Rationale: Peripheral artery disease (PAD) is common among the elderly and increases the risk of cardiovascular events, disability and death. PAD course and outcomes depend not only on the condition of macrovasculature but also on the tissue perfusion. We have previously shown that Type 2 diabetic patients with lower extremity ischemia have significantly lower perfusion than healthy volunteers, and the ratio of basal perfusion in the arm and leg (BP1/BP3) measured by incoherent optical fluctuation flowmetry (IOFF) allows to identify hemodynamically significant stenoses. Aim: To analyze associations between perfusion parameters registered by IOFF and the severity of vascular involvement in PAD patients. Methods: This single center cross-sectional study included 38 PAD patients admitted to the Department of Vascular Surgery and Coronary Artery Disease. The arteries were assessed with duplex Doppler ultrasonography (DDU), according to the results of which the PAD severity score and ankle-brachial index (ABI) were calculated. Skin microhemodynamic parameters were recorded by IOFF. The basal perfusion on the arm (BP1), the dorsal foot surface and the toe (BP2 and BP3), the ratio BP1/BP3, local thermal hyperemia (LTH2 and LTH3) and an increase in perfusion after heating on two leg zones (LTH2-BP2, LTH3-BP3) were evaluated and expressed in perfusion units (PU). BP1, BP3, and BP1/BP3 values were additionally measured with laser Doppler flowmetry (LDF). The analysis was performed depending on the degree of arterial involvement determined by DDU for each limb separately (n = 73). There were ≥ 50% stenoses in 15 extremities (Group 1), occlusion of one of the major arteries in 42 (Group 2) and ≥ 2 occlusions in 16 lower extremities (Group 3). Results: In the groups 1, 2 and 3, the values of most parameters estimated by IOFF decreased with an increase in severity of limb lesions. As an example, the respective perfusion parameters for the big toe in the study groups were as follows: BP3 4.0 [2.0; 9.8], 2.2 [0.9; 3.7] and 1.1 [0.7; 2.6] PU (p = 0.007); LTH3 10.0 [6.4; 14.9], 5.0 [1.5; 7.8] and 2.5 [1.4; 4.5] PU (p 0.001), and LTH3-BP3 3.8 [2.6; 7.8], 2.4 [0.6; 4.3] and 1.2 [0.4; 1.5] PU (p = 0.001). The BP1/BP3 ratio in the above mentioned group increased: 1.8 [0.8; 7.7], 7.2 [3.4; 21.3] and 14.2 [6.6; 18.3] (p = 0.004), respectively. No similar trend was found for this parameter registered by LDF. There were significant correlations between the lower extremities perfusion parameters measured by IOFF and ABI, with the correlation coefficients ranging from 0.365 to 0.717 (p 0.05). Conclusion: The functional parameters of the skin microhemodynamics vary with different PAD severity. In addition, they correlate with clinical indicators of atherosclerosis. The IOFF technique can be promising as an additional quantitative method for assessment of microvascular blood flow in patients with PAD.

