Aim. To evaluate changes in blood flow in the uterine and umbilical arteries in the second trimester of gestation in women with exacerbation of bronchial asthma associated with reactivation of cytomegalovirus infection (CMVI).Materials and methods. Using Doppler analysis, 115 patients were examined at 21-24 weeks of pregnancy, uncomplicated and complicated by exacerbation of mild to moderate asthma of cytomegalovirus etiology. The first group was represented by 30 seronegative women with uncomplicated pregnancy. The second group included 30 patients with mild asthma in the stage of exacerbation associated with CMVI, leading to chronic compensated placental insufficiency. The third group consisted of 30 patients with exacerbation of moderate asthma caused by CMVI reactivation, which initiated the development of chronic compensated placental insufficiency. The fourth group consisted of 25 women with moderate asthma in the acute stage against the background of the acute phase of CMVI, leading to the formation of chronic subcompensated placental insufficiency.Results. In women in the second group, in comparison with the first group, the following changes were determined: in the right uterine artery, the systolic-diastolic ratio (SDR) was, respectively, 2.75±0.07 and 2.04±0.03 rel. units (р<0.001), pulsation index (PI) – 1.15±0.04 and 0.76±0.02 rel. units (p<0.001), resistance index (RI) – 0.63±0.01 and 0.51±0.01 rel. units (p<0.001); in the left uterine artery, SDR was, respectively, 2.84±0.09 and 1.98±0.05 rel. units (p<0.001), PI – 1.20±0.05 and 0.74±0.03 rel. units (p<0.001), RI – 0.64±0.01 and 0.49±0.01 rel. units (p<0.001); in the absence of statistically significant differences in the indicators of SDR in the umbilical artery – 3.62±0.09 and 3.41±0.06 rel. units, respectively (р>0.05), PI – 1.23±0.03 and 1.19±0.03 rel. units (p>0.05) and RI – 0.73±0.01 and 0.70±0.01 rel. units (p>0.05). In the third group, in comparison with the second one, vascular resistance did not differ significantly in the right, left uterine arteries and the umbilical cord artery. In patients of the fourth group, in contrast to the third one, higher values of resistance to blood flow were observed: in the right uterine artery – SDR (3.41±0.07 and 2.87±0.07 rel. units, p<0.001), PI (1.48±0.07 and 1.18±0.03 rel. units, p<0.001), RI (0.70±0.01 and 0.65±0.01 relative units, p<0.001); in the left uterine artery – SDR (3.33±0.11 and 2.88±0.09 rel. units, p<0.01), PI (1.45±0.05 and 1.19±0.05 rel. units, p<0.001), RI (0.70±0.01 and 0.68±0.01 rel. units, p<0.01); and also in the umbilical artery – SDR (4.39±0.13 and 3.65±0.12 rel. units, p<0.001), PI (1.45±0.04 and 1.24±0.03 rel. units, p<0.001), RI (0.79±0.01 and 0.72±0.01 rel. units, p<0.001).Conclusion. In the pathogenesis of reduced blood flow in the basin of the uterine and umbilical arteries in women with exacerbation of moderately severe asthma of cytomegalovirus etiology, leading to the development of chronic subcompensated placental insufficiency, compared with uterine cord hemodynamics in asthma in the acute stage, caused by reactivation of CMVI in the second trimester of gestation, which initiates the formation of a chronic compensated form of placental dysfunction in the third trimester of pregnancy, an important role is played by viral stimulation of vasoconstrictor responses.

The word sarcoidosis comes from the Greek word “sarcoid”, meaning “having flesh or tissue”, and the Greek suffix “-osis”, meaning “condition”, referring to skin lesions on various parts of the body. Over the course of history, sarcoidosis has been consistently dealt with by physicians of various specialties. The palm of victory belongs to dermatologists, and further for quite a long period of time, phthisiatricians dealt with this problem, then pulmonologists, and, more recently, doctors of many other specialties. The term “Besnier-Boeck-Schaumann disease” was officially approved at the congress of dermatologists in Strasbourg in 1934. This name of the disease has been preserved to the present for a little less than 90 years. However, it should be noted that in recent years their names in the headlines and texts of articles are mentioned much less frequently. To our knowledge in the PubMed information registry, only one paper was published in 2022 on various clinical and experimental studies of sarcoidosis, which mentions the name of the disease as “BesnierBoeck-Schaumann disease”. For illustration, several presentations of own clinical and radiological observations are given, identical in their pathogenetic parameters, noticed and described for the first time by Besnier, Boeck, Schaumann and Löfgren. These presentations are formed using modern diagnostic technologies, which significantly expand the visualization possibilities of sarcoidosis variants and fully reveal the fullness of the symptom complexes that were noticed and described by the path-breakers of sarcoidosis.

