The aim of the studywas to identify the role of cytokine storm in COVID-19, that emerged at the end of 2019, based on the analysis of 80 publications, including 17.4% Russian and 82.6% foreign publications for 2014–2020 with an average impact factor of 11.94 and a maximum of 74.699. This review includes an in-depth discussion of the possible causes and pathogenetic factors of cytokine storm syndrome development caused by COVID-19. The results of research on the use of various principles of cytokine storm correction are provided. It has been established that lung damage and the development of a fatal outcome are caused not by the virus itself, but by the hyperreaction of the body's immune system. The leading role in this process belongs to the cytokine storm, including the action of IL-6.

The purpose is to study antibacterial and antimycotic properties of produced granular carbon sorbents. Material and methods. A VNIITU-1 carbon sorbent was used as a starting material, which was modified with polyvinylpyrrolidone and lactic and glycolic acids oligomers. Microbiological bench tests were carried out to determine the antibacterial and antimycotic activity of these granulated carbon hemosorbents. Antibacterial properties of sorbents were studied in relation to pathogenic and conditionally pathogenic microorganisms: Staphylococcus aureus, Pseudomonas aeroginosa, Klebsiella pneumonia, Escherichia coli, Streptococcus agalactiae as well as their mixtures: mixture No. 1 — S. aureus and E. coli; mixture No. 2 — S. aureus and P. aeruginosa. Results. Presented data demonstrate that the modified VNIITU-1 exhibits significant antibacterial and antimycotic activity against most of the studied microorganisms compared to original sorbent. Conclusion. Modified sorbents as antimicrobial and detoxifying drugs may further be employed in treatment of obstetrical-gynecological and surgical diseases. The carbon sorbents are promising materials for medicine, as they expand the potential of sorption therapy in clinical practice.

Objective: to develop a technology for obtaining the molded sorbent VNIITU1, to study its physicochemical and biomedical properties, and to evaluate its efficacy in preventing and treating pyoinflammatory complications in obstetrics.Materials and methods. The molded sorbent VNIITU-1 was designed from the carbon porous material based on nanodispersed carbon by mixing with a vehicle, extruding the mixture, drying the extrudate in an inert atmosphere, thermally treating and activating by steam, followed by washing with distilled water and drying (TU 9398043710698342013). The molded sorbent VNIITU-1 is apyrogenic and nontoxic (Toxicity Study Conclusion No. 1998.013.P dated 14.08.2013; Engineering Testing Assessment No. 12.404 ORTI/2013 dated 26.08.2013), it is destined for single administration, sterile, placed in a removable thread capron mesh container, and used to treat and prevent pyoseptic complications in puerperas at risk for infection, such as acute nonspecific postpartum endometritis. A total of 52 puerperas were examined and treated. They had been divided into 2 groups: a study group (n=37) and a comparison group (n=15). In the study group, the hemosorbent VNIITU1 as a porous carbon applicator was postpartum inserted into the uterine cavity, by concurrently performing traditional antibiotic therapy to prevent infectious complications. The comparison group received only traditional antibiotic therapy. The uterine cavity aspirate was examined for IL1β and IL6 levels, its microbial profile, and microbial growth patterns in culture media. The data were processed using a package of applied STATISTICA6.1 programs and standard mathematical tables in Microsoft Excel. Descriptive and variation statistical methods were applied. The data were presented as Me [low quartilehigh quartile (LQHQ)]; two pre and posttreatment dependent variables were compared using the Wilcoxon and Mann-Whitney tests.Results. The molded carbon sorbent VNIITU1 was found to have pronounced antibacterial activity against S.aureus, P.aeroginosa, K.pneumonia, E.coli and S.agalactiae. Examination of lavages from the surface of the sorbent after its removal from the uterine cavity, by using a transmission electron microscope, revealed castoff epithelial cells, leukocytes, macrophages, and microorganisms, which determines the capacity of the sorbent to eliminate not only soluble toxins, but also microorganisms and disintegrating cell elements. Conclusion. The proposed procedure to postpartum endometritis in puer peras at risk for infection via insertion of the porous carbon applicator VNIITU1 into the uterine cavity is more effective than the traditional approach and it can improve treatment results, by completely eliminating pathogens from the uterus and by reducing the level of local proinflammatory cytokines.

Present work deals with specific immunologic changes that are typical to various types of mixed infection caused by viruses from Herpesviridae family during their activation phase. These changes include increased amounts of CD3+/CD25+ lymphocytes and CD3+/CD4+ cells, decreased levels of CD3+/CD95+ cells, increased contents of natural killer cells, altered interrelations between the immune system parameters. Involvement of cytomegalovirus or Epstein-Barr virus (EBV) in the mixed infection is associated with some special changes of the lymphocyte subsets. I.e., a co-infection with herpes virus simplex (HSV) type 1/2 and cytomegalovirus is characterized by increased amounts of activated T-lymphocytes and T-helper cells, whereas mixed HSV/EBV infection is accompanied by sharp reduction in CD3+/CD95+ lymphocytes.