ЦЕЛЬ: оценить различия параметров реакции кожного микрососудистого русла на нагрев в зависимо- сти от массы тела среди лиц без диабета и пациентов с сахарным диабетом 2 типа. МАТЕРИАЛЫ И МЕТОДЫ: участниками исследования стали пациенты с сахарным диабетом (СД) 2 типа и без него. Анализировали различия показателей перфузии в 4 группах пациентов: 1) без СД с избыточной массой тела (n = 33, 54±14 лет); 2) без СД с ожирением (n = 18, 54±14 лет); 3) с СД с избыточной массой тела (n = 31, 61±9 лет); 4) с СД с ожирением (n = 56, 59±9 лет). Измерение кожной микроциркуляции про- водилось методом лазерной доплеровской флоуметрии на дорсальных сторонах руки и стопы. Перфузия кожи регистрировалась первые 2 минуты в покое, далее во время нагрева до 42°С в течение 300 с. Затем рассчитывались следующие показатели: 1) Базовая перфузия – средний уровень микроциркуляции в покое за первые 2 минуты; 2) Тангенс угла наклона кривой гиперемии за 120 с от начала нагрева (Наклон-120); 3) Локальная тепловая гиперемия (ЛТГ) – средний уровень перфузии во время нагрева; 4) Абсолютный прирост перфузии – разница между ЛТГ и БП (ЛТГ-БП). Данные представлены в виде медиан и квартилей. Различия между группами оценивались с помощью критерия Краскела−Уоллиса. РЕЗУЛЬТАТЫ: наклон-120 на руке в группе №1 составил 1,3 (1,1; 1,4), №2 − 0,97 (0,8; 1,1), №3 − 0,97 (0,6; 1,1), №4 – 0,9 (0,7; 1,2) [p=0,001]. При попарных сравнениях было показано, что различия между груп- пами были связаны с лучшей реактивностью микрососудов на нагрев у пациентов без СД и без ожирения, в то время как пациенты с ожирением имели сниженное значение показателя «Наклон-120», сопостави- мое с пациентами с СД (как с ожирением, так и без). Отмечено снижение ЛТГ на руке в группах №1-4: 22,7 (18,8; 25,2), 17,55 (15,8; 19,6), 16,6 (13,9; 19,4) и 15,9 (12,2; 20,4) ПЕ [p<0,001]. Сходная тенденция отмечена и в отношении параметра ЛТГ-БП [p<0,001]. В области ног различия были значимы только среди лиц с СД: при ожирении оказался ниже Наклон-120 по сравнению с избыточной массой тела: 0,4 (0,2; 0,7) против 0,7 (0,4; 0,8) [p=0,025]. ВЫВОДЫ: было продемонстрировано, что реакция сосудов на нагрев нарушается при ожирении и ещё больше уменьшается при наличии СД. Худшие значения показателей наблюдались у пациентов с СД и ожирением. При этом изменения, возникающие на фоне ожирения у лиц без СД аналогичны тем, которые мы наблюдали ранее у пациентов с СД на фоне развития диабетических микроангиопатий. Таким образом, снижение реактивности микроциркуляторного русла наблюдается не только на фоне развития микрососудистых осложнений СД, но и на фоне метаболических нарушений, таких как ожирение, даже при отсутствии нарушений углеводного обмена. Это позволяет предположить, что диагностика микро- циркуляторных нарушений в перспективе может быть использована не только с целью определения риска развития микроангиопатий, но и для оценки риска манифестации СД.

The aim of the present study was to assess variations in blood flow parameters from month to month during functional tests in conditionally healthy individuals. Ten volunteers (age: 36.4 ± 14.3 years) were included in the study. Cutaneous blood flow was assessed using incoherent optical fluctuation flowmetry (IOFF). Each study was performed monthly for 9 months (March to November). Blood flow was recorded simultaneously in perfusion units (PU) from 3 channels on the right and left sides of the body (6 in total) during an occlusion (index finger) and local thermal (dorsum of the foot and big toe) functional tests. As a result, we found clear differences in perfusion values from month to month. We also found a significant correlation between perfusion and temperature in the test room. Thus, we can conclude that when measuring skin blood flow, it is not sufficient to maintain a constant probe temperature, but that the temperature of the test room must be carefully controlled. In addition, multidirectional differences in vascular reactivity were observed depending on the month on the glabrous (index finger, big toe) and nonglabrous (dorsum of the foot) skin. The study will be continued.

In this paper, we propose a method for measuring a pulse wave velocity (PWV) along the entire body of the patient with the use of a standard tonometer cuff and a photoplethysmography (PPG) sensor attached to a toe. This approach makes it possible to calculate PWV simultaneously with the measurement of a blood pressure (BP), which takes several minutes. To test the developed method, 2 contrasting groups of subjects were recruited: group 1 (n=15) - healthy volunteers; group 2 (n=14) - patients with diabetes mellitus (DM). Healthy volunteers had the lowest median PWV value: 5.055 [4.427; 5.295] m/s, whereas in the group 2, the median PWV was significantly higher than in the group 1: 5.905 [5.612; 6.215] m/s, p<0.001. The proposed method for measuring PWV correlates with clinical data and allows a rapid integral assessment of vascular stiffness in both the trunk and lower extremities.

