Aim. To assess the epidemiological situation on tuberculosis (TB) in the Republic of Crimea in 2014­-2021 based on the study of morbidity, prevalence and mortality.

Materials and methods. The analysis was conducted based on official data presented by the Crimean Republican Clinical Center of Phthisiology and Pulmonology.

Results. During the study period in the Republic of Crimea the TB incidence decreased in 2.1 times. The downward tendency of both the incidence of all forms of TB (the growth rate is 51.7%) and pulmonary TB (growth rate is 50.2%) has been de­tected. The incidence of destructive forms of TB in Crimea reduced by 1.6 times, the proportion of destructive forms among first-time detected cases of TB was 48.2%. The peak of TB prevalence in the Republic of Crimea was in 2014 (132.1 cases per 100,000 population). In the following years there was a positive trend and by 2021 the rate decreased by 1.7 times, amounting to 77.8 cases per 100 thousand population. During the study period in the region there was a 2-fold decrease in the TB mortality rate from 17.1 in 2014 to 8.3 cases per 100 thousand population in 2021 (growth rate -51.5%). Despite the steady decrease in the mortality rate from all forms of TB in the region, there is still a stable high proportion of TB patients who died before the first year of follow-up. One of the reasons for the negative situation should be called the late diagnostics of the pathology under study, which is confirmed by the average percentage for the period 2014-2021 of untimely detected cases of TB, as well as neglected forms of TB (33.7% and 22.5%, respectively). During the period when the Republic of Crimea was a part of the Russian Federation, the financing of TB service increased by 2.1 times and, accordingly, the possibility of improving the quality and efficiency of medical care for TB patients increased, which is certainly one of the important reasons for the positive trends in improving the epidemiological situation of TB in the re­gion for the period 2014-2021.

Conclusion. Over the period 2014-2021 in the Republic of Crimea, against the background of significant improvement in the financing of TB services in the region, positive dynamics in the main indicators of the epidemiological situation of TB (morbidity, prevalence and mortality) were observed. At the same time, the part of TB patients who died before the first year of follow-up remained high.

Introduction. Chronic obstructive pulmonary disease (COPD) is a severe respiratory pathology, the main risk factor for which is tobacco smoking. The progression of bronchial obstruction is subject to individual variability which indicates an important role of genetic factors in the pathogenesis of COPD.

Aim. To establish the possible effects of TRPM8 gene polymorphisms on the rate of bronchial obstruction progression in COPD patients.

Materials and methods. The study included 134 COPD patients. All patients underwent genotyping of six TRPM8 gene polymorphisms by asymmetric LATE-PCR. In order to assess the rate of the disease progression post-bronchodilator spirometry was per­formed twice with an interval of one year and a decrease in FEV₁ >50 ml was considered as the presence of progressive bronchial obstruction.

Results. The patients were divided into two groups: the first group included patients with progression of bronchial obstruction (59 people), the second group included patients without progression of bronchial obstruction (75 people). When analyzing the relationship between the individual polymorphisms of TRPM8 gene and the severity of COPD progression it was found that the carriage of the C allele for rs11562975 polymorphism predominates in patients with pro­gressive obstruction. In the dominant model the frequency of GC+CC genotypes carriage among persons from the first group was 35.6% versus 10.7% in the second group (p=0.001). At the same time, the effect of polymorphism remained significant regardless of gender, age, pack-year index, baseline FEV₁ and the exacerbations frequency (OR 3.7, 95% CI [1.29; 10.3], p=0.01). In addition, carriers of the C allele were characterized by a more significant annual decrease in FEV₁ during the year compared with patients who had the GG genotype (-120.0 [-340.0; -30.0] ml/year vs. -20.0 [-130.0; 40.0] ml/year, respectively, p=0.002).

Conclusion. The obtained results indicate that carriage of the C allele (genotypes GC and CC) for rs11562975 polymorphism of TRPM8 gene is a risk factor for a more severe course of COPD with a progressive decrease in FEV₁.

Introduction. Chronic obstructive pulmonary disease (COPD) is a pathology accompanied by a pro­gressive and irreversible deterioration in airway patency. It is known that macrophages of the respiratory tract are actively involved in the reorganization of the extracellular matrix leading to the development of bronchial remodeling.

Aim. To assess the relationship between the progression rate of bronchial obstruction in COPD, the expression of TRP channels on alveolar macrophages, and the levels of inflammatory markers in the respiratory tract.

