Vol 26, No 2 (2023)

Immune status in developing restenosis in patients with occlusive-stenotic lesion of the femoral-popliteal arterial segment after femoral-popliteal bypass surgery

Victor A. Lazarenko, Elena A. Bobrovskaya, Ilia S. Ivanov, Vyacheslav A. Lipatov, Vladimir N. Mishustin, Elizaveta I. Godunova

4-12 591

Abstract

Objective: to assess the immune status of systemic and local blood flow after femoral-popliteal bypass surgery in patients with and without restenosis. Materials and methods. The analysis of the treatment of 82 patients who underwent femoral-popliteal bypass surgery was carried out. Depending on the condition of the reconstruction zone after 12 months, the patients were divided into two groups: group I - 21 patients without restenosis, group II - 61 patients with the development of restenosis. The analysis of IgA, IgM, IgG, circulating immune complexes (CIC), interleukin (IL)-6, IL-1 in the systemic and local blood flow before and after surgery was performed. Results. In patients with the development of restenosis of the reconstruction zone, the level of IgA in the systemic and IgA, IgM in the local bloodstream was initially lower, the level of CIC, IL-1, IL-6 in the systemic and IgG, IL-1, IL-6 in the local bloodstream was higher, after surgery, the level of IgA in the local bloodstream was lower, higher - IgM in systemic and IL-6 in local blood flow in comparison with patients without restenosis. The correlation between the immune status and the development of restenosis was established: before surgery in the systemic circulation - IgA (r=-0.31, p<0.01), CIC (r=0.39, p<0.001), IL-6 (r=0.25, p<0.05), IL-1 (r=0.26, p<0.05), in the local bloodstream - IgA (r=-0.26, p<0.05), IgM (r=-0.30, p<0.01), IgG (r=0.26, p<0.05), IL-6 (r=0.30, p<0.01), IL-1 (r=0.29, p<0.01); after surgery in the systemic circulation - IgM (r=0.33, p<0.01), in the local - IgA (r=-0.24, p<0.05), IL-6 (r=0.40, p<0.001). The relationship between the degree of chronic arterial insufficiency (r=0.22, p<0.05), the ankle- brachial index after surgery (r=-0.27, p<0.05) with the development of restenosis was revealed. Conclusion. The interrelation of the immune status of the systemic and local blood flow before and after surgery and restenosis in the anastomosis zone after femur-popliteal bypass surgery has been shown. The study of the immune status will make it possible to develop an algorithm for restenosis prevention.

Features of the course of the early neonatal period in newborns from mothers who underwent COVID-19 during pregnancy (pilot prospective cohort study)

Olga G. Betz, Arsen A. Kornilov, Irina G. Khmelevskaya

PDF (Rus)

13-19 432

Abstract

Objective: analysis of the course of the early neonatal period in newborns from mothers who underwent COVID-19 at different gestation periods. Materials and methods. Full-term children under the age of 7 days of life born in the Regional Perinatal Center of Kursk in 2021 were under observation: group 1 - as a result of pregnancy complicated by COVID-19 infection (47 people); group 2 - control group (31 people). The main indicator of the study is the pathological nature of the course of the early neonatal period. Results. The anthropometric data at birth did not differ significantly. Transient neonatal tachypnea (19.1% in group 1 versus 9.6% in group 2, respectively), intrauterine pneumonia (19.1% in group 1 versus 3.2% in group 2, respectively; both had bilateral p values = 0.040) were detected more frequently in newborn infants. Conclusion. COVID-19 infection during pregnancy was found to be a risk factor for the development of respiratory disorders in newborns in the early neonatal period. When interpreting these data, the limitations of the study should be taken into account: the sample size, the observational nature of the study, and the methods used to measure the indicators.