The article substantiates an approach to evaluate the minimal erythema dose (MED) in dermatology without test exposure. Arguments are given in support of using a number of optical noninvasive diagnostic methods for this purpose. A photosensitivity of human skin to ultraviolet radiation in the 305–315 nm waveband is determined by skin optical properties, morphological parameters of the skin and vessels' reactivity in the skin. These quantities can be measured before a treatment, so the evaluation of individual MED is not impossible.

INTRODUCTION:The development of new highly accurate, inexpensive and accessible methods for the detection of lower-extremity peripheral artery disease (LE-PAD) in diabetic patients is required. The aim of this study was to evaluate the accuracy of a new incoherent optical fluctuation flowmetry (IOFF) method in detecting legs with hemodynamically significant stenoses compared to ankle brachial index (ABI) and transcutaneous oximetry (TcPO2) in patients with diabetes mellitus (DM).MATERIALS AND METHODS:Patients were recruited into 2 groups. Group 1 included patients with DM without LE-PAD and/or diabetic foot syndrome; Group 2 included patients with DM and LE-PAD. All patients underwent the following measurements: ultrasound (reference method), ABI, TcPO2, and the new IOFF method.RESULTS:The new IOFF method showed a sensitivity of 79.5% and a specificity of 89.8% in detecting limbs with hemodynamically significant stenosis (AUC 0.890, CI 0.822-0.957). TcpO2 allows the diagnosis of LE-PAD with 69.2% sensitivity and 86.2% specificity (AUC 0.817, CI 0.723-0.911). Using a standard ABI cut-off of less than 0.9, the sensitivity and specificity for this parameter were 34.5% and 89.7%, respectively. Increasing the diagnostic cut-off of the ABI on the study group to 0.99 improved sensitivity to 84.6% and specificity to 78% (AUC,0.824 CI 0.732-0.915).CONCLUSIONS:The new IOFF technique has demonstrated high sensitivity and specificity in the detection of LE-PAD in patients with DM. The high accuracy, rapid measurement, and potential availability suggest that the new IOFF method has a high potential for clinical application in the detection of PAD.

INTRODUCTION. Gua Sha massage is widely used in medicine and cosmetology. However, to date, there are very little data to quantitatively demonstrate changes in tissue perfusion due to Gua Sha massage. AIM. To evaluate the dynamics of perfusion indices in the forehead area after a five-minute Gua Sha massage. MATERIALS AND METHODS. 15 apparently healthy women, median age 49 [42.5; 49] years, body mass index 21.6 [19.1; 23.9] kg/m2, were enrolled in the study. Perfusion indices were assessed via the incoherent optical fluctuation flowmetry (IOFF) method using a new prototype diagnostic device Vasotest. Perfusion was assessed before and within 60 minutes following the massage. RESULTS. The study showed a significant increase in perfusion after the massage procedure by an average of 1.85 times compared to the baseline level (from 6.7 [3.7; 7.9] to 12.4 [10.4; 14.4] (p 0.001). Further, within 3540 minutes after the massage, there was a smooth exponential decrease in the perfusion index from to baseline values (p 0.05). CONCLUSIONS. The dynamics of perfusion changes due to Gua Sha massage have been quantitatively registered, which broadens scientific views on the role of Gua Sha massage in increasing blood supply to tissues. In the future, individual assessment of perfusion can be used to customize the tactics for the procedure.