Materials and methods. The study enrolled 37 patients with COPD, including 23 people with a FEV₁ deterioration >50 ml/year and 14 with FEV₁ decline <50 ml/year. The expression of TRPV1, TRPV4, TRPA1, TRPM8 channels was determined on alveolar macrophages by flow cytometry. Analysis of cytokines was performed in sputum supernatant by multiplex assay on a flow cytometer.

Re­sults. It was found that in patients with progressive bronchial obstruction TRPV4 expression was significantly increased: 14.2 (10.8; 23.4)% vs. 8.6 (3.6; 15.4)% (p=0.03). In addition, in the general group of patients a highly significant inverse correlation was found between TRPV4 expression and the dynamics of FEV₁ (p=-0.52, p<0.001). Patients with a decrease in FEV₁ >50 ml/year were characterized by significantly elevated levels of IL-2, IL-4, IL-17A, IL-10, IL-12p70, CXCL10 and MCP-1. Additionally, we found that concentrations of several cytokines were directly correlated with TRPV4 expres­sion on macrophages: IL-4 (p=0.51, p=0.001), CXCL10 (p=0.59, p<0.001), MCP-1 (p=0.56, p<0.001), TGF-ei (p=0.42, p=0.009), IFN-y (p=0.37, p=0.02).

Conclusion. TRPV4 channels expressed on alveolar macrophages are involved in the inflammatory process and airway remodeling in COPD, which is manifested by their relationships with the level of certain cytokines production, as well as the rate of the progression of bronchial obstruction.

Introduction. Transient receptor potential (TRP) channels expressed on many cells, including macro­phages, are an attractive target for pharmacological modulation for the treatment of various diseases. At the same time, currently available data on the functional role of TRP on macrophages are scarce.

Aim. To establish the effect of TRPA1 and TRPM8 channels on the production of cytokines by macrophages during pro-inflammatory (M1) and anti-inflammatory (M2) polarization.

Materials and methods. Macrophages were obtained from monocytes of 8 healthy donors by differ­entiation in the presence of GM-CSF or M-CSF. Cell polarization was achieved by adding to the culture medium 100 ng/ml LPS + IFN-y 20 ng/ml (M1) or IL-4 20 ng/ml (M2) for 24 h. In order to modulate TRP activity, cinnamaldehyde 100 цМ (TRPA1 agonist), HC-030031 100 цМ (TRPA1 blocker), WS-12 10 цМ (TRPM8 agonist), or RQ-00434739 1 цМ (TRPM8 blocker) were used.

Results. It was found that during M1 polarization TRPA1 channels inhibited the pro­duction of CXCL10, and TRPM8 increased the level of IL-8. Under polarization to the М2 phenotype, TRPA1 suppressed the production of pro-inflammatory cytokines IL-ie, TNF-a, IL-6, IL-12p70 and IFN-y, and TRPM8 did not significantly affect the levels of the analyzed mediators.

Conclusion. The obtained results indicate that in terms of cytokine production by macrophages, TRPA1 has a predominantly anti-inflammatory effect, while TRPM8 shows a limited influence, which come to the regulation of IL-8 synthesis.

Introduction. The role of neutrophil inflammation of the bronchi in patients with asthma in the devel­opment and manifestation of cold airway hyperresponsiveness (CAHR) has not been sufficiently studied.

Aim. To assess the level of neutrophils and the activity of myeloperoxidase (MPO) in the bronchi of asthma patients with cold-induced bronchospasm.

Materials and methods. In 138 patients with mild-to-moderate asthma with CAHR, the level of asthma control (ACT), lung function (FEV₁), cellular composition of sputum was examined before and after the bronchoprovo­cation test by isocapnic hyperventilation with cold air (IHCA). In sputum samples, the percentage of neutrophils, eosino­phils, and bronchial epithelial cells (structurally intact cylindrical ciliated and goblet cells) was assessed; the concentration and activity of MPO in neutrophils were studied by the cytochemical method.