Many modern sorbents have low sorption activity toward toxic substances of protein nature. Sorption selectivity for protein compounds can be enhanced by chemical modification of the sorbent surface withpolyvinylpyrrolidone. At the first stage of the study, 58 patients after surgical removal of abdominal cavity tumors were examined and treated. In 28 patients, the postoperative period was complicated with diffuse purulent peritonitis. So, the complex therapy of these patients was supplemented with 1-2 hemosorption sessions using a VNIITU-1 carbon sorbent in a sterile saline solution. The sorbent, which was awarded with a gold medal of the International Salon of Innovations and In vestments, has a meso-porous surface that allows toxic substances of low and moderate molecular weight to be removed from the human body. The hemosorption sessions substantially reduced hematological, immunological and biochemical disorders and ultimately decreased mortality in the early postoperative period by a factor of 3.7. The second stage of the study was aimed to develop a molded carbon sorbent based on VNIITU-1 for selective sorption of pro-inflammatory cytokines form blood plasma. Bench testing was performed with blood plasma obtained during plasmapheresis from 15 patients with acute pancreatitis complicated with pancreonecrosis and diffuse purulent peritonitis. Blood plasma perfusion was carried out on a Unirol-1 device using the 10 cm3 columns filled with the sorbent, at a rate of 15 ml/min and a plasma/sorbent ratio of 10/1. Overall, 50 ml of plasma was passed through the column. The TNFα, IL-1β, IL-4, and IgA contents were determined in blood plasma before and after the sorption. The modified hemosorbent VNIITU-1-PVP showed much higher sorption capacity and selectivity than the initial VNIITU-1. This concerns pro-inflammatory cytokine interleukin-1β: its concentration decreased by a factor of 33.5 and TNFα was virtually absent. The level of antiinflammatory cytokine interleukin-4 was nearly twofold higher as compared to blood plasma that was passed through VNIITU-1. The IgA content remained virtually unchanged.

Abstract. Immunological characteristics of phagocytic activity and cellular immunity are presented for 112 patients with acute destructive pancreatitis with suppurative complications (group I), versus non-septic cases. We evaluated lymphocyte subpopulation profiles, phagocytic activity of leukocytes, serum levels of interferon-γ and circulating immune complexes. A mixed-type secondary immune deficiency was shown to develop in pancreatic necrosis. Distinct signs typical to immune deficiency, as well as lack of cellular immune potential were evident as soon as by day 3 of the disease.

Objective: to evaluate the impact of Leiden mutation on the course of severe acute pancreatitis. Subjects and methods. One hundred and twelve people were examined. Group 1 comprised 50 patients diagnosed with severe acute pancreatitis without coagulation factor V (Leiden) mutation. Group 2 included 42 patients with severe acute pancreatitis who were found to have Leiden mutation. Acute pancreatitis was first diagnosed in both groups. Group 3 consisted of 20 apparently healthy individuals (a control group). The severity of the underlying disease was determined in accordance with the clinical and laboratory parameters recommended by the I. I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care. Results. This investigation revealed an association of Leiden mutation with trends in the development of acute pancreatitis. Group 2 exhibited a more severe disease: large focal pancreatic necrosis was twice more common and infectious complications developed more frequently; more aggressive and radical treatments were more often used. The patients with Leiden mutation had higher mortality rates (33% in the Leiden mutation group and 24% in the non-mutation group. Conclusion. The findings should be kept in mind in elaborating new diagnostic methods and principles in the treatment of the underlying disease and in the prevention of its complications in patients with severe acute pancreatitis. Key words: acute pancreatitis, Leiden mutation.