ЦЕЛЬ: исследовать информативность комбинации разных неинвазивных оптических подходов в диа- гностике заболеваний артерий нижних конечностей (ЗАНК) у пациентов с сахарным диабетом (СД). МАТЕРИАЛЫ И МЕТОДЫ: проведено обсервационное исследование на 54 пациентах с СД 2 типа (39 конечностей со стенозами/окклюзией, 69 – без стенозов). Наличие гемодинамически значимых стено- зов магистральных артерий нижних конечностей (более 50%) оценивали по результатам ультразвукового дуплексного сканирования (УЗДС) как референтного метода. Всем пациентам оценивали показатели гемо- динамики при помощи комплексной технологии, реализующей методы некогерентной оптической флук- туационной флоуметрии (НОФФ), фотоплетизмографии и тонометрической осциллометрии. Технология позволяет одновременно оценивать перфузию тканей стопы в ходе теплового теста, перфузию тканей руки, скорость пульсовой волны, форму пульсовой волны. Дополнительно пациентам оценивали лодыжечно- плечевой индекс (ЛПИ) как стандартный скрининговый метод выявления ЗАНК. РЕЗУЛЬТАТЫ: применение показателей перфузии на стопе в ходе теплового теста, измеренных методом НОФФ, позволяет с чувствительностью 79,5% и специфичностью 88,4% выявлять конечности с гемоди- намически значимыми стенозами (AUROC 0,884, CI: 0,817-0,953). При комбинации показателей перфузии на руке и ноге, формы пульсовой волны и скорости пульсовой волны при помощи модели множественной логистической регрессии, чувствительность модели в выявлении конечностей со стенозами значимо воз- растает до 88,6%, а специфичность – до 92,8 % (AUROC 0.928, CI: 0.8742-0.9809). При этом чувствительность и специфичность ЛПИ, как стандартного метода выявления ЗАНК значимо ниже, и составляет 48,7% и 87,0 % соответственно. ВЫВОДЫ: комбинация нескольких параметров гемодинамики, оцениваемых одномоментно при помо- щи комплексной оптической технологии, позволяет добиться высокой чувствительности и специфичности в выявлении ЗАНК у пациентов с СД (88,6% и 92,8% соответственно). Техническая простота измерения (10 минутное измерение с низкой оператор-зависимостью) позволяет рассматривать подход как перспектив- ный для скринингового выявления ЗАНК.

The aim of the present study was to evaluate changes in cutaneous blood flow detected by incoherent optical fluctuation flowmetry (IOFF) in diabetic patients with diagnosed microangiopathies. The study includes 52 patients with type 2 diabetes mellitus (12 males, 40 females, median age 57 (51; 60) years). All patients were examined using the IOFF method using functional tests: occlusion test on the index finger, local heat test on the dorsum of the foot, and local heat test on the big toe. The patients were divided into 2 groups: 13 patients with both diabetic retinopathy and diabetic nephropathy (Group 2, severe microcirculatory disorders) and 39 patients with only 1 microangiopathic complication or without any (Group 1). Local thermal hyperaemia (LTH2_1) was higher in Group 1 than in Group 2 (p = 0.011). Post-occlusive reactive hyperaemia (PORH_2) was higher in Group 2 than in Group 1 (p = 0.009). No changes were detected on the big toe. When PORH_2 and LTH2_1 were used in combination, the area under the ROC curve (95% CI) was 0.733 (0.62 to 0.846). Thus, the IOFF method has the potential to accurately detect blood flow abnormalities associated with diabetic microangiopathies.

AIMS:Early detection of microangiopathic complications of diabetes mellitus (DM) is necessary to analyze the patient's condition and prevent disease progression. The study was aimed to investigate the relationship between the presence of retinopathy and decreased reactivity of the microcirculatory bed in patients with diabetes. METHODS:The study involved 130 subjects: healthy volunteers (n = 48), DM patients without retinopathy (n = 53) and with retinopathy (n = 29). Skin microvascular reactivity was assessed on the forearm using laser Doppler flowmetry with a local heating test combined with occlusion. RESULTS:The slope of local thermal hyperemia curve (Slope-120) and other parameters of microvascular reactivity showed difference in pairwise comparisons between the groups. Slope-120 had the highest sensitivity (0.759) and specificity (0.717) in detection of diabetic retinopathy. The decrease of Slope-120 was associated with retinopathy (odds ratio (OR) - 8.3 (2.9-24.1), p < 0.001), even after adjusting for other factors (OR - 11.0 (1.6-77.2), p = 0.016). CONCLUSIONS:Thus, assessment of skin microvascular reactivity may be a useful test for detecting signs of microangiopathic complications and for screening patients in risk group. Decreased microvascular reactivity has been shown to be prospective as an independent indicator of retinopathy in type 1 DM.