Results. The patients were divided into three groups: group 1 (n=94) - patients with mild cold-induced bronchospasm, group 2 (n=28) - with moderate broncho­spasm, group 3 (n=16) - with severe bronchospasm (AFEV₁=- 13.5±0.3, -24.6±0.5, -36.9±1.5%, respectively). Patients did not differ in the level of asthma control (16 [12; 21]; 16 [13; 20] and 16 [12; 21] ACT points, respectively). Patients of the third group had lower values of bronchial patency in comparison with the first and second groups: FEV₁ 79.4±3.2; 92.4±1.7 (p<0.01); 92.1±2.9% and FEF_25-75 46.4±4.3; 66.1±2.5 (p<0.001); 63.2±4.0% (p<0.01). In sputum after the IHCA test in groups 2 and 3, an increase in the number of neutrophils was recorded from 35.5±3.9 to 46.0±3.8% (p<0.05) and from 39.0±3.8 to 52, 4±4.4% (p<0.05), respectively, while the number of neutrophils in group 1 did not change (43.2±2.4 and 44.3±2.1%). The concentration of MPO in response to the IHCA test in all groups significantly increased by more than 30% (p<0.05).

Conclusion. The mobilization of neutrophils in a mixed pattern of airway inflammation in asthma pa­tients is associated with worsening of cold-induced bronchospasm. An increase in the content of MPO in neutrophil gran­ules in response to the action of cold air is aimed at enhancing the secretion of the enzyme in the interstitium, activating its oxidative activity in the respiratory tract, and escalating the oxidative/halogenating stress that accompanies broncho­spasm.

Aim. To study the functional state of immunocompetent blood cells by assessing the membrane potential of mitochondria (MPM) in bronchial asthma in children, depending on the controllability of the course of the disease.

Materials and methods. 167 children suffering from asthma aged from 1 to 17 years were examined, two groups were formed: 1 - controlled course of asthma (n=70), 2 - partially controlled and uncontrolled course of asthma (n=97). The functional and energetic status of immunocompetent blood cells was assessed by flow cytometry with determination of MPM using JC-1 dye.

Results. The proportion of cells with reduced MPM in children with asthma in comparison with conditionally healthy children is higher in all pools - lymphocytes (46.1% vs. 34.0%), monocytes (12.0% vs. 9.0%), gran­ulocytes (11.3% vs. 7.0%). A higher percentage of cells with reduced MPM was found in the pools of monocytes (15.4% vs. 8.8%) and granulocytes (13.8% vs. 6.7%) with uncontrolled asthma. “Method for a comprehensive assessment of the energy security of immunocompetent blood cells” has been developed and patented. According to this method, the degrees of energy deficiency are relevant to the control of the course of asthma: in group 1, there is no energy deficit in 12.9% of cases, the first degree of deficiency in 40%, the second in 20%, the third in 27.1%; in the second group - 11,3%, 15,5%, 42,2%, 31,0% accordingly.

Conclusion. The use of the developed method for a comprehensive assessment of the energy security of immunocompetent blood cells as an additional method to the approved medical standards, technically performed in a short time and with high accuracy, makes it possible to conduct early preclinical diagnostics of energy-deficient con­ditions of immunocompetent blood cells in asthma; according to the degree of disturbances detected, it is reasonable to determine the choice, the amount of necessary therapy and evaluate the effectiveness of treatment.

Aim. To study the possibility of predicting the asthma control at various stages of the development of the disease, possibly on the basis of taking into account the genetic polymorphisms of Toll-like receptors, cytokines and detoxification system genes using the statistical method of learning neural networks.

Materials and methods. We ex­amined 167 children with bronchial asthma. The degree of asthma control was determined, the following mutations were detected: TLR2-Arg753Glu, TLR4-Asp299Gly, TLR4-Ghr399Ile, TLR9-T1237C, TLR9-A2848G; IL4-C589T, IL6- C174G, IL10-G1082A, IL10-C592A, IL10-C819T, IL12B-A1188C, TNFa-G308A; GSTM, GSTT, GSTM/GSTT, GSTP1 Ile105Val, GSTP1 Ala114Val, by PCR. The STATISTICA Automated Neural Networks package was used to model neural networks.

Results. The model is based on the MLP (15-9-3) multilayer perceptron architecture with a layer of 15 input neurons (by the number of analyzed variables), a hidden intermediate layer of 9 neurons and an output layer of 3 neurons by the number of values of the classified variable (control). The training algorithm was chosen by BFGS as the most adequate to the classification task. The error function is traditionally chosen as the sum of squared deviations. The activation function of output neurons is Softmax. The activation function of the intermediate layer is hyperbolic. The volume of the training sample was 88 sets. The volume of samples for testing and quality control of the model was 36 sets. The resulting model was able to predict 79.01% of the correct values of the target variable (the degree of asthma control).