Aim. To assess the morphological changes in the bloodstream and chorionic villi with partial premature detachment of a normally located placenta in women with exacerbation of herpesvirus (HSV type 1) and cytomegalovirus infection (CMVI). Materials and methods. An X-ray phlebographic and histological examination of 87 placentas was carried out in uncomplicated pregnancy and partial premature detachment of a normally located placenta, developed after reactivation of HSV type 1 and CMVI in patients in the second trimester of gestation. The first group included 32 placentas from women with CMV-seronegative uncomplicated pregnancy, the second group included 21 placentas from patients with exacerbation of HSV type 1, the third – 18 placentas from women with CMVI reactivation, in the fourth – 16 placentas from patients with combined exacerbation of HSV type 1 and CMVI. In all cases, a dosed injection of red lead on drying oil (1:3) was carried out through the umbilical cord vein into the placental blood vessels. In the same areas of the intact placenta and with partial premature detachment of the normally located placenta, the morphological structure of the biopsy specimens was analyzed before and after the introduction of contrast into the bloodstream. When isolating DNA in the tissues of the organ, PCR was used. Results. In the second group, in comparison with the first one, placental hypoplasia was diagnosed in 14.3% (0%), hematomas on its fetal part in 19% (3.1%, p>0.05), hemorrhages in the maternal part in 38% (6.2%, p<0.01), foci of sclerosis in 9.5% (9.3%, p>0.05), tortuosity of the veins of the first order in 14.3% (6.2%, p>0.05), the phenomenon of “amputation” of veins in 19% (9.3%, p>0.05). Cotyledons with weakly contrasted vessels occurred in 4 cases (in the first group 3, p>0.05), and with non-visualized bloodstream – in 3 cases (in the first group 2, p>0.05). A clear-cut structure of veins of the 2nd order was found in 3 cases, and extravasation in the tissues of the organ – in 2 cases. CMV DNA was isolated in 14.3% of biopsies. In the second group, unlike the first one, terminal villi with partial desquamation of syncytiotrophoblast were visualized in 23.8% (9.3%, p>0.05), with necrosis and calcification of syncytial kidneys in 23.8% (6.25%, p>0.05), with clots in the veins in 9.5% (6.25%, p>0.05), with moderate plethora in 76.1% (65.6%, p>0.05) and with pronounced plethora in 28.5% (12.5%, p>0.05). More often, villi with edema, an increase in collagen fibers, fibrinoid and vascular inflammation, as well as avascular terminal villi were found. The third group, unlike the first one, was characterized by an increase in the number of hematomas on the fetal to 27.8% (p<0.05) and on the maternal parts of the placenta up to 55.6% (p<0.001), as well as blind-ended vessels up to 38.9% (p<0.05). In 5.6% of cases, CMV DNA was determined, as well as pronounced sclerotic changes (50%, p<0.05), inflammation of the walls of blood vessels and stroma of the villi. In the fourth group, HSV DNA was identified in 31.3%, and CMV DNA – in 37.5% of cases (p<0.05), in comparison with the third group, partial desquamation of syncytiotrophoblast was a frequent morphological finding (75%, p<0,05), necrosis and calcification of syncytial nodules (87.5%, p<0.05), calcium deposit in clots of the veins of the stem villi of the I and II order (56.2%, p<0.05) and a pronounced plethora of capillaries of the terminal villi (81 .2%, p<0.01) against the background of a decrease in the number of villi with moderate blood filling (18.7%, p<0.01), which contributed to ischemia, premature stimulation of endothelial activity and contraction of the smooth muscle elements of the blood vessels of the placenta and uterus. Conclusion. With partial premature detachment of a normally located placenta caused by reactivation of combined HSV type 1 and CMVI, compared with that initiated by mono-HSV type 1 or mono-CMVI, the frequency of morphological markers of damage to the venous bed increases in cotyledons, as a result of the cyto- and angiodestructive influence of pathogens infections.

Aim. To study changes in the cytokine status in women with exacerbation of bronchial asthma caused by reactivation of cytomegalovirus infection (CMVI) in the second trimester of gestation.Materials and methods. The concentration of pro-inflammatory cytokines (TNFα, IL-1β, IFNγ, IL-2) in blood serum was assessed in 112 women in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of asthma caused by reactivation of CMVI. The first group included 30 women seronegative for CMVI with uncomplicated pregnancy. The second group consisted of 30 patients with exacerbation of mild asthma associated with CMVI, initiating the formation of chronic compensated placental insufficiency. The third group consisted of 27 patients with exacerbation of moderate asthma induced by CMVI reactivation leading to the development of chronic compensated placental insufficiency. The fourth group included 25 women with exacerbation of moderate asthma due to the acute phase of CMVI, which induces the development of chronic subcompensated placental insufficiency.Results. It was found that in the blood serum of women of the first group, the concentration of TNFα was (Me) 21.5 (13.8–30.1) pg/mL, IL-1β – 18.2 (13.6–34.0) pg/mL, IFNγ – 137.4 (109.5‒174.2) pg/mL and IL-2 – 29.8 (21.0‒38.9) pg/mL. In patients of the second group, compared with the first one, there was an increase in the level of TNFα by 3.79 times (p=0.000001), IL-1β – by 4.8 times (p=0.000001), IFNγ – by 1.73 times (p=0.000001) and IL-2 by 2.91 times (p=0.000001). In the third group, unlike the second one, no significant differences were found between the concentrations of TNFα, IL-1β, IFNγ, and IL-2. In patients of the fourth group, in comparison with the third group, higher values of TNFα (1.35 times, p=0.00507), IL-1β (1.86 times, p=0.000001), IFNγ (1.31 times, p=0.000167), and IL-2 (1.5 times, p=0.0056) were registered.Conclusion. During exacerbation of moderate asthma of cytomegalovirus etiology, leading to chronic subcompensated placental insufficiency, in comparison with exacerbation of moderate asthma caused by reactivation of CMVI, initiating the formation of chronic compensated placental insufficiency, activation of the systemic inflammatory response is most pronounced, leading to stimulation of the migration of monocytes, lymphocytes and neutrophils to the focus of inflammation at the level of small bronchi; also leading to disruption of intersystem relationships and to hemodynamic dysfunction of the placenta.