BACKGROUND: Endothelial dysfunction and microvascular disturbances are suggested to play a key role in higher morbidity and worse prognosis in patients with COVID-19 and cardiometabolic diseases. OBJECTIVE: Study was aimed to establish relationships between the skin microcirculation parameters and various clinical and laboratory indicators. METHODS: The study included 18 patients with moderate disease according to WHO criteria. Skin microcirculation measurements were performed by laser Doppler flowmetry using a heating test on the hairy skin of the right forearm. RESULTS: Baseline perfusion only correlated with C-reactive protein (Rs = 0.5, p = 0.034). Microcirculation indices characterising the development of hyperaemia during the first minute of heating (LTH1 and AUC(60)) showed significant correlations (Rs from 0.48 to 0.67, p < 0.05) with indices of general blood analysis and blood coagulation (fibrinogen, D-dimer, haemoglobin, erythrocyte count and haematocrit). Indexes characterising the dynamics of hyperaemia development over longer time intervals showed correlation with the glomerular filtration rate (Rs = 0.6, p = 0.009). CONCLUSION: Known COVID-19 risk factors (haemorheological parameters, age) are correlated with the microvascular reactivity to heating in patients with COVID 19. We suggest that, prospectively, the method of laser Doppler flowmetry could be used for non-invasive instrumental assessment of microcirculatory disorders in patients with COVID-19.

ЦЕЛЬ: оценить различия параметров реакции кожного микрососудистого русла на нагрев в зависимо- сти от массы тела среди лиц без диабета и пациентов с сахарным диабетом 2 типа. МАТЕРИАЛЫ И МЕТОДЫ: участниками исследования стали пациенты с сахарным диабетом (СД) 2 типа и без него. Анализировали различия показателей перфузии в 4 группах пациентов: 1) без СД с избыточной массой тела (n = 33, 54±14 лет); 2) без СД с ожирением (n = 18, 54±14 лет); 3) с СД с избыточной массой тела (n = 31, 61±9 лет); 4) с СД с ожирением (n = 56, 59±9 лет). Измерение кожной микроциркуляции про- водилось методом лазерной доплеровской флоуметрии на дорсальных сторонах руки и стопы. Перфузия кожи регистрировалась первые 2 минуты в покое, далее во время нагрева до 42°С в течение 300 с. Затем рассчитывались следующие показатели: 1) Базовая перфузия – средний уровень микроциркуляции в покое за первые 2 минуты; 2) Тангенс угла наклона кривой гиперемии за 120 с от начала нагрева (Наклон-120); 3) Локальная тепловая гиперемия (ЛТГ) – средний уровень перфузии во время нагрева; 4) Абсолютный прирост перфузии – разница между ЛТГ и БП (ЛТГ-БП). Данные представлены в виде медиан и квартилей. Различия между группами оценивались с помощью критерия Краскела−Уоллиса. РЕЗУЛЬТАТЫ: наклон-120 на руке в группе №1 составил 1,3 (1,1; 1,4), №2 − 0,97 (0,8; 1,1), №3 − 0,97 (0,6; 1,1), №4 – 0,9 (0,7; 1,2) [p=0,001]. При попарных сравнениях было показано, что различия между груп- пами были связаны с лучшей реактивностью микрососудов на нагрев у пациентов без СД и без ожирения, в то время как пациенты с ожирением имели сниженное значение показателя «Наклон-120», сопостави- мое с пациентами с СД (как с ожирением, так и без). Отмечено снижение ЛТГ на руке в группах №1-4: 22,7 (18,8; 25,2), 17,55 (15,8; 19,6), 16,6 (13,9; 19,4) и 15,9 (12,2; 20,4) ПЕ [p<0,001]. Сходная тенденция отмечена и в отношении параметра ЛТГ-БП [p<0,001]. В области ног различия были значимы только среди лиц с СД: при ожирении оказался ниже Наклон-120 по сравнению с избыточной массой тела: 0,4 (0,2; 0,7) против 0,7 (0,4; 0,8) [p=0,025]. ВЫВОДЫ: было продемонстрировано, что реакция сосудов на нагрев нарушается при ожирении и ещё больше уменьшается при наличии СД. Худшие значения показателей наблюдались у пациентов с СД и ожирением. При этом изменения, возникающие на фоне ожирения у лиц без СД аналогичны тем, которые мы наблюдали ранее у пациентов с СД на фоне развития диабетических микроангиопатий. Таким образом, снижение реактивности микроциркуляторного русла наблюдается не только на фоне развития микрососудистых осложнений СД, но и на фоне метаболических нарушений, таких как ожирение, даже при отсутствии нарушений углеводного обмена. Это позволяет предположить, что диагностика микро- циркуляторных нарушений в перспективе может быть использована не только с целью определения риска развития микроангиопатий, но и для оценки риска манифестации СД.

