Introduction. Bitter taste receptors (TAS2R) are a family of receptors consisting of 25 members expressed in various organs and tissues of the body. Despite the high potential of TAS2R agonists as therapeutic agents for the treatment of asthma, there are only a few studies describing the expression of these receptors in asthma.

Aim. To conduct a comparative analysis of the full spectrum of TAS2R genes expressed in the nasal epithelium of healthy individuals and patients with asthma, as well as to identify TAS2R associated with the disease characteristics.

Materials and methods. The study included 23 patients with asthma (mean age 41.4 ± 3.15 years), predominantly of moderate severity, and 8 healthy volunteers (mean age 38.4 ± 1.67 years). Cells for analysis were obtained via brush biopsy from the inferior nasal turbinate. mRNA expression was analyzed using next-generation sequencing (NGS) on MGISEQ-200 sequencer. Pulmonary function was assessed using spirometry. Asthma control was evaluated using the Asthma Control Test (ACT) questionnaire.

Results. Among the patients with asthma, expression of TAS2R4, TAS2R5 and TAS2R20 was detected in 100% of the samples; other highly expressed genes included TAS2R38, TAS2R14, TAS2R19 and TAS2R31. In the control group, only TAS2R20 was consistently detected, while TAS2R4, TAS2R5, TAS2R14, TAS2R10 and TAS2R38 were expressed less frequently but at least in half of the samples. Expression of TAS2R9, TAS2R16 and TAS2R43 was completely absent both in asthma and control samples. TAS2R20 was expressed 1.6-fold higher in patients with asthma compared to the control group (FDR p=0.07), and inversely correlated with disease control (ρ = -0.74, FDR p = 0.001). Expression of TAS2R4 and TAS2R5 was inversely correlated with airway patency, particularly with FEF₅₀ (FDR p = 0.04) and MEF_25-75 (FDR p = 0.01).

Conclusion. TAS2R4, TAS2R5, and TAS2R20 receptors, which show the most stable and high mRNA expression in the nasal epithelium of patients with asthma, are of the greatest interest for further study. Expression of TAS2R20 is associated with asthma and increases as the disease control decreases, while TAS2R4 and TAS2R5 undergo upregulation in individuals with more pronounced bronchial obstruction. 

Aim. To assess the serum level of the apoptosis-inducing ligand TRAIL in patients with chronic obstructive pulmonary disease (COPD) 12 months after COVID-19 in relationship to measures of systemic inflammation.

Materials and methods. The study included 90 patients aged 46 to 79 years with stable COPD who had experienced COVID-19 (regardless of COPD and COVID-19 severity) 12 months after hospital discharge. The comparison group consisted of 43 patients with stable COPD and no history of COVID-19. The serum TRAIL level was measured by enzymelinked immunosorbent assay using specific antibodies (RayBiotech, Human, USA). Levels of interleukin (IL)-6, IL-10, vascular endothelial growth factor (VEGF) (Vector-Best, Russia), and C-reactive protein (CRP) (Biochemmack, Austria) were determined by direct serological “sandwich-type” assays with mono- and polyclonal antibodies.

Results. Twelve months after COVID-19, patients with stable COPD showed intensified apoptosis and systemic inflammation, evidenced by a 33.7% increase in serum TRAIL, 71.3% in IL-6, 57.5% in CRP, and 69.0% in VEGF compared to COPD patients without a history of COVID-19. A strong association was found between TRAIL and IL-10 levels (p  <  0.01), a moderate positive correlation was noted with IL-6 (p  <  0.05), and a weak correlation with CRP (p  >  0.05).

Conclusion. This is the first report of significantly higher serum TRAIL activity 12 months after COVID-19 in patients with stable COPD compared to those without a history of COVID-19. TRAIL ligand showed a strong association with systemic inflammation markers (IL-10, IL-6), reflecting apoptosis-dependent mechanisms of inflammation in COPD. Measuring serum TRAIL levels may be useful for comprehensive evaluations of patients with COPD recovering from COVID-19.  

Introduction. Chronic obstructive pulmonary disease (COPD) and chronic heart failure are often combined in clinical practice and present difficulties in differential diagnosis. COPD exacerbations can lead to deterioration of cardiac function, significantly affecting the prognosis of the disease.

We aimed to estimate diagnostic significance of cardiac activity indices obtained by echocardiography in COPD exacerbation and in the dynamics of the disease.