Features of intracardiac hemodynamics in patients with acute myocardial infarction with st segment elevation who underwent COVID-19

Vadim P. Mikhin, Anna I. Gindler, Natalya V. Zaikina, Margarita P. Zaikina, Tamara A. Nikolenko, Valentina V. Savelyeva, Marina A. Chernyatina, Anton M. Aleksandrov

PDF (Rus)

20-30 438

Abstract

Objective: to evaluate the features of central and intracardiac hemodynamics in patients with ST-segment elevation myocardial infarction (STEMI), who underwent COVID-19 during inpatient stay and 6 months after the development of STEMI. Materials and methods. 140 patients with STEMI were included in the study. The patients were randomized into 2 groups: I - main group - patients with STEMI who suffered COVID-19 (52 people) in the period from 1.5-6 months before the development of acute coronary syndrome (ACS), II - comparison group (88 people) which included patients with STEMI who did not have COVID-19 in the anamnesis. All patients underwent PCI with stenting of the infarct-related artery in the first 24 hours from the onset of ACS. The parameters of central and intracardiac hemodynamics in all patients were determined for 2-3 days (1^st control point), 9-11 days (2^nd control point), after 6 months (3^rd control point) from the moment of hospitalization for STEMI. Results. In the patients of the main group of the study, more pronounced changes in the systolic-diastolic LV function were recorded on the 2-3 day of STEMI: LV EF by 8.5%, Sm by 7.2% and E' by 24.5% (p<0.05) were lower than in the control group, respectively, E/E' by 11.5% and WMSI by 21.8% (p<0.05) were higher than in the comparison group. On the 9^th-11^th day of the disease in patients with STEMI who underwent COVID-19, a slowdown in the recovery of the studied parameters was revealed: the LV EF value was lower than in the control group by 11%, Sm by 12% and E' by 20% (p<0.05), respectively, and the value of E/E' by 27% and WMSI by 25% (p<0.05) were higher than in the comparison group. 6 months after STEMI, there were no significant differences in Sm, E', E/E' values in the main and control groups, however, a lower LVEF and WMSI value was noted in comparison with the control group (p<0.05). Conclusion. Unidirectional positive dynamics of systolic-diastolic function parameters in hospital and post-hospital follow-up periods was observed in patients with STEMI, both those who had COVID-19 and without COVID-19 in the anamnesis. However, in patients who underwent COVID-19, there were more pronounced violations of LV systolic-diastolic function on 2-3 days and less pronounced, delayed positive dynamics of these parameters during the hospital and post-hospital treatment periods.

Phenotypic approach to personalization of pharmacotherapy in patients with congenetive heart failure with low left ventricular ejection fraction

Sergey V. Povetkin

PDF (Rus)

31-39 348

Abstract

Objective is to present a review of the literature data concerning the personalization of pharmacotherapy in patients with chronic heart failure with low left ventricular ejection fraction. The article discusses modern approaches to phenotyping patients with chronic heart failure with a low left ventricular ejection fraction (HFrEF). Various criteria of phenotyping are considered, both technologically complex and having the prospect of implementation into real practice in the future, and currently being implemented. For the current period, the most acceptable approach from a practical point of view remains the phenotyping of patients with HFrEF, based on clinical, hemodynamic parameters, which allows prioritizing the appointment of medicines. The article discusses the choice of optimal classes of drugs that affect the prognosis of patients with HFrEF, based on taking into account such markers as blood pressure, heart rate, presence of atrial fibrillation, presence and degree of renal dysfunction, electrolyte balance, a combination of these parameters. A phenotypic approach to the treatment of patients with HFrEF will help to ensure the personalization of pharmacotherapy for heart failure with maximum benefit for a particular patient.

Evaluation of the immunotropic activity of neuropeptide compound Lys-Lys-Arg-Arg-Pro-Gly-Pro in conditions of "social" stress

Anna L. Yasenyavskaya, Alexandra A. Tsibizova, Lyudmila A. Andreeva, Nikolay F. Myasoedov, Marina A. Samotrueva

PDF (Rus)