(1) Background: To date, there are no studies evaluating the ability of the incoherent optical fluctuation flowmetry (IOFF) method to assess foot tissue perfusion. The aim of this study was to evaluate the correlation between perfusion values measured by IOFF and TcPO2 in patients with diabetes-related lower-extremity complications. (2) Methods: This was an observational, cross-sectional, two-center study. Diabetic patients with peripheral artery disease and/or diabetic foot ulcers were studied (n = 27, examinations were carried out on 54 legs). Perfusion in the foot tissues was assessed using TcPO2 (reference standard for this study) and the IOFF method. (3) Results: High correlation coefficients of all perfusion parameters measured by IOFF with TcPO2 (Rs 0.7 to 0.76) were shown. The study demonstrated that the IOFF method allows, with a sensitivity of 85.7% and a specificity of 90.0%, the identification of patients with a critical decrease in TcPO2 < 20 mmHg. (4) Conclusions: The high correlation of IOFF parameters with TcPO2 and the moderately high sensitivity and specificity in detecting patients with severe ischemia of foot tissues shows the promise of the method for assessing a tissue perfusion in patients with diabetes-related lower-extremity complications.

АКТУАЛЬНОСТЬ Хроническое воздействие ультрафиолетового (УФ) излучения является важным фактором, влияющим на характер и темпы возрастной дегенерации кожи. Выраженность фотостарения определяется визуально, что приводит к ошибкам в диагностике и тактике ведения пациента. Современные оптические методы, позволяющие оценивать оптические маркеры (отражающие разные звенья патогенеза хронического УФ-повреждения кожи) являются перспективным решением этой проблемы. ЦЕЛЬ ИССЛЕДОВАНИЯ Анализ применимости коллагена и липофусцина как флуоресцентных маркеров для оценки УФ-индуцированных изменений кожи in vivo. МАТЕРИАЛ И МЕТОДЫ Здоровые добровольцы (n=44) разделены на 4 возрастные группы. Среди участников проводили анкетирование, регистрировали оптические параметры кожи зон, подвергаемых хроническому УФ-воздействию (лоб, скулы, мочки ушей) методами лазерной флуоресцентной спектроскопии при помощи прибора ЛАКК-М (ООО НПП «ЛАЗМА»), анализировали эффективные длины волн флуоресценции (λf): 420 и 455 нм — максимум флуоресценции коллагена и эластина; 480 нм — совокупность эндогенных флуорофоров (липофусцин, ФАД, жирные кислоты); 580 нм — липофусцин; оценивали меланиновый индекс при помощи прибора Спектротест (НПП «Циклон-Тест»). Количественные переменные сравнивали с помощью критерия Краскела—Уиллиса с последующими апостериорными попарными сравнениями с помощью критерия Данна с поправкой Бонферрони. РЕЗУЛЬТАТЫ Индексы тканевого содержания коллагена/эластина (ηf(455)) и липофусцина (ηf(480)) были статистически значимо выше у пациентов старшей возрастной группы. Увеличение флуоресцентного сигнала коллагена/эластина с возрастом может быть обусловлено эластозом, а также ростом среднего уровня меланиновой пигментации. Скуловая область и область мочки уха являются наиболее информативными точками для оптической диагностики УФ-индуцированных изменений кожи. ЗАКЛЮЧЕНИЕ При помощи лазерной флуоресцентной спектроскопии показана потенциальная возможность использования коллагена и липофусцина как флуоресцентных маркеров хронических УФ-индуцированных изменений кожи. Полученные данные могут быть применены для диагностики фотостарения и выявления лиц с повышенным риском развития опухолей кожи.