In animals and humans after a contact with pesticides, there is a risk of immunotoxic effects, which causes the secondary immunodeficiencies. The pesticide load on the organism makes it difficult to conduct the serological indication of infectious diseases, becoming a cause of false positive or negative results. The treatment of intoxication is based on the methods of efferent, symptomatic and pathogenetic therapy. We investigated the modified carbon enterosorbent, obtained after impregnating a 15 % solution of arginine, on the model objects (laboratory mongrel male rats with the mass of 180-200 g). Enterosorbtion was appointed 2 days after the intoxication, when the absorption of pesticide from the gastrointestinal tract into the blood stream has occurred. Thus, it was possible to evaluate immunocorrecting effects of the modified sorbent, which were caused not by sorbtion of toxicant in the gastrointestinal tract, but by its influence on the intensity of enterohepatic and enterogematic pesticide circulation. It was established that the intoxication of rats with deltametrin in the dose of 17.4 mg/kg ( 1/ 5 LD 50) caused the rise of the IL-1β, IL-8, TNF-a and lactoferrine levels in blood. Participation in formation of a cascade of inflammatory reactions is a common property of this group of immunoregulatory molecules. But under the excess of pro-inflammatory cytokines, the undesirable processes accompanied with the hypercatabolic and hyperdynamic effects become dominant. The increase of serum lactoferrine concentration in animals exposed to deltametrin may be regarded as a result of inflammatory process. The arginine-modified carbon sorbent used for enterosorbtion leveled the described changes.

Проведено модифицирование поверхности углеродного мезопористого гемосорбента ВНИИТУ-1 – поли-N-винилпирролидоном, обладающего собственной антибактериальной активностью. Модифицирование проводилось в два этапа: 1) пропитка водным раствором мономера (N-винилпирролидона) и инициатора; 2) полимеризация в инертной атмосфере. Состав продуктов реакции полимеризации проанализирован методом ЯМР 13. Современными физико-химическими методами исследованы текстурные характеристики, рельеф (морфология), содержание общего азота исходного и модифицированных сорбентов. Стендовые медицинские испытания показали, что после контакта с модифицированным сорбентом происходит уменьшение количества бактериальных клеток Staphylococcus aureus и ингибирование их роста по сравнению с исходным углеродным сорбентом.

The surface of a VNIITU-1 carbon mesoporous hemosorbent is modified with poly-N-vinylpyrrolidone, which possesses its own antibacterial activity. The modification is performed in two steps: (1) impregnation of the monomer, N-vinylpyrrolidone, and the initiator in an aqueous solution and (2) polymerization in an inert atmosphere. The composition of products produced during polymerization reaction is analyzed by NMR 13C. The texture characteristics, the relief and the morphology, and the content of nitrogen in the initial and modified sorbents are studied by current physicochemical methods. Bench tests show that the contact with the modified sorbent leads to a decrease in the amount of Staphylococcus aureus bacterial cells and inhibition of their growth in comparison with the initial carbon sorbent.

Phagocyte activity and the interferon system was studied in 40 patients with multiple sclerosis (MS), including 22 patients with remitting MS type, 7 patients with primary progressive MS and 11 patients with secondary progressive MS. A control group included 15 healthy people. Changes in the parameters studied were found in all groups of patients. The most marked changes in the phagocyte section of immunity and in the interferon system were seen in patients with primary progressive and secondary progressive MS. The data obtained may be used in diagnosis and choice of treatment in MS patients.

StudieS of lymphocyte SubSetS in patientS with a mixed infection cauSed by the viruSeS from Herpesviridae family abstract. Present work deals with specific immunologic changes that are typical to various types of mixed infection caused by viruses from Herpesviridae family during their activation phase. These changes include increased amounts of CD3 + /CD25 + lymphocytes and CD3 + /CD4 + cells, decreased levels of CD3 + /CD95 + cells, increased contents of natural killer cells, altered interrelations between the immune system parameters. Involvement of cytomegalovirus or Epstein-Barr virus (EBV) in the mixed infection is associated with some special changes of the lymphocyte subsets. I.e., a co-infection with herpes virus simplex (HSV) type 1/2 and cytomegalovirus is characterized by increased amounts of activated T-lymphocytes and T-helper cells, whereas mixed HSV/EBV infection is accompanied by sharp reduction in CD3 + /CD95 + lymphocytes. (Med. immunol.,

Objective: to evaluate the efficiency of cytokine sorption with carbon with a locally aminocaproic acid-modified surface from the plasma of patients with general purulent peritonitis. Materials and methods. The material of the investigation was the plasma obtained during plasmapheresis in 10 patients with acute pancreatitis complicated by pancreonecrosis and general purulent peritonitis, which was used to estimate before and after sorption the content of the cytokines: interleukin (IL)-1/8, IL-4, and IL-8 by enzyme immunoassay. The sorption properties of carbon hemosor-bent and aminocaproic acid-modified sorbent were comparatively evaluated. Results. Aminocaproic acid-induced modification of the carbon adsorbent surface with its further polycondensation results in the higher content of superficial functional groups (oxygen- and nitrogen-containing) that enhance the hydrophility of the surface and the specific pattern of sorption, thus acting as a means for controlling and regulating the plasma concentration of regulatory proteins, primarily the proinflammatory cytokine IL-1^3, the chemokine IL-8 and the T-helper cell clone cytokine IL-4.