Aim. To assess the effect of serum homocysteine levels on treatment outcomes in patients with COVID19-associated lung damage, depending on the use of folic acid in complex treatment.

Materials and methods. An open, prospective comparative study included 71 hospitalized adult patients with COVID-19-associated lung disease who did not require mechanical ventilation. The main group included 51 patients who received folic acid 15 mg per day in a complex treatment in a fixed combination with pyridoxine hydrochloride and cyanocobalamin. The comparison group included 20 patients in whose therapy folic acid was not used.

Results. The use of folic acid was accompanied by a decrease in serum homocysteine concentration by 2.120 (-0.230; 3.680) µmol/L (p=0.004). When constructing a logistic regression model, the effect of a decrease in serum homocysteine (OR 1.289; 95% CI 1.026‒1.620; p=0.029), methylenetetrahydrofolate reductase MTHFR C677T genotype (OR 10.897; 95% CI 1.240‒95.772; p=0.031) on the achievement of 7th day of hospitalization, the cessation of isolation of SARS-CoV-2 virus RNA from the respiratory tract. Multiple linear regression analysis showed an association between the duration of hypoxemic respiratory failure, determined with SaO₂≤93%, with the degree of change in serum homocysteine concentration after treatment, single nucleotide polymorphisms of methylenetetrahydrofolate reductase MTHFR C677T, methionine synthase MTR A2756G and methionine synthase reductase MTRR A66G, initial volume of lung damage ≥50% according to CT data, indicators of D-dimers, C-reactive protein, hemoglobin, platelets, concomitant hypertension, diabetes mellitus (R=0.699; R²=0.489; p=0.005).

Conclusion. The dynamics of the decrease in serum homocysteine after treatment is an important predictor of the cessation of isolation from the respiratory tract of the SARS-CoV-2 virus RNA on the 7th day of treatment, reducing the duration of hypoxemic respiratory failure in patients with lung damage associated with COVID-19 infection.

Introduction. Hospital discharge after COVID-19 does not mean a complete recovery.

Aim. To predict lung gas-exchange impairment in patients after COVID-19-associated pneumonia.

Materials and methods. An observational retrospective cross-sectional study was conducted. 316 patients (78% men) with long-term COVID-19 and postCOVID computed tomography (CT) changes, without lung diseases in history were enrolled. Spirometry, body plethysmography, diffusion test were performed.

Results. In whole group the medians of ventilation parameters were within the normal ranges. However, 78 (25%) patients had a restrictive type of ventilation disorders, 23 (7%) had airway obstruction, and 174 (55%) had a decrease in diffusion capacity of the lungs (DL_CO). The general group was divided into two subgroups depending on the DLCO value: subgroup 1 – DL_CO is within the normal range and subgroup 2 – DL_CO is reduced. The DL_CO analysis between the subgroups showed statistically significant differences in duration from the COVID19 onset (lower in subgroup 2) and in the computer tomography abnormalities in the acute period of COVID-19 (CT_max) (more in subgroup 2) whereas there were no differences in gender, age, body mass index (BMI). Analyzing the odds ratio showed that the chance of a decrease in DLCO after COVID-19 increased 6.5 times with CT_max of more than 45%, 4 times with a duration from the COVID-19 onset less than 225 days, 1.9 times if the age is younger than 63 years while male gender and BMI did not have an impact on DL_CO in the post-COVID period. The logistic regression model with identified predictors demonstrated the accuracy, sensitivity and specificity of 81%, 82%, 80%, respectively.

Conclusion. According to our model CT_max of more than 45%, the duration from the COVID-19 onset less than 225 days, age younger than 63 years are important predictors for reducing DL_CO after COVID-19.

Aim. To analyze indicators of the vascular endothelium function in patients with chronic obstructive pulmonary disease (COPD) depending on the COVID-19 history.

Materials and methods. 98 patients with stable COPD who had COVID-19, regardless of the severity of the infection, were examined 4-8 weeks after discharge from the infectious disease hospital (Group 1). The comparison group included 50 patients with stable COPD without a history of COVID-19 (Group 2). To assess the vascular endothelium function, in all patients the following were determined: endothelin-1 (ET-1, fmol/L), total homocysteine (Hcy, µmol/L), antigen to von Willebrand factor (vWF, fmol/L), C-reactive protein (CRP, mg/L). The following parameters of arterial stiffness (AS) were recorded using sphygmomanometry (Vasera-1000, Japan): pulse wave velocity (PWV, m/s), right/left cardio-ankle vascular index (R/L-CAVI, units), augmentation index on the right shoulder (R-AI, units), augmentation index on the common carotid artery (C-AI, units).