Aim. To evaluate changes in immunity in the second trimester of pregnancy in women with exacerbation of bronchial asthma associated with reactivation of cytomegalovirus infection (CMVI). Materials and methods. The concentration of secretory immunoglobulin A (sIgA), immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM) and circulating immune complexes (CIC) was studied in 112 women at 21-24 weeks of uncomplicated pregnancy and pregnancy complicated by exacerbation of mild-to-moderate asthma associated with CMVI. The first group included 30 women seronegative for CMV, with an uncomplicated pregnancy. The second group consisted of 30 patients with exacerbation of mild asthma, initiated by the acute phase of CMVI, which induces the development of chronic compensated placental insufficiency. The third group consisted of 27 patients with moderate asthma in the acute stage against the background of the acute phase of CMVI, leading to the formation of chronic compensated placental insufficiency. The fourth group included 25 patients with exacerbation of moderate asthma with CMV etiology, initiating the development of chronic subcompensated placental insufficiency. Results. In women of the second group, the concentration of sIgA was 5.91±0.371 mg/L, IgA – 2.64±0.089 mg/mL, IgG – 15.4±0.791 mg/mL, IgM – 2.32±0.144 mg/mL, CIC – 0.176±0.004 optical density units (in the first group, respectively, 4.31±0.266 mg/L, p<0.001; 2.37±0.06 mg/mL, p<0.05; 13.3±0.293 mg/mL, p<0,05; 1.11±0.06 mg/mL, p<0.001; 0.092±0.005 optical density units, p<0.001). In patients of the third group, in contrast to the second one, no differences in immunity parameters were detected. In the fourth group, in comparison with the third one, lower parameters of sIgA (3.21±0.213 mg/L, p<0.001), IgA (1.43±0.081 mg/mL, p<0.001), as well as higher IgG values were detected (19.8±0.418 mg/mL, p<0.001), IgM (2.94±0.082 mg/mL, p<0.01) and CIC (0.198±0.005 optical density units, p<0.05). Conclusion. In patients with moderate asthma with exacerbation against the background of CMVI reactivation, which initiates the formation of chronic subcompensated placental insufficiency, in contrast to women with moderate asthma in the stage of CMVI exacerbation in the second trimester of pregnancy, leading to chronic compensated placental insufficiency in the third trimester of gestation, a more pronounced imbalance of humoral immunity and autoimmune disorders are found, which are important in the development of chronic placental dysfunction.

Aim. To study the etiology of placental insufficiency in women in the second trimester of gestation during the influenza A(H3N2) epidemic and the A(H1N1)pdm pandemic.Materials and methods. In 1865 patients in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of chronic ENT pathology leading to the development of placental insufficiency, using laboratory methods in the blood, nasal epithelium and biological fluids, pathogens of monoand mixed infections (influenza A(H1N1)pdm), A(H3N2), influenza B, parainfluenza type 1-3, adenovirus, respiratory syncytial virus (RS), cytomegalovirus (CMV), herpes simplex virus type 1 and type 2 (HSV-1,2 type), candida infection (Candida albicans), chlamydia (Chlamydia trachomatis), mycoplasmosis (Mycoplasma hominis) and ureaplasmosis (Ureaplasma urealyticum) were detected. The first group consisted of 873 women with placental insufficiency diagnosed during the influenza A(H3N2) epidemic, the second group consisted of 890 patients with placental insufficiency diagnosed during circulation of the influenza A(H1N1)pdm in the population. The control group were 42 women without ENT diseases and placental insufficiency caused by monoand mixed viral infections during influenza A(H3N2) and 60 women with similar somatic, infectious and obstetric status, examined during pandemic influenza A(H1N1)pdm.Results. With the development of placental insufficiency in women of the second group, compared with the first one, mono-influenza B and parainfluenza types 1-3 are diagnosed less frequently, as well as a combination of influenza A(H1N1) pdm and influenza B; influenza A(H1N1)pdm and parainfluenza types 1-3; influenza A(H1N1)pdm and RS virus; CMV and Chlamydia trachomatis; Mycoplasma hominis and Ureaplasma urealyticum; HSV-1,2 type, Candida albicans and Chlamydia trachomatis; as well as HSV-1,2 type, Candida albicans and Ureaplasma urealyticum. At the same time, exacerbations of mono-CMV, mono-HSV-1,2 type and Candida albicans are more common, as well as combinations of CMV+HSV-1,2 type; CMV+Candida albicans; CMV+Ureaplasma urealyticum; and CMV+Mycoplasma hominis; CMV+HSV-1,2 type+Candida albicans.Conclusion. In the etiology of placental insufficiency in acute diseases of the ENT organs in women in the second trimester of gestation against the background of circulation of the A(H1N1)pdm influenza in the population, compared with placental dysfunction in pregnant women with a similar ENT pathology during the influenza A(H3N2) epidemic, there is an increase in the proportion of monocytomegalovirus, herpesvirus and candida infections, as well as mixed cytomegalovirus infection, the reactivation of which may be due to more pronounced virusinduced immunosuppression and hormonal status disorders, leading to local dysbiosis.