40-49 337

Abstract

Objective: to investigate immunotropic activity of the argenine-containing neuropeptide compound Lys-Lys-Arg-Arg-Pro-Gly-Pro in conditions of "social" stress. Material and methods. The study was conducted on mongrel male rats of 6 months of age using a model of "social" stress based on the provision of permanent residence of animals in conditions of sensory contact, as a result of which submissive and aggressive types of behavior were formed. All animals were divided into groups: control I - rats who were in a cage one at a time and received water for injection in an equivalent volume; control II - groups of stressed animals with aggressive and submissive types of behavior; three groups of stressed rats were intraperitoneally injected with Lys-Lys-Arg-Arg-Pro-Gly-Pro at a dose of 100 mcg/kg/day and the comparison drug Imunofan (Arginyl-alpha-aspartyl-lysyl-valyl-thyrosyl-argininum) at an average therapeutic dose of 0.7 mcg/kg/day. The following indicators were evaluated: delayed hypersensitivity reaction index, antibody titer of direct hemagglutination reaction, phagocytic activity of peripheral blood neutrophils, leukocyte formula indicators. Results. The results obtained in the course of this study indicate that the arginine-containing neuropeptide compound Lys-Lys-Arg-Arg-Pro-Gly-Pro contributes to the correction of immune changes that occur against the background of exposure to chronic "social" stress, namely, an increase in the delayed hypersensitivity reaction index, the level of anti-erythrocyte antibodies, the total number of leukocytes and a decrease in phagocytic activity of peripheral blood neutrophils (phagocytic number and phagocytic index), as well as restoration of the percentage ratio of elements of the leukocyte formula. Conclusion. Thus, the study of the immunotropic activity of the argenine-containing neuropeptide compound Lys-Lys-Arg-Arg-Pro-Gly-Pro showed the presence of an immunocorrecting effect on the cellular and humoral links of immunity, which actualizes the need for a detailed study of the immune mechanisms of this compound.

New experimental model of diabetes mellitus for the study of gestational pathology

Anton N. Kaplin

PDF (Rus)

50-58 412

Abstract

Diabetes mellitus, as one of the most common socially significant diseases, has not lost its relevance for decades. Experimental models for studying this endocrinopathy are of scientific value not only in historical terms, but also greatly enrich modern ideas about various pathophysiological aspects of its course. Objective - to develop and test a new method for inducing diabetes mellitus (DM) with relative insulin deficiency for modeling gestational pathology. Materials and methods. The study was carried out on mature white female rats (30 individuals) of the Wistar line weighing 200-250 g. Using the method of pacreato-slenectomy described in the work, DM with relative insulin deficiency was induced in animals, after which ten female rats with hyperglycemia were transplanted to intact males. Results. Diabetes mellitus in laboratory animals was induced by removing the gastrosplenic part of the pancreas, which made it possible to reproduce the state of rather long-term hyperglycemia (up to 61 days of the experiment) with a high degree of both early and late survival. Female rats selected for the second stage of the experiment were able to become pregnant from intact males and carry offspring, while maintaining stable elevated blood glucose levels throughout the entire gestation period. Conclusion. The experimental model proposed by the authors can provide an opportunity for a long-term study of DM with relative insulin deficiency, as well as testing of new antidiabetic drugs, including against the background of pregnancy.

Serum levels of 25-hydroxyvitamin D and interleukin-1β in Helicobacter pylori-infected women with postmenopausal osteoporosis

Eduard A. Maylyan, Elena S. Zhadan, Andrey E. Bagriy, Olga A. Trunova, Evgeny V. Prokhorov

PDF (Rus)

59-65 309

Abstract

Dysfunction of the gastrointestinal system in Helicobacter pylori lesions significantly reduces the absorption of not only calcium (Ca), but also vitamin D and other nutrients, the intake of which is critical for bone formation. H. pylory can contribute to the formation of osteoporosis and due to the development of the inflammatory process. The inflammatory process is an important component of the pathogenesis of the above bone disease. Objective: to study of the levels of 25(OH)D and interleukin-1β in blood serum in postmenopausal OP in women with a positive test for antibodies to the Helicobacter pylori CagA antigen. Materials and methods. The study included 250 postmenopausal women, whose indicators (Me [Q1; Q3]) were 62 [56; 68] years, and the duration of the postmenopausal period is 13 [7; 20] years. In all patients, the content of 25(OH)D and interleukin-1β (IL-1β) concentrations were determined in blood serum samples. And total antibodies (IgA, IgM, IgG) to the CagA antigen of the pathogen Helicobacter pylori. Results. In the female group with postmenopausal osteoporosis, the presence of helicobacteriosis is associated with a decrease in the level of 25-hydroxyvitamin D in the blood serum by 14.8% (p=0.045). Serum IL-1β values in postmenopausal women do not depend on H. pylori infection (p>0.05). A negative correlation was found between the values of 25(OH)D and IL-1β in women with osteoporosis and a positive test for total antibodies to H. pylori (rs=-0.25; p<0.05). Conclusion. The results of the study demonstrate that the decrease in vitamin D depends on the infection with Helicobacter pylori in women with postmenopausal osteoporosis (p=0.045). The results of the studies obtained can be used in the diagnostic and treatment-and-prophylactic measures for women in the postmenopausal period.