Results. The concentration of biomarkers Hcy, ET-1, vWF in the 1st group was significantly higher than in the 2nd group (p<0.01, p<0.05 and p<0.05, respectively). The studied parameters of AS in patients with COPD were significantly higher than the reference values, regardless of the presence of a COVID-19 history. In patients of the 1st group, the indices R-AI and CAI (p<0.05) were significantly higher than in patients of the 2nd group. Correlation analysis showed relationships between R-CAVI and CRP (r=0.513, p<0.001) and CRP and ET-1 (r=0.485, p<0.01).

Conclusion. In patients with COPD, the past COVID-19 leads to more significant shifts in the functional activity of the vascular endothelium than in isolated COPD of a stable course and is associated with active systemic inflammation.

Aim. Study of the nature and characteristics of changes in the coronary bed in patients with acute coronary syndrome (ACS) and chronic obstructive pulmonary disease (COPD).

Materials and methods. The study included 85 patients with ACS: group 1 included 47 patients with ACS and COPD, group 2 included 38 patients with ACS. All patients underwent a comprehensive clinical, instrumental and laboratory examination.

Results. In the majority of patients of group 1 (76.6%), two- and three-vessel lesions of the coronary bed were revealed, and arterial stenoses were multiple, located mainly in the middle and distal parts of the arteries. In (76.3%) patients of the 2nd group, one- and two-vessel lesions of the coronary bed with localization of stenoses mainly in the proximal and middle segment of the coronary arteries (CA) were revealed. The total number of stenosis and hemodynamically significant stenosis was higher in group 1 compared to group 2 (p=0.01). Extended stenoses were more common in group 1 patients (p=0.04). Damage to the CA of the 2nd order was also higher in the 1st group of patients (p=0.01). The 1st group was divided into two subgroups: 1A (26 people) − patients with COPD of moderate severity and 1B (21 people) − patients with severe COPD. In patients of subgroup 1B, a more significant lesion of the coronary bed was noted due to an increase in the total number of stenoses (p=0.02), hemodynamically significant stenoses (p=0.01), localized in the proximal (p=0.04) and distal (p=0.02) segments of the coronary artery, in the branches of the 2nd order (p=0.02), as well as occlusions and critical stenoses of the coronary artery (p=0.02).

Conclusion. The severity of COPD in patients with ACS significantly affects the number of hemodynamically significant proximal and distal stenoses, as well as branches of the second order coronary arteries, which reduces the effectiveness of surgical treatment and worsens the prognosis of patients with comorbidities.

Introduction. The involvement of macrophages in the realization of oxidative / halogenating stress andthe role of macrophage populations in maintaining the balance of Th1/Th2 cytokines in patients with asthma with osmotic types of bronchial hyperresponsiveness has not been sufficiently studied.

Aim. To study the role of macrophages, myeloperoxidase (MPO), IL-12, IL-13 in the formation of the bronchial response to the hyperosmolar trigger in patients with asthma.

Materials and methods. The object of the study was asthma patients (n=35). The level of asthma control (Asthma Control Test, points), cellular composition (%) and MPO (pixel) of induced sputum (IS), bronchial response (ΔFEV_1IHS, %) after 3-minute ultrasonic inhalation of hypertonic (4.5% NaCl) solution (IHS) were assessed. Before and after the IHS test, exhaled air condensate was collected, in which the concentration of IL-12, IL-12 (pg/mL) was determined.

Results. Patients with asthma did not control the disease, ACT was 14 (11; 16.5) points. Group 1 (n=15) included individuals with bronchial hyperresponsiveness to the IHS, group 2 (n=20) included patients with lack of it (ΔFEV_1IHS -19.8±1.9 and 1.43±0.72%, respectively, p<0.001). Baseline FEV1 in groups 1 and 2 was 89.5±2.8 and 93.7±2.3%, respectively (p>0.05). The percentage of sputum macrophages in group 1 was lower (40 [15.95; 50.75]%), and the average cytochemical coefficient in phagocytes was higher (141.4±9.7) than in group 2 (50 [42.5; 63.6]; p=0.039 and 98.8±12.3; p=0.013, respectively). IL-12 expression was to be more significant than IL-13 expression in the initiation of airway inflammation and hyperresponsiveness to hyperosmolar stimulus.