Materials and methods. The study included 128 people, including 103 patients with COPD exacerbation, who made up 3 groups: group A (n = 21), group B (n = 24), group E (n = 58) in according to GOLD (2023) categorization. The control group consisted of 25 people without COPD. In the course of the study, the following control points were established: 1st follow-up point – primary examination, 2nd point – after 3-6 months, 3rd point – after 9-12 months. The diagnosis of COPD and the degree of FEV₁ limitation were confirmed by the results of spirometry on Easy on-PC (ndd Medizintechnik AG, Switzerland) before and after the bronchodilator test. Lung function was additionally assessed by diffusiometry. CAT and mMRC questionnaires were used for clinical characterization of patients. Structural and functional state of the heart was assessed by transthoracic echocardiography with 5 MS sector transducer with the frequency of 1.5-4.6 mHz using constant-wave, pulsed-wave Doppler modes, tissue Doppler and speckle-tracking echocardiography to assess global longitudinal ventricular strain.

Results. In all groups of COPD patients at exacerbation the changes of cardiac activity were revealed, as evidenced by the decrease of systolic function indices of both heart ventricles and signs of diastolic dysfunction, the most pronounced in group E in patients with high risk of exacerbations and pronounced clinical manifestations of the disease. According to the correlation analysis, systolic and diastolic dysfunction of both heart ventricles are associated with the degree of airway patency disorders, lung diffusion capacity and associated with an increase in NT-proBNP. In patients of groups A and B partial correction of some echocardiographic parameters in 3-6 months after exacerbation was noted. In group E, unfavorable tendencies to deterioration of cardiac activity are formed within a year.

Conclusion. COPD exacerbation is accompanied by changes in echocardiographic parameters reflecting structural and functional heart disorders and precapillary pulmonary hypertension, most pronounced in group E. Echocardiographic monitoring provides a complete analysis of the dynamics of changes in cardiac performance in COPD patients who have undergone exacerbation of the disease, which is of great clinical importance for prognosis and development of treatment tactics.

Aim. To evaluate the clinical efficacy and the effect on serum homocysteine levels of combined folic acid, cyanocobalamin, and pyridoxine hydrochloride therapy in the comprehensive treatment of pneumonia in hospitalized patients with COVID-19.

Materials and methods. An open-label, prospective, comparative study included 75 hospitalized patients with moderate to severe pneumonia associated with COVID-19 confirmed by detection of SARS-CoV-2 RNA in the respiratory tract. The main group consisted of 28 patients who received micronutrient therapy with 30 mg/day of folic acid plus cyanocobalamin and pyridoxine in addition to standard treatment. The comparison group comprised 47 patients who did not receive additional micronutrient therapy. The Charlson Comorbidity Index was 1.14 ± 0.93 in the main group and 0.47 ± 0.69 in the comparison group (p ≤ 0.001). Disease severity before and after treatment was assessed using the NEWS, qSOFA, 4C Mortality, and WHO Ordinal scales. Chest computed tomography (CT) was performed. Laboratory parameters included complete blood count, serum levels of C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), homocysteine, triglycerides, and low- and high-density lipoprotein cholesterol (LDL, HDL).

Results. In the main group, elimination period of SARS-CoV-2 RNA was achieved in 7.2 ± 3.4 days versus 15.6 ± 6.3 days in the comparison group (p < 0.001). After micronutrient therapy, disease severity decreased according to qSOFA and 4C Mortality scales. The main group showed a reduction in the total pneumonia volume from 32.0 (19.8–73.0)% to 26.5 (11.8–50.8)% (p = 0.035) and a reduction in the volume of parenchymal consolidation from 9.0 (0.0–37.3)% to 2.0 (0.0–17.0)% (p = 0.027). In the comparison group, there was no decrease in the total volume of lung involvement, and the area of parenchymal consolidation increased. These clinical and CT findings were associated with reductions in CRP, serum homocysteine, and LDL levels. Multiple linear regression models demonstrated that administration of the folic acid, cyanocobalamin, and pyridoxine hydrochloride combination shortened the elimination period of SARS-CoV-2 RNA from the respiratory tract (regression coefficient β = –8.648 ± 1.781; p < 0.001) and contributed to a decrease in parenchymal consolidation volume after treatment (β = –13.492 ± 4.834; p = 0.011), with the effect also linked to baseline LDH levels (β = 0.0235 ± 0.00857; p = 0.008) and patient age (β = 0.167 ± 0.0608; p = 0.008).

Conclusion. The use of folic acid, cyanocobalamin, and pyridoxine hydrochloride in the comprehensive management of patients with COVID-19-associated pneumonia is associated with a shorter SARS-CoV-2 RNA elimination period from the upper respiratory tract, a more pronounced reduction in disease severity, and a decreased extent of lung parenchymal consolidation. These effects coincide with lower serum homocysteine levels.  