Aim. To evaluate changes in immunological parameters and umbilical blood flow in pregnant women with exacerbation of chronic bronchitis associated with cytomegalovirus infection (CMVI).Materials and methods. The concentration of secretory immunoglobulin A (sIgA), immunoglobulin E (IgE), circulating immune complexes (CIC), interleukin- 6 (IL-6), interleukin-4 (IL-4) and systolic-diastolic ratio (SDR) in the umbilical artery was studied in 80 women with exacerbation of chronic bronchitis in the second trimester of pregnancy, uncomplicated and complicated by the acute phase of CMVI. The first group was represented by 30 women with cytomegalovirus seronegative physiological pregnancy; the second – 25 patients with exacerbation of chronic bronchitis caused by reactivation of CMVI, complicated by the development of chronic compensated placental insufficiency (CCPI); the third – 25 women with chronic simple bronchitis in the acute stage in the setting of the acute phase of CMVI, initiating the formation of chronic subcompensated placental insufficiency (CSPI) at 30-34 weeks of gestation.Results. In the first group, the concentration of sIgA in blood serum was 4.3±0.26 mg/L, IgE – 3.64±0.23 IU/mL, CIC – 0.091±0.005 AU, IL-6 – 2.41±0.21 pg/mL, IL-4 – 30.1±2.19 pg/mL, cortisol – 527.2±20.95 nmol/L, and SDR in the artery umbilical cord – 3.41±0.06 relative units. In women of the second group, in comparison with the first one, there was an increase in the concentration of sIgA by 1.40 times (p<0.01), IgE – by 1.95 times (p<0.001), CIC – by 1.83 times (p<0.001) , IL-6 – 2.61 times (p<0.001), IL-4 – 1.29 times (p<0.05), cortisol – 1.35 times (p<0.001) in the absence of statistically significant differences the magnitude of vascular resistance in the umbilical artery. In the third group, in comparison with the first one, there was a decrease in sIgA values by 1.26 times (p<0.05) in the setting of an increase in the concentration of IgE by 2.56 times (p<0.001), CIC – by 2.09 times (p<0.001 ), IL-6 – by 3.65 times (p<0.001), IL-4 – by 1.64 times (p<0.001), cortisol – by 1.52 times (p<0.001) and SDR in the umbilical artery – 1.27 times (p<0.001). In women of the third group, in contrast to the second one, a decrease in the concentration of sIgA by 1.77 times (p<0.001), as well as an increase in IgE by 1.31 times (p<0.01), CIC ‒ by 1.14 times (p<0.001), IL-6 ‒ 1.39 times (p<0.001), IL-4 ‒ 1.27 times (p<0.05), cortisol ‒ 1.13 times (p<0.05) and SDR in the umbilical artery ‒ 1.21 times (p<0.001). A direct correlation was established between IL-6 and cord blood flow (r=0.53; p<0.01), as well as an inverse relationship between sIgA and cortisol (r=-0.44; p<0.05).Conclusion. In the second trimester of gestation, exacerbation of chronic simple bronchitis caused by reactivation of CMVI, which initiates the development of CSPI, in contrast to chronic bronchitis in the acute stage, associated with the acute phase of chronic CMVI, which induces the formation of CCPI, is accompanied by an imbalance of nonspecific local and systemic immune responses, as well as stress-reaction, which leads to the growth of SDR in the umbilical artery.

Aim. To establish the relationship of immunological and hemodynamic parameters of the fetoplacental system during exacerbation of chronic bronchitis of cytomegalovirus etiology. Materials and methods. A study was carried out of the concentration of TNFα, IgA, IgM in the blood serum and the systolic-diastolic ratio (SDR) in the right uterine artery (RUA) in 80 women in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of cytomegalovirus infection (CMVI). Three groups were retrospectively distinguished. The first group included 30 patients with CMV seronegative physiological pregnancy, the second group included 25 women with exacerbation of chronic bronchitis caused by CMVI reactivation, initiating the development of chronic compensated placental insufficiency (CCPI), in the third group – 25 pregnant women with chronic bronchitis in the acute stage, induced by CMVI, leading to the formation of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation. Results. In the first group, the concentration of TNFα in the blood serum was Me 16.4 (13.1–33.8) pg/mL, IgA – Me 2.5 (2.23–2.62) mg/mL, IgM – Me 0.99 (0.87–1.56) mg/mL, and SDR in RUA – Me 1.95 (1.87–2.30). In the second group, compared with the first one, there was an increase in the concentration of TNFα by 4.95 times (p=0.000001), IgM − by 2.51 times (p = 0.000001) and SDR in RUA by 1.25 times (p = 0.000001) with a 1.49-fold decrease in the IgA level (p = 0.000001). In the third group, compared with the first one, there was an increase in TNFα by 6.12 times (p = 0.000001), IgM − by 2.98 times (p = 0.000001) and the value of SDR in RUA by 1.70 times (p = 0.000001) against the background of a 2.31-fold decrease in IgA concentration (p = 0.000001). In patients of the third group, in comparison with the second group, higher levels of TNFα (by 1.23 times, p = 0.000001), IgM (by 1.18 times, p = 0.000001) and SDR in the RUA (by 1.35 times, p = 0.000001), as well as lower values of the IgA concentration (1.54 times, p = 0.000001). Conclusion. In women with exacerbation of chronic bronchitis caused by CMVI reactivation, leading to the formation of CSPI, in contrast to patients with a similar bronchopulmonary pathology of cytomegalovirus origin and the development of CCPI, a more pronounced activation of the systemic inflammatory response and an imbalance in the humoral component of immune system lead to an increase in vascular resistance in the RUA pool.