Conclusion. The lower concentration of macrophages in the bronchi of asthma patients with airway hyperresponsiveness to hyperosmolar stimulus is most likely due to an increase in the secretory function of cells. A high level of MPO activity in these patients depended on the peroxidase function of secreting macrophages, was associated with M1 polarization of macrophages, and indicated a Th1 immune response associated with the participation of IL-12 in the regulation of airway hyperresponsiveness to a hypertonic trigger.

Introduction. Cold airway hyperresponsiveness (CAH) is a common condition in patients with asthma, which worsens the clinical course of the disease and the patients’ quality of life. MUC5AC and MUC5B are the main secreted mucins in the respiratory tract, which are involved in normal mucociliary clearance, but also capable of provoking the development of pathological changes in case of dysregulation of their balanced production.

Aim. The aim of this study was to determine the dynamics of MUC5AC and MUC5B expression during experimental cooling in patients with asthma depending on the status of CAH.

Materials and methods. The study enrolled 98 subjects including 26 patients with chronic non-obstructive bronchitis without exacerbation (control group) and 72 patients with asthma. The expression of MUC5AC, MUC5B and TRPM8 was determined in the upper respiratory tract by quantitative reverse transcription PCR. The production of MUC5AC and MUC5B was also measured in sputum by ELISA. All patients underwent a bronchoprovocation test with isocapnic cold air hyperventilation to detect CAH, and a similar nasal challenge was performed to assess the effect of cooling on the expression of the studied genes.

Results. Patients with asthma had 4.22-fold increase in the expression of MUC5AC (p=0.02) in the nasal epithelium as compared with the control group. CAH was associated with an initial 7.33-fold upregulation of MUC5AC (p=0.008) as well as with further increase in MUC5AC expression but a decrease in MUC5B in response to cooling, which was not observed in asthma patients without CAH. Basal TRPM8 expression was associated with baseline level of MUC5AC (ρ=0.41, p=0.04), MUC5B (ρ=0.55, p<0.001) and amount of sputum produced after the cold bronchoprovocation.

Conclusion. Asthma patients with CAH demonstrate a more pronounced imbalance in the production of mucins, which is aggravated by cold exposure. This, in turn, can lead to a number of pathological disorders associated with a more severe course of the disease.

Introduction. It is known that oxidative stress causes pathological changes in the tissues and organs of the human body and in many cases it can explain the disorders associated with chronic obstructive pulmonary disease (COPD).

Aim. The aim of the study was to investigate the degree of oxidative stress in peripheral blood leukocytes of COPD patients.

Materials and methods. We examined 23 patients with COPD of varying severity, 8 smokers without signs of bronchial obstruction and 9 healthy volunteers who had never smoked. All subjects underwent spirometry to assess lung function. The level of oxidative stress was determined using flow cytometry by adding 10 µM 2',7'-dichloro dihydrofluorescein diacetate to isolated peripheral blood leukocytes, in basal conditions and under pro-inflammatory stimulation with 0.1 ng/ml phorbol-12-myristate-13-acetate (PMA).

Results. Patients with COPD demonstrated elevated levels of intracellular oxidative stress compared with controls both under basal conditions and during PMA stimulation (p<0.05). When analyzed in subgroups, stimulation led to a significant increase in oxidative stress regardless of cell type (p<0.01). Smokers tend to have elevated measured values, occupying an intermediate position between non-smokers and COPD patients. The absolute increase in the oxidative stress index was higher in the cells of COPD patients; the values of the relative increase were almost identical in the studied groups. The dynamics of oxidative stress in the cells of smokers tended to be more pronounced than in non-smokers.

Conclusion. The obtained results indicate that the leukocytes of COPD patients are characterized by a higher level of intracellular oxidative stress. In addition, smoking has been found to be a factor of oxidative stress development in healthy individuals.