73 АССОЦИАЦИЯ МЕЖДУ СНИЖЕНИЕМ РЕАКТИВНОСТИ МИКРОЦИРКУЛЯТОРНОГО РУСЛА КОЖИ И НАЛИЧИЕМ ДИАБЕТИЧЕСКОЙ РЕТИНОПАТИИ ПРИ САХАРНОМ ДИАБЕТЕ 1 ТИПАКрасулина К .А . 1 , Глазков А

Cat allergy is a major trigger factor for respiratory reactions (asthma and rhinitis) in patients with immunoglobulin E (IgE) sensitization. In this study, we used a comprehensive panel of purified cat allergen molecules (rFel d 1, nFel d 2, rFel d 3, rFel d 4, rFel d 7, and rFel d 8) that were obtained by recombinant expression in Escherichia coli or by purification as natural proteins to study possible associations with different phenotypes of cat allergy (i.e., rhinitis, conjunctivitis, asthma, and dermatitis) by analyzing molecular IgE recognition profiles in a representative cohort of clinically well-characterized adult cat allergic subjects (n = 84). IgE levels specific to each of the allergen molecules and to natural cat allergen extract were quantified by ImmunoCAP measurements. Cumulative IgE levels specific to the cat allergen molecules correlated significantly with IgE levels specific to the cat allergen extract, indicating that the panel of allergen molecules resembled IgE epitopes of the natural allergen source. rFel d 1 represented the major cat allergen, which was recognized by 97.2% of cat allergic patients; however, rFel d 3, rFel d 4, and rFel d 7 each showed IgE reactivity in more than 50% of cat allergic patients, indicating the importance of additional allergens in cat allergy. Patients with cat-related skin symptoms showed a trend toward higher IgE levels and/or frequencies of sensitization to each of the tested allergen molecules compared with patients suffering only from rhinitis or asthma, while there were no such differences between patients with rhinitis and asthma. The IgE levels specific to allergen molecules, the IgE levels specific to cat allergen extract, and the IgE levels specific to rFel d 1 were significantly higher in patients with four different symptoms compared with patients with 1–2 symptoms. This difference was more pronounced for the sum of IgE levels specific to the allergen molecules and to cat extract than for IgE levels specific for rFel d 1 alone. Our study indicates that, in addition to rFel d 1, rFel d 3, rFel d 4, and rFel d 7 must be considered as important cat allergens. Furthermore, the cumulative sum of IgE levels specific to cat allergen molecules seems to be a biomarker for identifying patients with complex phenotypes of cat allergy. These findings are important for the diagnosis of IgE sensitization to cats and for the design of allergen-specific immunotherapies for the treatment and prevention of cat allergy.