Aim. To give immune-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection (CMVI).Ma­terials and methods. The concentration of IL-ie, IL-2 and progesterone was studied in the blood serum, and the pulsation index (PI) in the right uterine artery (RUA) was determined in 80 patients at 21-24 weeks of gestation, uncomplicated and complicated by exacerbation of chronic simple bronchitis due to reactivation of CMVI. In a retrospective analysis, 3 groups were formed. The first group - 30 women with CMV-seronegative physiological pregnancy; the second - 25 patients with chronic bronchitis in the acute stage, initiated by the acute phase of CMVI, leading to chronic compensated placental in­sufficiency (CCPI); the third - 25 women with exacerbation of chronic bronchitis CMVI etiology, causing the development of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.Results. In the first group, the concentration of IL-ie was 22.8±0.02 pg/mL, IL-2 - 30.6±2.34 pg/mL, progesterone - 130.8±8.19 nmol/L, and the value of PI in RUA - 0.83±0.04 rel. units. In patients of the second group, compared with the first, the level of IL-ie in­creased by 3.82 times (p<0.00i), IL-2 - by 2.55 times (p<0.00i) and PI in the RUA - by i.40 times (p<0.00i) against the background of a decrease in the progesterone concentration by i.47 times (p<0.00i). The third group compared with the first was characterized by an increase in the concentration of IL-ie by 6.87 times (p<0.001), IL-2 - by 3.19 times (p<0.001) and PI in RUA by i.66 times (p<0.00i) with lower levels of progesterone (i.93 times, p<0.00i). In the third group, in contrast to the second one, an increase in IL-ie was observed by 1.79 times (p<0.001), IL-2 - by 1.24 times (p<0.05) and PI in RUA - by i.i7 times (p<0.05), as well as a decrease in progesterone levels by i.3i times (p<0.0i). There was an in­crease in the relationship of PI in RUA with the concentration of IL-ie (r=0.69; p<0.001), IL-2 (r=0.75; p<0.001) and progesterone (r=-0.55; p<0.01).Conclusion. A more pronounced systemic inflammatory reaction, leading to inhibition of progesterone synthesis and increased resistance to blood flow at RUA develops in exacerbation of chronic bronchitis in the second trimester of gestation against the background of reactivation of CMVI, which initiates the development of CCPI, in comparison with the exacerbation of bronchopulmonary pathology of a similar etiology, which determines the formation of subsequent CCPI.

Introduction. The role of an alternative adenylate cyclase pathway of hormonal signal transmission under the action of synthetic glucocorticosteroids with the participation of endogenous stress-limiting activity of the adrenal cortex in conjunction with the adaptive capabilities of airway homeostasis in patients with asthma under conditions of osmotic stress has not been studied at present. Aim. To assess the dynamics of cortisol and cyclic adenosin monophosphate (cAMP) in asthma patients with different airway responses to hypoosmolar stimuli when using anti-inflammatory combination therapy with inhaled corticosteroids/long-acting β2 -agonists (ICS/LABA). Materials and methods. 96 patients diagnosed with asthma received combined anti-inflammatory therapy with ICS/LABA for 24 weeks. Group 1 included patients (n=18) with airway hyperresponsiveness to hypoosmolar stimulus, group 2 (n=78) – with no reaction of the bronchi to a 3-minute ultrasonic inhalation of distilled water. At baseline and at the end of treatment, the lung function was studied; to assess the regulatory function of glucocorticoids using non-genomic signaling pathways, the levels of cortisol in blood serum and cAMP in blood leukocytes were determined. Results. Patients of group 1 in comparison with the second one initially had a lower FEV1 ‒ 88.2±5.3 and 98.5±1.7%, respectively (p<0.05), after treatment in both groups there was a slight tendency to an increase in FEV1 (98.5±5.7 and 101.4±2.5%, respectively, p>0.05). The concentration of cortisol and cAMP at baseline and after 24 weeks of therapy in patients of group 1 was 588.7±32.0 and 495.0±48.7 nmol/L, 61.7±5.1 and 76.5±5, 2 pmol/106 cells (p<0.01); in group 2 − 610.5±20.1 and 522.2±15.60 nmol/L (p<0.001), 76.2±2.2 and 90.6±2.5 pmol/106 cells (p<0.001). Conclusion. In asthma patients with airway osmotic hyperresponsiveness, persistent adaptation to osmotic stress is traced, which is combined with a more significant impairment of the lung function and indicates insufficient therapeutic control over glucocorticoid regulation of osmotic stress by the selected volume of ICS/LABA therapy.

Introduction. Hypoalimentation with the formation of protein-energy malnutrition can reduce the body’s resistance to acute respiratory infections (ARI). Soy and pumpkin can be a promising source of normalization of the diet.Aim. To study the effectiveness of the use of soybean-pumpkin products in the diet of healthy people to increase the resistance of the human body to ARI.Materials and methods. An open, randomized, parallel group study was conducted. Group 1 included 18 people who took a soy-pumpkin drink and dessert for 10 weeks in addition to their usual diet. Group 2 included 17 people on a regular diet. The concentration of vitamin E, cholesterol, α- and β-lipoproteins was determined in blood serum. Diene conjugates and unoxidized lipids were determined in the expired air condensate (EAC) by means of spectrophotometry. Lung function was assessed using spirometry.Results. According to the questionnaire survey, 50% of the participants in group 1 registered a positive dynamics from the regular use of soybean-pumpkin products. Only one participant underwent ARI. In the 2nd group, 7 people (41%) applied for medical help (χ2=4.43; p˂0.05), of which 6 (35%) had ARIs. At the end of the observation, an increase in vitamin E (from 34.1±0.68 to 36.4±0.55 μg/mL, p=0.0036), a decrease in total cholesterol (from 4.85±0.23 to 4.32±0.14 mmol/L, p=0.0013) and β-lipoproteins (from 2.92±0.24 to 2.31±0.18 mmol/L, p=0.0003). At the beginning of the study, in individuals of group 1, there was a relationship between age and the concentration of total cholesterol (r=0.50; p=0.036) and β-lipoproteins (r=0.47; p=0.048), as well as the weight and level of α-lipoproteins (r=-0.49; p=0.041), the concentration of unoxidized lipids (r=0.55; p=0.02), diene conjugates (r=0.48; p=0.043) in EAC. After regular use of soybean-pumpkin products, this correlation dependence was lost.Conclusion. Regular use of soy-pumpkin products for 10 weeks has a beneficial effect on the lipid profile of the blood, increases antioxidant defence, and reduces the susceptibility of a healthy person to ARI.