Aim. To assess correlations of adaptive potential (AP) with metabolic factors in workers of the Yakutia river fleet before and after the voyage in order to assess the impact of a long voyage.

Materials and methods. Before a long voyage in 45 men, a questionnaire was conducted, measurement of height, body weight, heart rate, blood pressure, determination of body mass index and AP. The correlation of AP (according to R.M.Baevsky) with biochemical (aspartate transaminase, alanin transaminase, alkaline phosphatase, gamma glutamyl transferase, lactate dehydrogenase, creatine kinase, glucose, cholesterol, triglycerides) and hormonal (TSH, free T3, free T4, testosterone, cortisol) indicators was evaluated, and also with blood plasma metabolites (62 metabolites) determined by gas chromatography with mass spectrometry before after a long voyage.

Results. Distribution by AP level of rivermen – 37.8% have satisfactory adaptive potential, 24.4% have functional stress of adaptive mechanisms, 20.0% have unsatisfactory adaptation and 17.8% have a sharp decrease in the functional capabilities of the circulatory system with the phenomenon of disruption of adaptive mechanisms. The revealed correlations of AP have associations with age, overweight, obesity and metabolic syndrome. Correlations were found with creatinine, testosterone, palmitic acid before the long voyage, and with creatine kinase, glucose, urea, testosterone, gluconic and threonic acids after the voyage. After a long voyage, the number of correlations of AP with metabolic parameters increases.

Conclusion. In workers of the Yakutia river fleet the revealed results of metabolic changes indicate an aggravation of disadaptive changes in the conditions of a long voyage. Taking into account the identified features, it is necessary to carry out preventive measures to reduce the severity of disadaptive metabolic changes during a long voyage and rehabilitation actions after the voyage.

Aim. To evaluate the phospholipid composition of erythrocyte membranes in parturient women who had COVID-19-associated community-acquired pneumonia (CAP) in the third trimester.

Materials and methods. The material for the study was erythrocytes of peripheral blood of 65 parturient women diagnosed with COVID-19, moderate/severe course, CAP of viral etiology (main group). Patients of the main group, depending on the severity of CAP, were divided into two subgroups: subgroup 1 – moderate course of pneumonia (n=33), subgroup 2 – severe course of pneumonia (n=32). The control group consisted of 35 healthy parturient women. The quantitative composition of phospholipids was studied by two-dimensional thin-layer chromatography according to Kirchner.

Results. In subgroup 1, the concentration of phosphatidylethanolamine and phosphatidylcholine in erythrocyte membranes was below the standard values by 38% and 29%, respectively (p<0.001), in subgroup 2, these indicators decreased by 32% and 48%, respectively (p<0.001). At the same time, a significant increase in the concentration of lysophosphatidylcholine was found in patients of subgroup 1 by 92% (p<0.001) and in patients of subgroup 2 by 110% (p<0.001), compared with the group of healthy individuals. In addition, structural changes in the lipid bilayer of erythrocyte membranes under conditions of COVID-19associated CAP were characterized by a pronounced increase in the concentration of minor fractions of phospholipids: phosphatidylserine and phosphatidylinositol in subgroup 1 by 63% and 53%, respectively (p<0.001), in subgroup 2 by 79% and 68%, respectively (p<0.001), compared with similar indicators in the control group.

Conclusion. With COVID19-associated CAP in maternity women, structural disorganization of the phospholipid components of erythrocyte membranes is determined, manifested by a decrease in the concentration of phosphatidylethanolamine and phosphatidylcholine with a simultaneous increase in the level of lysophosphatidylcholine, phosphatidylserine and phosphatidylinositol. These disorders increase with increasing severity of pulmonary inflammation. The revealed changes in the lipid spectrum of peripheral blood and the composition of erythrocyte membrane phospholipids in COVID-19-associated CAP indicate the need to develop methods for their correction.

Introduction. Cytomegalovirus (CMV) infection directly and indirectly can cause placental dysfunction. One of the reasons for its development may be a deficiency of energy supply due to changes in the level of fatty acids (FA) – the main sources of energy in the cell.

Aim. Analysis of the fatty acids concentration and causes of its changes in the placenta during exacerbation of CMV infection in the first trimester of pregnancy.