Pathophysiological aspects of dental hyperesthesia and ways to eliminate it in elderly patients after a new coronavirus infection COVID-19

Mikhail M. Shvetsov, Igor I. Bobyntsev, Andrey K. Iordanishvili

PDF (Rus)

66-72 379

Abstract

Currently, there is no scientifically substantiated information on the occurrence of dental hyperesthesia and its causes in patients who have undergone a new coronavirus infection COVID-19. Objective: to study the occurrence of dental hyperesthesia, to analyze the causes and to find ways to eliminate it in elderly patients after a new coronavirus infection COVID-19. Material and methods. The incidence of dental hyperesthesia was studied in 175 elderly people (from 61 to 75 years old) who had a new coronavirus infection COVID-19 2-4 months ago. As a control group, 125 elderly people were examined, who had not suffered from a new COVID-19 coronavirus infection before their examination. Functional resistance of hard tissues of teeth was assessed using the index of enamel resistance test (TER-test) according to V.R. Okushko and oral hygiene using the simplified index of oral hygiene of Green-Vermillion OHI-S. Results. It has been established that in the postcovid period, dental hyperesthesia is more common in elderly patients, the cause of which is the demineralization of tooth enamel due to the deterioration of individual oral hygiene. Generally accepted oral hygiene in elderly people suffering from dental hyperesthesia contributes to the normalization of the TER-test indicators with a period of 3 to 6 months of regular dental and oral care. The additional use of remineralizing ASEPTА gel for teeth by patients during dental care made it possible to achieve high structural and functional resistance of tooth enamel during the quarter. Conclusion. In people who have undergone a new coronavirus infection COVID-19, due to the deterioration of the hygienic condition of the oral cavity, there is a decrease in the mineralization of hard tooth tissues, which is a factor in the occurrence of dental hyperesthesia and confirms the crystal chemical theory of this pathology. The additional use of remineralizing ASEPTА dental gel for individual dental and oral care makes it possible to achieve high caries resistance of tooth enamel in a shorter time.

Development of a method for determining related impurities in a new biologically active compound of cardioprotective action by capillary electrophoresis

Evgeniya V. Kompantseva, Darya N. Lutsenko, Ekaterina R. Garcia, Alexander A. Ozerov, Tatiana M. Dementieva

PDF (Rus)

73-79 401

Abstract

The original biologically active compound (BAS) N-[2-[4-oxo-3(4H)-quinazolinyl]propionyl]-guanidine (VMA-13-15), which has cardioprotective and neuroprotective activity, was synthesized on the basis of the FSUE at VolgSMU of the Ministry of Health of the Russian Federation. In accordance with the XIV State Pharmacopoeia of the Russian Federation, one of the criteria for quality control of pharmaceutical substances is the indicator "Related Impurities". Based on the synthesis scheme and the structure of the analyzed BAS as a technological impurity, we can assume the presence of the initial compound - - unsubstituted quinazoline-4(3H)-one, due to the possible incomplete flow of the reaction. Objective: the development and validation evaluation of the methodology for determining the technological impurity (quinazoline-4(3H)-one) to include it in the draft regulatory document for the proposed BAS VMA-13-15 as a pharmaceutical substance. Materials and methods. The capillary electrophoretic conditions proposed earlier by us for the determination of the BAS under study were chosen for the analysis, under which the compounds in question are well separated as clear peaks with a migration time of 6.59 min for N-[2-[4-oxo-3(4H)-quinazolinyl]propionyl]-guanidine and 4.37 min for quinazoline-4(3H)-one. Results. As a result of this research, the methodology for determining the indicator "Related Impurities" in BAS VMA-13-15 using capillary electrophoresis system was developed. The developed technique was validated in accordance with the requirements of SF RF of the XIV edition and proved to be acceptable for determination of the identified technological impurity quinazoline-4(3H)-one. Conclusion. The developed technique makes it possible to detect an impurity in the content of 0.1% or more.