Aim. To assess the change in the lipid-synthesizing function of the liver in congenital cytomegalovirus infection (CMVI) in dead newborns.Materials and methods. The study of the lipid spectrum of umbilical cord blood in the first minutes of life was carried out in 59 full-term newborns with antenatal ontogenesis, unburdened and burdened with congenital CMVI. The first group consisted of 25 newborns of early neonatal age (control group) from mothers without moderate and severe obstetric and somatic pathology, as well as respiratory viral diseases and sexually transmitted infections. The second group included 18 children of the same age (comparison group), whose mothers suffered exacerbation of CMVI in the second trimester of pregnancy, which did not lead to antenatal viral aggression. The third group was represented by 16 newborns with congenital CMVI. The life expectancy of children was 2-5 days. In the first group, the main cause of death of children was prolonged ante- and intranatal hypoxia, atelectasis and hyaline membranes of the lungs, in the second group – prolonged antenatal hypoxia, intranatal hypoxia and atelectatic, hyaline and edematous-hemorrhagic pneumopathies, and in the third group – congenital CMVI, which manifested itself as cerebral ischemia of moderate and severe degree, meningoencephalitis, ventriculomegaly, pseudocysts of the vascular plexus and subarachnoid hemorrhages, monocytosis, vesiculopustulosis, hepatitis and pneumonia. In the blood serum from the umbilical vein during biochemical analysis, the concentration (mmol/L) of total cholesterol, high-density lipoproteins, low-density lipoproteins and triglycerides was estimated.Results. In newborns of the second group in the blood serum from the umbilical cord vein, the concentration of total cholesterol was 1.90±0.04 mmol/L, high-density lipoproteins – 1.49±0.06 mmol/L, low-density lipoproteins - 0.26±0,02 mmol/L and triglycerides – 0.49±0.03 mmol/L (in the first group, respectively, 1.93±0.06 mmol/L, p>0.05; 1.37±0.06 mmol/L, p>0.05; 0.43±0.02 mmol/L, p<0.001; 0.45±0.02 mmol/L, p>0.05). In the third group, compared with the second one, there was a decrease in the level of total cholesterol to 1.79±0.04 mmol/L (p<0.05) and high-density lipoproteins – to 1.28±0.06 (p><0.05) against the background of an increase in triglyceride concentration up to 0.59±0.03 mmol/L (p><0.05). Conclusion. The above changes in the lipid-synthesizing function of the liver indicate a direct and indirect effect of congenital CMVI on the morphological structure of hepatocytes and the activity of enzyme systems. Key words: full-term newborns, congenital cytomegalovirus infection, total cholesterol, high-density lipoproteins, lowdensity lipoproteins, triglyceride>˂ 0.05) and high-density lipoproteins – to 1.28±0.06 (p<0.05) against the background of an increase in triglyceride concentration up to 0.59±0.03 mmol/L (p><0.05). Conclusion. The above changes in the lipid-synthesizing function of the liver indicate a direct and indirect effect of congenital CMVI on the morphological structure of hepatocytes and the activity of enzyme systems. Key words: full-term newborns, congenital cytomegalovirus infection, total cholesterol, high-density lipoproteins, lowdensity lipoproteins, triglycerides>˂ 0.05) against the background of an increase in triglyceride concentration up to 0.59±0.03 mmol/L (p˂ 0.05).Conclusion. The above changes in the lipid-synthesizing function of the liver indicate a direct and indirect effect of congenital CMVI on the morphological structure of hepatocytes and the activity of enzyme systems.