Materials and methods. Biosamples (venous blood, epithelium from the inner surface of the cheek, mucous membrane of the cervical canal, villous chorion) of 32 CMV-seropositive women with an exacerbation of CMV infection in the first trimester of pregnancy (main group) and 30 CMV-seronegative women (control group) were studied. Exacerbation of CMV infection was diagnosed by ELISA to detect IgM and IgG with avidity of 65% or more, PCR to detect CMV DNA. The profile and relative concentration of individual FA in villous chorion lipid extracts were studied by gas-liquid chromatography. The activity of pyruvate dehydrogenase, succinate dehydrogenase, NADP-dependent malate dehydrogenase, and glucose-6-phosphate dehydrogenase was determined by a histochemical method on sections of freshly frozen villous chorion tissues.

Results. In the main group placentas, the concentration of medium-chain saturated fatty acids was statistically significantly lower: capric by 50%, lauric by 51%, unsaturated myristoleic by 44%; long-chain unsaturated acids: palmitoleic, oleic, linoleic and α-linolenic fatty acids by 52%, 55%, 57% and 64%, respectively; of polyunsaturated fatty acids with a very long chain: eicosapentaenoic and docosahexaenoic by 44% and 41%, respectively. The activity of enzymes: succinate dehydrogenase, pyruvate dehydrogenase, NADP-dependent malate dehydrogenase and glucose-6-phosphate dehydrogenase decreased.

Conclusion. Thus, we found a decrease in energy supply in the placenta during exacerbation of chronic CMV infection in the first trimester of pregnancy. Disorders of placental energy metabolism can cause placental insufficiency, which has adverse consequences for fetal development.

Introduction. The rising incidence of obesity among children and adolescents has become a major public health problem. Problems of female reproductive function associated with obesity include menstrual irregularities, complications of pregnancy and childbirth, and infertility.

Aim. To conduct a prospective analysis of carbohydrate, lipid metabolism, neuroendocrine regulation in women with primary infertility and hypothalamic syndrome of puberty.

Materials and methods. Prospective, longitudinal study of adolescent girls (n=170) with hypothalamic dysfunction for 14.2±1.6 years, mean age was 14.41±0.26 years. The second stage of the study included an assessment of the hormonal status and metabolic changes in 86 women, of which 46 were fertile, 26 had primary infertility and 14 had secondary infertility, mean age was 21.89±1.15 years. Clinical and laboratory methods were used to study the indicators of lipid and carbohydrate metabolism, pituitary-ovarian and adrenal hormonal regulation systems, instrumental and functional research methods, as well as statistical analysis methods were carried out.

Results. Among adolescent girls with hypothalamic dysfunction a high proportion of secondary amenorrhea − 31% (p=0.042) and metabolic syndrome − 86% was revealed, as well as a significant increase in follicle-stimulating hormone, testosterone, cortisol and a decrease in the concentration of progesterone, inhibin B, an increase in cholesterol, low density lipoproteins, triglycerides, the HOMA index, insulin and a decrease in high density lipoprotein cholesterol. We found a high proportion of polycystic ovary syndrome − 19.8%, polymenorrhea − 18.6%, oligomenorrhea − 19.8%, primary infertility − 30.2%, (p=0.001) in women with a history of hypothalamic obesity in the pubertal period. We determined a set of primary infertility predictors: the presence of triglyceridemia and hyperlipidemia in the puberty period (OR 9.5; 95%CI [1.7–51.9]) and hormone-dependent diseases in the reproductive period (OR 5.6; 95%CI [2.5–18.2]).

Conclusion. In our opinion, timely prevention and correction of lipid metabolism disorders in adolescents, as well as early detection of hormone-dependent diseases in the reproductive period are promising for the prevention of reproductive disorders.

Introduction. The increase in the number of patients with post-COVID syndrome determines the relevance of their rehabilitation in sanatorium and resort institutions, of both local and climate-therapeutic resorts.

Aim. To identify the possibility for the rehabilitation of patients with severe forms of COVID-19 in the conditions of the climatic pulmonological resort of the South Coast of Crimea in the winter season.