Conclusion. The application of the developed program makes it possible to predict the possibility of uncontrolled or partially controlled asthma at any stage of the disease, including preclinical and pre-nosological for groups with a high risk of asthma. This allows you to individually adjust the measures of secondary and even primary prevention of asthma within the personal­ization of therapeutic approaches.

Aim. To develop a method for determining the lung inflation by the indexes of forced expiratory flow­volume spirometry.

Materials and methods. In 43 patients with mild persistent uncontrolled asthma in combination with osmotic airway hyperresponsiveness, the lung function indexes were assessed by spirometry using a bronchodilation test and bodyplethysmography.

Results. From the entire set of parameters, using regression analysis, two equations were con­structed, with the inclusion of the main spirometric indicators (FEV₁ in % of the due value, AFEV_t and AFEF₇₅ after the bronchodilation test, in %). The equations obtained make it possible to calculate lung inflation indices in asthma patients with osmotic airway hyperresponsiveness to select patients for referral for bodyplethysmography and multispiral computed tomography of the lungs in order to diagnose the severity of hyperinflation.

Conclusion. The developed regression models provide an opportunity for a preliminary assessment of the presence and degree of lung hyperinflation in asthma patients with osmotic airway hyperresponsiveness, to determine personal approaches to basic anti-inflammatory therapy and, if necessary, to correct it in a timely manner.

Introduction. As a result of the coronavirus infection (COVID-19) pandemic, almost 74.9 thousand people died of pneumonia in Russia in 2021. Community-acquired pneumonia (CAP) is accompanied by a systemic re­sponse of the body to inflammation in the lung tissue and disorder of microhemocirculation. The method of laser Doppler flowmetry (LDF) allows assessing the general parameters of the microcirculatory bed and determining the state of various factors regulating the nutritive flow.

Aim. To conduct a comparative analysis of LDF indices in patients with COVID-19- associated and bacterial CAP.

Materials and methods. 140 patients were examined, 100 of them with non-severe CAP (main group), and 40 patients with extrapulmonary pathology (comparison group). The main group included 44 people with bacterial CAP and 56 people with COVID-19-associated CAP. Bacteriological studies of sputum were performed; detection of SARS-CoV-2 RNA in swabs from the oropharynx and nasopharynx by PCR, LDF to assess the state of pe­ripheral blood flow was carried out.

Results. In patients with COVID-19-associated CAP, compared with patients with bacterial CAP, a decrease in the microcirculation index by 1.26 times (p<0.0005), an increase in the coefficient of variation by 1.11 times (p<0.0005) was found.

Conclusion. In patients with COVID-19-associated CAP, compared with patients with bacterial CAP, more significant pathological changes in Dopplerograms were detected, which may indicate more pronounced disorders in the microcirculatory bed in COVID-19-associated CAP caused by exposure to the SARS-COV- 2 virus. Perhaps the established fact can lead to adverse outcomes of the course of the disease.

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.

Aim. To assess the morphological structure of cotyledons with non-contrasted blood vessels in the pla­centas in women who had an exacerbation of mono- and mixed cytomegalovirus infection (CMVI) in the second trimester of pregnancy.

Materials and methods. The histometric parameters of the villi were studied with different visualization on X-ray phlebograms of blood vessels in 112 cotyledons of placentas in women with pregnancy, uncomplicated and com­plicated by mono- and mixed-CMVI (combination of CMVI and reactivation of chronic herpes virus infection type 1 HSV). The first group (control) included 36 cotyledons with a clear contrasting of the vascular bed in the placentas from women with an uncomplicated gestational period. The main group was represented by 76 cotyledons: subgroup 2a - 24 cotyledons, in which the bloodstream was not detected, in placentas from patients with exacerbation of mono-CMVI as­sociated with chronic subcompensated placental insufficiency (CSPI); subgroup 2b - 16 cotyledons with blood vessels not diagnosed by X-ray phlebography, in placentas from women with mixed CMVI infection, initiating the development of CSPI; subgroup 3a - 21 cotyledons with non-contrasted bloodstream in placentas from patients with exacerbation of mono-CMVI and chronic decompensated placental insufficiency (CDPI); subgroup 3b - 15 cotyledons with a similar an­giographic picture in placentas from women who had an exacerbation of mixed CMVI in the second trimester of gestation and CDPI. Identification of cotyledons with a clear visualization of blood vessels and with a non-contrasted vascular bed in the marginal part of the placenta was carried out by dosed administration of minium on linseed oil (1:3) through the vein of umbilical cord and assessment of the angiographic picture on X-ray, which were obtained using the RUM-20M apparatus with X-ray image amplifier Sapphire (Russia). For histological analysis, tissue pieces were taken in the same places before and after injection of the contrast mass into the bloodstream of the organ, on the damaged areas of which clamps were applied.