Aim. To give an immunomorphological assessment of the systemic inflammatory response in newborns with congenital cytomegalovirus infection. Materials and methods. A study of the concentration of TNF-α in serum of umbilical cord blood, as well as the structure of blood vessels of the pulmonary circulation and loose fibrous connective tissue of the lungs in 41 dead full-term newborns with various antenatal anamneses was carried out. The first group consisted of 25 children from mothers who during pregnancy did not have herpesvirus, cytomegalovirus and acute respiratory viral infections, moderate and severe somatic and obstetric pathology. The death of newborns occurred on 2-5 days of life in the setting of birth trauma, intranatal, postnatal hypoxia, atelectasis and hyaline membranes of the lungs. The second group was represented by 16 newborns diagnosed with congenital cytomegalovirus infection. The reason for their death on days 2-5 of life was cerebral ischemia of moderate and severe degrees, hypertensive-hydrocephalic and convulsive syndromes, pseudocysts of the vascular plexus, subependymal and subarachnoid hemorrhages, monocytosis, vesiculosis, pneumonia, hepatitis and meningoencephalitis. Antenatal viral invasion was observed against the background of prolonged intrauterine hypoxia and chronic subcompensated and decompensated placental insufficiency. Results. In newborns of the second group, the concentration of TNF-α in the umbilical cord blood increased to 47.3±2.25 pg/mL (in the first group – 26.4±2.23 pg/mL, p<0.001). In contrast to the first group, aggregates and hemolysis of erythrocytes, microthrombi, leukocytes, edema of endothelial cells, hyperchromia of their nucleus, as well as desquamation of endotheliocytes into the lumen of blood vessels, were frequent morphological findings in the small-caliber pulmonary arteries in full-term newborns of the second group. In the setting of thickening of the intima of these vessels, dystrophic changes in smooth muscle cells were revealed, and in the adventitia, the tortuosity of collagen fibers. In the perivascular loose fibrous connective tissue, edema, dissociation of collagen fibers and areas of their excessive development, single hemorrhages and accumulations of monocytic-lymphocytic cellular elements were recorded. In the lungs, aspiration and edematous-hemorrhagic pneumopathies, as well as pneumonia, were more common. Conclusion. In case of systemic inflammatory response in newborns with congenital cytomegalovirus infection, markers of endothelial pathology and structural and functional rearrangement of connective tissue are more common in small branches of the pulmonary artery, which increase the predisposition of children to pulmonary hypertension in the postnatal period of their development..

Introduction . The phenomenon of airway hyperresponsiveness in response to changes in air humidity is widespread among patients with asthma. Transient receptor potential channels of the vanilloid subfamily (TRPV) are of interest in terms of study of specific mechanisms of bronchial osmotic hyperresponsiveness. Aim . The aim of the study was to evaluate the expression TRPV1, TRPV2 and TRPV4 genes at mRNA level in the epithelium of the upper and lower respiratory tract in asthma patients with osmotic airway hyperresponsiveness. Materials and methods . We examined 35 patients with mild and moderate asthma. All patients underwent bronchoprovocation tests with hypo- and hyperosmotic solutions. Expression of TRPV receptors was studied in brush biopsies of the nasal and bronchial epithelium by quantitative PCR with reverse transcription. Results . Airway hyperrresponsiveness to hypoosmotic and hyperosmotic stimuli was observed in 25% and 50% of cases, respectively. It was found that patients with lower baseline FEV 1 had overexpression of TRPV1 (3.2 times, p=0.05) and TRPV2 (6.2 times, p=0.013) in the bronchial epithelium. Hypoosmotic airway hyperresponsiveness was associated with increased expression of the TRPV1 (7.4 times, p=0.004) and TRPV2 (18.5 times, p=0.014) genes in the bronchial epithelium. Airway hyperresponsiveness to hypertonic stimulus was also characterized by higher expression of TRPV1 (4.7 times, p=0.013) and TRPV2 (7.6 times, p=0.024). No difference in TRPV4 expression levels was found. Conclusion . The obtained data indicate the up-regulation of TRPV1 and TRPV2 in the bronchial epithelium of asthma patients with osmotic airway hyperresponsiveness, what, in turn, may indicate the role of these receptors in the development of airway osmotic-induced responses and in the pathogenesis of asthma.

Aim. To study the effect of hypothermia and hypogravity on the morphofunctional state of the mucous membrane of the trachea. Materials and methods . The conditions of hypogravity were modeled in a clinostat for modeling hypogravity (Patent RU183861U1). The study was conducted on 30 male rats, 8-10 weeks old with a body weight of 150300 g. All animals were divided into 3 groups (the control one including intact rats; the experimental one with rats of orthostatic hanging for 30 days and the experimental one with orthostatic hanging for 30 days against the background of cold (-15°C) exposure in a climate chamber. Oscillatory activity of cilia was recorded using a computer system. To evaluate the cilia activity, the frequency of cilia beating by cilia per second of time (Hz) was recorded as well as histological analysis of tracheal tissues. Results. It was found out that a combination of two stress factors, which include orthostatic hanging and prolonged exposure to low temperatures, significantly changes the morphological and functional structure of the tracheal mucosa compared with the intact group of animals and the group of orthostatic hanging. Long-term action of cold and orthostatic hanging was accompanied by a decrease in the height of the cilia of the ciliated epithelium and tracheal epithelium, accompanied by a significant decrease in cilia vibrations. Conclusion. The combined effect of the orthostatic hanging and prolonged exposure to low temperatures leads to morphological and functional disturbance of the mucosal epithelium, which in the future will require appropriate correction.