Materials and methods. Clinical-anamnestic, laboratory, functional and computed-tomographic results of the examination of the thorax of a patient who had a severe form of COVID-19. Rehabilitation was carried out 21 days complexly using climatotherapy, therapeutic exercise, respiratory, medication and physiotherapy. The effectiveness of treatment was assessed using a 6-minute step test, Borg scale, mMRC dyspnea scale, oxygen assessment chart, rating of health status, Hospital Anxiety and Depression Scale (HADS), Fatigue Assessment Scale (FAS), dyspnea assessment index (DDI/TDI), questionnaires of life quality EQ-5D and SF-36.

Results. At the end of the rehabilitation course, general well-being improved, shortness of breath decreased, exercise tolerance increased, positive dynamics of spirographic parameters, Borg scale scores and a 6-minute step test were noted. The indicators of depression on the HADS scale normalized, positive dynamics was noted according to the SF-36 questionnaire of the psychological component of health. The severity of pain/discomfort and anxiety/depression according to the EQ-5D questionnaire decreased. The X-ray picture has improved. When determining the diffusion capacity of the lungs (DL_CО), an increase of 30% from the initial value was revealed.

Conclusion. Rehabilitation of a patient who had a severe form of COVID-19 with bilateral lung damage in the conditions of the climatic pulmonology resort of the South Coast of Crimea in the winter season is effective. To assess the lung function of patients who have undergone COVID-19, the most effective method can be considered the determination of lung diffusion capacity (DL_CО). Spirogram indicators do not always objectively reflect the severity of the condition.

Aim. Demonstration of three clinical cases of immune thrombocytopenic purpura (ITP) that developed during the pandemic of a novel coronavirus infection (COVID-19) from the personal practice of the authors.

Materials and methods. A brief review of the literature on the diagnosis and differential diagnosis of COVID-19-associated ITP is presented. Three clinical observations of this pathology are given.

Results. In two situations, thrombocytopenia developed after severe COVID-19-associated pneumonia. In one case, ITP was diagnosed after a viral infection; PCR test for COVID19 was negative. A young patient without comorbidities with severe thrombocytopenia and hemorrhagic syndrome was treated with glucocorticoids and thrombopoietin receptor agonists (TPO-RAs). After achieving remission, glucocorticoids were first discontinued, and then TPO-RAs. In elderly patients with a serious comorbid pathology, glucocorticoids were prescribed for a short time, and remission was achieved with TPO-RAs.

Conclusion. The choice of therapy for ITP that developed during the COVID-19 pandemic depends on the clinical situation, the presence or absence of COVID-19 infection, the patient’s somatic status, and the presence of comorbid pathology. TPO-RAs play an important role in the treatment of ITP, including those associated with COVID-19.

Introduction. The prescription of statins is a method of prevention and treatment of cardiovascular diseases (CVD) with proven long-term safety and efficacy. Monotherapy with statins reduces the concentration of low-density lipoprotein cholesterol and the overall risk of cardiovascular mortality, but patients remain at residual risk associated with elevated triglyceride level. There is evidence that the residual risk of CVD can be reduced by the use of long-chain ω3 polyunsaturated fatty acids (ω3 PUFAs) − eicosapentaenoic (EPA 20:5 ω3) and docosahexaenoic (DHA 22:6 ω3). At the same time, in relation to reducing the risk of developing cardiovascular events, these acids have shown controversial results.

Aim. Based on the analysis of the available literature, analyze the reasons for the discrepancies in the results of studies of CVD outcomes and discuss the heterogeneity of the body’s response to the intake of ω3 PUFAs.

Materials and methods. The PubMed database was searched for information over the past five years on selected inclusion criteria. Information requests included the following keywords: “eicosapentaenoic acid, docosahexaenoic acid, hypertriglyceridemia, cardiovascular risk.”

Results. The dose, type and ratio of the combination of ω3 PUFAs used may be important in evaluating the effect of ω3 PUFAs in reducing the risk of cardiovascular events and mortality. This review summarizes the latest literature data on the prospects for the use of statins, the combination of EPA+DHA and EPA monotherapy in the treatment of hypertriglyceridemia and reducing the risk of CVD. The heterogeneity of the body’s response to the intake of ω3 PUFAs is discussed.

Conclusion. Despite the inconsistency of the results of meta-analyses of the effectiveness of the use of combinations of various types of ω3 PUFAs, it is obvious that further study of the combined use of EPA and DHA, their dosing regimen and combination with statin therapy will make them attractive for reducing the residual risk of CVD.

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.