Results. In the first group, the cotyledons had clear contours of the blood vessels and the vein draining them. Avascular villi (AV) accounted for 2.05±0.22%, villi with syncytiocapillary membranes (SCM) - 33.5±2.41%, villi with one (1) SCM - 77.1±2.07%, with two (2) SCM - 20.9±1.98% and with three (3) SCM - 1.42±0.09%. In subgroup 2a, compared with the first group, there was a deformation of the lumen of the vein of the stem villi of the I and II order, in which erythrocyte aggregates, single leukocytes and rarely thrombi were determined, as well as signs of edema and partial desquamation of endotheliocytes, fibrinoid and inflammatory changes in the vessel wall. The number of AV increased (by 6.87 times, p<0.001) and the number of villi with SCM decreased (by 2.05 times, p<0.001) with no significant differences between villi with 1, 2, and 3 SCM. In subgroup 2b, in comparison with subgroup 2a, mod­erate folding of the endothelium, areas of its partial desquamation, AV (1.39 times, p<0.01) and villi with 2 SCMs (1.44 times, p<0.05) were more common against the background of a decrease in the concentration of villi with 1 SCM (by 1.19 times, p<0.05). In subgroup 3b, a greater number of vessels were found that did not provide outflow of blood from cotyle­dons (12, p<0.001) and had an arcuate shape (10, p<0.001) compared with subgroup 3a, where their number was, respec­tively, 3 (p<0.001) and 2 (p<0.001). A more pronounced folding of the endothelial lining was determined, as well as ag­gregates, neutrophils, lymphocytes and thrombi in the lumen of the vessels. There was an increase in the percentage of villi with 1 SCM (by 1.13 times, p<0.05), as well as a decrease in the frequency of occurrence of villi with 2 SCM (by 1.67 times, p<0.05) and 3 SCM (by 2.13 times, p<0.001). In cotyledons of subgroup 3b, in contrast to those of subgroup 2b, blindly ending vessels were more common (2 times, p<0.05), arcuate course of veins (2.5 times, p<0.05), lumen de­formity, hyperchromia of the nucleus and total desquamation of cells, thrombi with calcification, complete and partial obliteration of the arterial lumen, inflammation, fibrinoid degradation of the muscular layer of vessels and the deposition of calcium salts in it, as well as AV (1.29 times, p<0.05) and villi with 1 SCM (1.40 times, p<0.001); less often villi were detected with SCM (1.35 times, p<0.05), with 2 SCM (2.78 times, p<0.001) and 3 SCM (1.57 times, p<0.05).

Conclusion. In women with exacerbation of mixed CMVI in the second trimester of gestation and CDPI, in contrast to patients with reactivation of mono-CMVI leading to CDPI, angiodestructive and angioobstructive processes, as well as inhibition of angiogenesis, are more pronounced in cotyledons with non-visualized blood vessels. This increases vascular resistance and blocks the flow of the contrast mass during its dosed injection into the vascular bed of the placenta.

Introduction. Human peripheral blood mononuclear cells (PBMCs) are a pool of immune cells and they are also a convenient model system for studying immune pathologies.

Aim. Testing for bioactivity of glycerolipid prepa­rations from fern and horsetail species containing long chain polyunsaturated fatty acids (LCPUFAs) towards PBMCs without exogenous stimulation and after phorbol-12-myristate-13-acetate (PMA) plus ionomycin stimulation.

Materials and methods. Glycerolipid preparations were produced by fractionation of total lipids, isolated from young fronds of the fern Matteuccia struthiopteris and shoots of the horsetail Equisetum arvense, on silica. Egg phosphatidylcholine was used for comparison. Fatty acids were analyzed by gas chromatography. Mononuclear cells were isolated from blood of patients with asthma. Parameters of cell viability and activation were estimated by flow cytometry.