Aim. To assess the functional state of the liver in congenital cytomegalovirus infection in dead full-term newborns. Materials and methods . 59 newborns who died on the 2-5 day of life were examined. 25 of them (the first, control group) did not have intrauterine viral aggression and sexually transmitted infections against the background of the absence of a negative impact of moderate and severe somatic and obstetric pathology in their mothers during gestation; in 18 (second group, comparison), markers of congenital infection were not determined against the background of an exacerbation of cytomegalovirus infection in their mothers in the second trimester of pregnancy; 16 (the third group, the main group) were diagnosed with intrauterine cytomegalovirus infection. The cause of death of children in the first group was complications of childbirth, intrapartum hypoxia, atelectasis and hyaline membrane lung; in the second one there were utero, intrapartum and postnatal hypoxia, and atelectasis of the lungs; in the third group there was cerebral ischemia, ven-triculomegaly, choroid plexus pseudocyst and subarachnoid hemorrhage, local and generalized forms of congenital infection. The content of total protein, albumins, total, indirect, and direct bilirubin, medium-molecular peptides, and lactate dehydrogenase activity were determined in blood serum from the umbilical vein using a biochemical method. Results. It was found out that the second group of newborns in comparison with the first group did not show significant differences in the concentration of total protein and albumins. At the same time, in the third group, there was a drop in the total protein content to 52.8±1.28 g/L (in control it was 61.8±1.42 g/L; p<0.05) and albumins to 31.2±1.34 g/L (in control it was 38.2±1.21 g/L; p<0.05) against the background of the maximum increase in total bilirubin to 40.0±2.05 mmol/L (in control it was 26.5± 2.18 mmol/L; p<0.001), indirect bilirubin to 37.9±2.04 mmol/L (in control it was 24.6±2.17 mmol/L; p<0.001), direct bilirubin to 2.61±0.18 mmol/L (in control it was 1.89±0.07 mmol/L; p<0.001), lactate dehydrogenase to 267.6±12.41 IU/L (in control it was 210.6±10.12 IU/L, p<0.001) and medium-molecular peptides to 0.312±0.012 units of optical density (in control it was 0.278±0.005 units of optical density; p<0.001). Conclusion. The above-mentioned biochemical changes indicate that the predominance of anaerobic processes and more pronounced endotoxemia play an important role in the pathogenesis of disturbances of the liver's protein synthesis and pigment functions in newborns with intrauterine cytomegalovirus infection.

Aim . To study the change in the physico-biochemical properties of the nasopharyngeal aspirate in newborns with congenital cytomegalovirus infection (CMVI). Materials and methods . The pH, the concentration of medium molecular weight peptides, seromucoid, total cholesterol, triglycerides, and the activity of lactate dehydrogenase in the nasopharyngeal aspirate in 59 full-term infants with intrauterine development, uncomplicated and complicated by congenital CMVI, who died at 2-5 days of life, were studied. The first group included 25 children of early neonatal age (control group), whose mothers did not have moderate and severe obstetric and somatic pathologies during pregnancy, as well as respiratory viral infections and sexually transmitted infections. The second group was represented by 18 newborns (comparison group) from mothers with exacerbation of CMVI in the second trimester of gestation, which does not lead to antenatal infection of their offspring. The third group consisted of 16 newborns (main group) with diagnosed intrauterine CMVI. Results . In the nasopharyngeal aspirate in the newborns of the second group, in comparison with the first one, there were no statistically significant differences in pH (7.02±0.016 and 7.05±0.016, respectively, p>0.05). At the same time, there was a decrease in the concentration of total cholesterol (0.196±0.006 and 0.238±0.003 mmol/L, respectively, p<0.001), an increase in the concentration of medium molecular weight peptides (0.595±0.032 and 0.345±0.005 mmol/L, respectively, p<0.001), seromucoid (0.112±0.002 and 0.098±0.001 optical density units, respectively, p<0.001), triglycerides (0.160±0.005 and 0.145±0.004 mmol/L, respectively, p<0.05) and lactate dehydrogenase activity (345,0±14.16 and 287.6±10.23 IU/L, respectively, p<0.01). In the third group, in comparison with the second one, a decrease in pH by 1.01 times (p<0.01) and in total cholesterol by 1.35 times (p<0.001), an increase in the concentration of medium molecular weight peptides by 1.32 times (p<0,05), seromucoid – 1.13 times (p<0.001), triglycerides – 1.24 times (p<0.001) and the level of lactate dehydrogenase – 1.15 times (p<0.05). Conclusion . In dead newborns with intrauterine CMVI, a change in the physico-biochemical properties of the nasopharyngeal aspirate in the first minutes after birth indicates an antenatal direct and indirect negative effect of the infection on the state of the amniotic membrane, placenta and organs of the intrauterine fetus.

SUMMARY. Aim. To give an echographic and biochemical characterization of the hepatobiliary system in case of congenital cytomegalovirus infection (CMVI) in dead full-term infants. Materials and methods. A research was carried out at birth and during the first day of 59 children who died on the 2 nd -5 th day of life. Group 1 (control) consisted of 25 full-term newborns from mothers who did not have moderate and severe obstetric and somatic pathologies, as well as respiratory viral diseases and sexually transmitted infections. Group 2 (experimental) included 18 newborns whose mothers suffered from an exacerbation of CMVI in the second trimester of pregnancy without markers of congenital viral infection in their offspring. Group 3 (main) was represented by 16 newborns with congenital CMVI. The main cause of death in 1st group of children was prolonged intranatal hypoxia, atelectasis and hyaline membrane of the lungs; in group 2 – ante-, intra- and postnatal hypoxia, as well as common lung atelectasis; in group 3 – cerebral ischemia of moderate and severe degrees, ventriculomegaly, pseudocysts of the vascular plexus and subarachnoid hemorrhages, local and generalized forms of congenital infection. Ultrasound analysis determined the size, echostructural picture of the liver and the structure of the gallbladder. The activity of alanine aminotransferase, aspartate aminotransferase, γ-glutamyltranspeptidase and alkaline phosphatase was evaluated by biochemical methods in blood serum from the umbilical vein. Results. In newborns of group 2, hepatomegaly was detected in 5.6%, increased echogenicity of blood vessels and portal tracts in 11.1%, and S-shaped deformation of the gallbladder in 5.6%. However, statistically significant differences in the frequency of increase in echogenicity of the parenchyma in children of groups 2 and 1