lower (p<0,001) than in the group of patients with ОС and the control group. It was found that in patients with ОС after COVID-19, the level of β-defensin-1 in the saliva was negatively correlated with the duration of the COVID-19 (RSpearman=- 0,78, p<0,001), which can be interpreted as an objective indicator of the effect of SARS-CoV-2 on epithelial cells of the oral mucosa.

Actual problems of mycoses caused by dimorphic pathogens

The literature review focuses on actual problems of the particularly dangerous mycoses – coccidioidomycosis, histoplasmosis, blastomycosis, paracoccidioidomycosis. The review presents modern data on the global spread of these fungal infections. Planetary climate changes widen the endemic areas of particularly dangerous mycoses by increase of the inhalational exposure of soil after dust storms, earthquakes and floodings. The prevaling view on the life cycle of agents of coccidioidomycosis (Coccidioides immitis, C.posadasii) is that these fungi dwell in soil (are saprobes) and so for them human and small-mammal fauna are only accidental hosts. The new alternative hypothesis implies that tissue form (spherule) of Coccidioides spp. lives in host granulomas of small mammals and transforms into spore producing hyphae when the animal host dies. It is demonstrated that Histoplasma capsulatum contains at least four different cryptic species, that differ genetically and express different virulence. Recently, discoveries of novel dimorphic systemic fungal pathogens have challenged the current taxonomy of family Ajellomycetacae. The new genus Emergomyces including five species is described. Another dimorphic pathogen is discovered and named Blastomyces percursus. These fungi cause disseminated mycoses globally, primarily in HIVinfected patients.

Experience of using tocilizumab in the research unit of infectious hospital for patients with coronavirus infection (CoVID-19)

The objective of the study was the evaluation of the effectiveness of tocilizumab in patients with coronavirus infection COVID-19 who were treated in the intensive care unit of an infectious diseases hospital. Material and methods. There was carried out a retrospective analysis of the case histories of 40 patients with confirmed severe and extremely severe coronavirus infection COVID-19. The average age of the patients was 58.3 ± 1.8 years, the total lung lesion volume was 83.2 ± 2.0%. Results: The survival rate of patients who received immunosuppressive therapy with tocilizumab in combination with pulse therapy of glucocorticosteroids was 55%, and 44% of patients with 100% lung involvement. The use of tocilizumab (4-8 mg / kg) led to a statistically significant decrease in the level of C-reactive protein in the blood, which was an indicator of adequate pharmacotherapy of the "cytokine storm" in the ICU.