Results. The glycerolipid prep­arations from the fern and horsetail were found to have a cytotoxic effect while egg phosphatidylcholine was not. The most active was the fraction of fern lipids eluted with methanol which reduced cell viability by 64.6 (51.1-79.0)% in the concentration 2 pg/ml and caused complete cell death in 20 pg/ml. After cell stimulation with PMA/ionomycin, the cyto­toxic effect of the preparation increased although the level of PBMCs expressing the marker CD69 did not change. The cytotoxic effect of other glycerolipid preparations was observed in the higher concentrations (20 and/or 80 pg/ml) and it was less pronounced: the cell viability reduced by 7.1 (6.7-9.4)% for the fraction of fern lipids eluted by the mixture chlo­roform - methanol - water (3:5:2), by 39.8 (26.4-41.6)% and 12.0 (10.0-15.5)% for the fractions of the horsetail lipids eluted with methanol and the chloroform-methanol-water mixture, respectively, in the concentration 80 pg/ml.

Conclu­sion. Comparison of fatty acid composition of the glycerolipid preparations did not confirm a contribution of LCPUFAs to the observed effects. Identification of an active component may allow development of a drug for the local application in a hyperimmune response or for model experiments.

. Mediastinal cystic formations are well-shaped, often round formations that contain fluid and are lined with epithelium. The main cystic formations include congenital benign cysts (bronchogenic, duplicating the esophagus, neuroenteric, pericardial and thymic cysts), meningocele, mature cystic teratomas and lymphangiomas. Many tumors (e.g., thymomas, Hodgkin's disease, germ cell tumors, mediastinal carcinomas, lymph node metastases, nerve root tumors) may undergo cystic degeneration, especially after radiation or chemotherapy, and show mixed solid and cystic elements on computed tomography (CT) or magnetic resonance imaging (MRI), as well as acquire the structure of cavity formations during the tumor destruction. If the degeneration is extensive, such tumors may be virtually indistinguishable from con­genital cysts. However, the history of the disease, visualization of the anatomical location of the formation, some details visible on CT or MRI, allow in many cases to make the correct diagnosis. Familiarity with the radiographic features of mediastinal cystic lesions facilitates accurate diagnosis, differentiation from other cystic lesions, and thus ensures optimal treatment of a patienta.

Introduction. Sex differences in the course and outcomes of the disease were found during the COVID- 19 pandemic.

Aim. To summarize the knowledge about the mechanisms underlying sex differences in COVID-19, with a focus on the role of estrogen.

Materials and methods. We conducted a study using various databases until September 2022 for the keywords “estrogen” and “COVID-19”. All articles were published in English.

Results. The review discusses the involvement of estrogen in the implementation of the immune response in viral infection. Individual paragraphs of the article are devoted to the effect of female sex hormones on coagulation, inflammation, and the renin-angiotensin system.

Conclusion. At the end of the paper, it is concluded that there is great potential for future work deciphering hormonal effects on human physiology to explain the heterogeneity in pathogenic responses and may facilitate the development of more effective and personalized interventions.

Introduction. At present, the mechanisms of the processes of resolving chronic inflammation in asthma are not fully understood. A search for new pharmacological preparations and substances for the treatment and control of the course of asthma is required. Promising in this direction are N-acylethanolamines (NAE) of polyunsaturated fatty acids - bioactive lipid molecules that exhibit many signaling functions. NAEs are capable of influencing the synthesis of pro-inflammatory cytokines and are also appear to be a substrate for the synthesis of pro-permissive lipid signaling molecules. This review collects data on NAE, provides an overview, biosynthesis, and describes their anti-inflammatory effects.

Aim. Summarizing the data of domestic and foreign researchers on the possibility of NAE in the treatment of respiratory diseases on the example of bronchial asthma.

Materials and methods. The review uses data from articles published in PubMed, Google Scholar, eLIBRARY.

Results. The study and compilation of literature on this issue made it possible to conclude that synthetic NAEs are promising pharmacological objects for asthma therapy, however, further testing of the anti-in­flammatory effects of NAEs and the establishment of the molecular mechanism of their action on inflammation processes are needed.

The review considers the main groups of drugs used to treat bronchial asthma depending on the severity of the disease. The mechanisms of action and effectiveness of taking anti-asthma drugs, their combinations and side effects are covered in detail. Particular attention is paid to targeted therapy with biological drugs, the action of which is aimed at reducing the allergic and inflammatory response in patients with severe asthma. This approach to therapy allows to change the natural course of the disease, reduce airway inflammation without side effects associated with glucocorticosteroids. The review of the current available drug therapies may be useful to clinicians in selecting appropriate strategies for the asthma treatment.