Determination of Mexidol in tablets by the method of derivative spectrophotometry

Lekso L. Kvachakhiya, Vladimir K. Shormanov, Elena V. Maksina

PDF (Rus)

80-85 692

Abstract

Mexidol (3-hydroxy-6-methyl-2-ethylpyridine succinate) is a drug that exhibits neuroprotective, antihypoxic, anti-ischemic, nootropic, anti-stress and geroprotective effects and can suppress or slow down oxidation reactions. Оbjective: to develop a selective and simple method for assessing the content of mexidol in tablets. Materials and methods. The objects of the study were mexidol (3-hydroxy-6-methyl-2-ethylpyridine succinate) and Mexidol tablets 0.125 g. Derivative spectrophotometry was used as an analysis method. Results. The ability of mexidol to intensively absorb electromagnetic radiation in the quartz ultraviolet region was revealed. This phenomenon is due to the fact that the analyte molecule contains a number of chromophore groups: a system of conjugated aromatic bonds of the pyridine ring, unpaired electrons at the nitrogen atom, and an enol hydroxyl conjugated with the aromatic system In the region of 292 nm, there is a linear dependence of the derivatives of the 2nd order of the specific absorption coefficient of mexidol on the amount of analyte in the photometric solution (range 2.5-50.0 μg/ml). A calibration graph has been constructed, and its equation has been calculated by the least-squares method. The correlation coefficient exceeds 0.999. The limits of detection and quantification are 1.25 and 2.5 µg/ml, respectively. The technique is characterized by the necessary reproducibility and correctness. The values of the standard deviation and relative standard deviation in the determination of the analyte using the proposed method (n=6; P=0.95) in the tablet mass are 1.16 and 0.012, respectively, in tablets of 0.125 g, 1.32 and 0.013, respectively. Conclusion. A simple and selective method has been developed for estimating the quantitative content of mexidol in 0.125 g tablets based on the calculation of second-order derivatives of spectra.

Study of the antioxidant activity of the herb alfalfa sickle (Medicago falcata L.)

Natalia N. Shvets, Yuri A. Sukhomlinov, Roman A. Bubenchikov

PDF (Rus)

86-92 406

Abstract

Objective: study of the antiradical and antioxidant activity of water, water-alcohol and alcohol extracts obtained from alfalfa sickle grass. Materials and methods. As an object of research of the antiradical and antioxidant activities of water, water-alcohol and alcohol extracts of alfalfa sickle, the grass of alfalfa sickle in the flowering stage, which was harvested in the Russian Federation in the Kursk region, was considered. The antioxidant activity was evaluated using a titrimetric method based on the result of the interaction of substances of a reducing nature that are present in extracts from alfalfa sickle grass and potassium permanganate used as a titrant. Antiradical activity was studied by spectrophotometric method based on the ability of extracts to inactivate DPPH (2,2-diphenyl-1-picrylhydrazyl). The content of phenolic compounds (direct spectrophotometry) in terms of chlorogenic acid and flavonoids (differential spectrophotometry) in terms of rutin was determined. Statistical analysis was used to process the data obtained as a result of experiments. Results. Processing of the results of data obtained during experiments to determine the level of antioxidant and antiradical activity for various concentrations of aqueous, water-alcohol and alcohol extractants from alfalfa sickle grass confirmed the presence of such effects for all types of extracts studied. Under experimental conditions with the use of 30% ethanol as an extractant, the maximum atioxidant activity was observed at the level of 58.55%. The use of 96% ethanol as an extractant showed similarly the maximum antioxidant activity, at the level of 56.63%, which is slightly less, but significantly exceeds other indicators. The content of flavonoids was fixed at the maximum level (0.51%) when using 30% ethanol. Under the same conditions, phenolic compounds were recorded with an index of 0.88%. The results obtained visualize a direct correlation between the level of antioxidant activity of the studied object of the herb Medicago falcata L. and the level of phenolic compounds in it. As for the use of 96% ethanol as an extractant, then in this extraction the content of hydroxycinnamic acids and flavonoids was less (0.14% and 0.04% respectively). Conclusion. The resulting data from a series of experiments on alfalfa sickle grass collected during the flowering phase confirm the prospects of medicinal plant raw materials Medicago falcata L. as a raw material having antioxidant activity, which makes it possible to consider it as a basis for continuing pharmacological research.

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Humans and their health

CLINICAL MEDICINE

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CLINICAL MEDICINE

MEDICOBIOLOGICAL SCIENCES

PHARMACEUTICAL SCIENCES

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