The aim of this study was to investigate the ratio of baseline perfusion levels in the skin of the palmar surfaces of the fingers and plantar surfaces of the big toe in healthy volunteers and patients with diabetes mellitus. Three study groups were included: healthy volunteers (group 1, n = 29), patients with type 2 diabetes mellitus (DM2) without diabetic foot syndrome (group 2, n = 27), and patients with diabetic foot syndrome (group 3, n = 27). All subjects were measured for the level of perfusion in the skin of the upper and lower extremities using the method of incoherent optical fluctuation flowmetry (IOFF). Perfusion was assessed in perfusion units (p.u.). The measurement was carried out sequentially, first on the left side of the body, then on the right. The baseline perfusion values from the index finger of the hand (BPh) and from the big toe of the foot (BPf) in perfusion units (p.u.) were assessed at rest. The BPh value in group 1 was 11.5 [5.4; 16.8] p.u.; in group 2, 17.4 [13.2; 24.8] p.u.; in group 3, 18.4 [13.2; 23.6] p.u. The BPh level was statistically significantly lower in group 1 than in groups 2 (p1–2 < 0.001) and 3 (p1–3 < 0.001). There was no statistically significant difference in finger perfusion between groups 2 and 3 (p2–3 = 1). The BPf values in groups 1, 2, and 3 were 4.4 [2.3; 8.8], 7.9 [5.4; 14.6], and 3.9 [1; 9.9] p.u., respectively. The BPf level in group 2 was higher than in group 1 (p1–2 = 0.006), but the parameter in group 3 was comparable to the values from group 1 (p1–3 = 0.73) and different from group 2 (p2–3 < 0.001). Thus, in group 3, there was a pseudonormalization of this index due to abnormally low BPf values in the extremities with hemodynamically significant stenoses. The baseline perfusion ratio (BPh/BPf) in groups 1, 2, and 3 was 2.11 [1.22; 3.03], 1.91 [1.18; 3.92], and 4.29 [1.8; 12.84], respectively. The BPh/BPf ratio in group 3 was significantly higher than in groups 1 (p1–3 < 0.001) and 2 (p2–3 < 0.001). The ability to detect the presence of hemodynamically significant lower limb arterial stenoses was analyzed by the BPf and BPh/BPf indices; the area under the ROC curve for BPf was 0.808 (0.729; 0.887); for BPh/BPf, 0.855 (0.782; 0.928). It was shown that an increase in the BPh/BPf ratio to exceed 3.7 with a sensitivity of 75.7

Introduction. The results of studies devoted to the influence of biological sex on microhemodynamic parameters are ambiguous. Today no studies of sex-specific microhemodynamics evaluated by the new incoherent optical fluctuation flowmetry method (IOFF) have been reported. Objective – to investigate the sex-specific differences of microhemodynamics assessed by the IOFF method in healthy volunteers. Materials and Methods. 27 healthy volunteers (10 men and 17 women) were included in the study. The groups were comparable by sex, age, and main clinical parameters. Perfusion was measured by the IOFF method. Parameters were evaluated while performing an occlusion test on the hand and a local heating test on the dorsum of the foot and the toe. Microcirculation reactivity was calculated as a relative increase of perfusion response to the vasodilation stimulus. Results. Women had significantly lower median baseline perfusion than men on the hand and on the dorsum of the foot (hand: 10 [6; 13] PU vs. 15 [10; 19] PU, p = 0.035; foot: 0.78 [0.68; 0.97] PU vs. 1.13 [0.99; 1.29] PU, p = 0.003). Women were demonstrated to have significantly higher reactivity response to thermal and occlusive stimuli than men (p < 0.05). Thus, at the third minute of heating, women had perfusion increased 5.39 [4.32; 6.64] times and men had 3.47 [3.13; 4.65] times (p = 0.018); after the release of the occlusion women had perfusion increased 1.93 [1.37; 3.02] times and men had 1.14 [1.01; 1.74] times (p = 0.011). Conclusion. Healthy women had been shown to have higher reactivity of microhemodynamics than men. A lower cardiovascular risk women have compared to men could be caused by sex-specific features of endothelium function.

XXVIII) НАЦИОНАЛЬНЫЙ ДИАБЕТОЛОГИЧЕСКИЙ КОНГРЕСС С МЕЖДУНАРОДНЫМ УЧАСТИЕМ «САХАРНЫЙ ДИАБЕТ