Introduction. To form a well-grounded judgment on changes in gas exchange over time during corrective oxygen therapy, instrumental diagnostic procedures, exercise testing, and assessment of pharmacological effects, it is important to know the repeatability of blood gas indicators, including all possible errors of measurement (technical, methodological and physiological).

Aim. To investigate the repeatability of blood gas indicators and oxygen saturation in arterialized capillary blood among patients with chronic respiratory diseases (CRDs) to ensure an objective evaluation of observed changes.

Materials and methods. A single-center observational prospective study included 200 patients over 18 years of age diagnosed with chronic respiratory diseases: 110/200 (55.0%) with various clinical forms of pulmonary tuberculosis, 58/200 (29.0%) with interstitial lung diseases, and 32/200 (16.0%) with chronic obstructive pulmonary disease. Two samples of arterialized capillary blood were collected at a 30-minute interval. Partial pressures of oxygen (PaO₂) and carbon dioxide (PaCO₂), as well as oxygen saturation (SaO₂), were analyzed using the Easy Blood Gas analyzer (Medica, USA). Repeatability, individual coefficient of variation, minimum significant change, and absolute and relative measurement errors for PaO₂, PaCO₂, and SaO₂ were calculated. Statistical processing was performed using MS Excel 2016 for Windows, IBM SPSS Statistics 23, and STATISTICA 10 with nonparametric methods.

Results. The repeatability of PaO₂ results was higher than that of SaO₂ by more than twofold (3.67 vs 1.14), despite a strong correlation between these parameters. In contrast, under severe gas exchange disorders, the repeatability of PaO₂ and SaO₂ was almost identical (2.86 and 2.89, respectively). The repeatability value for PaCO₂ was 1.92 but increased to 4.16 in cases of moderate hypercapnia.

Conclusion. In patients with chronic respiratory diseases, differences in arterialized capillary blood gas and oxygen saturation values of 3.67 mm Hg for PaO₂, 1.14% for SaO₂, and 1.94 mm Hg for PaCO₂ (upon repeated measurements in the same patient) should be considered clinically significant. Given the representative sample, inclusion criteria, distribution of data, 95% CI calculations, and precision of the measurement conditions, the authors propose that these findings can be applied to clinical practice.  

Introduction. Preserving the working population in strategically important northern territories is a key national priority.

Aim. To identify cardiorespiratory predictors that influence the decline in neurodynamic indicators of work capacity among young individuals permanently living in a Northern region.

Materials and methods. The study included 123 individuals aged 18–45 years, permanently residing in the oil- and gas-producing northern region of KhantyMansiysk Autonomous Okrug–Yugra in Russia. Exclusion criteria were shift workers, acute respiratory infections (ARI) at the time of examination, and any chronic diseases. Participants were divided into two groups: 90 individuals who experienced ARI fewer than four times a year and 33 individuals who experienced ARI four or more times a year. Neurodynamic, hemodynamic, and spirometric parameters, inflammation markers, and cardiorespiratory predictors of reduced neurodynamic performance were assessed.

Results. Decreased neurodynamic performance was detected in 36.4% of frequently ill participants versus 17.8% of infrequently ill participants. Compared to the group of infrequently ill persons, the group of frequently ill persons had longer residence in the northern region, lower forced expiratory volume in 1 second (FEV₁), higher systolic and diastolic blood pressure (SBP, DBP), increased central systolic aortic pressure (cSAP), and a higher LF/HF ratio in heart rate variability due to reduced high-frequency (HF) power. In addition, the group of frequently ill persons exhibited elevated lymphocyte counts and high-sensitivity C-reactive protein (hs-CRP). Inter-system associations were found among neurodynamic indices, respiratory function, hemodynamics, heart rate variability, and inflammatory activity.

Conclusion. Cardiorespiratory predictors of decreased neurodynamic performance in young adults permanently residing in a northern region include a tendency toward reduced FEV₁, elevated SBP and DBP, increased cSAP, and an increased LF/HF ratio in heart rate variability. Longer residence in the North and higher hs-CRP levels also play a significant role in the development of cardiorespiratory pathology affecting neurodynamic performance.  

Introduction. Omega-3 polyunsaturated fatty acids (PUFAs) play an active role in the functioning of various body systems. It is important to understand their influence on one of the most important physiological systems— the respiratory system.

Aim. To evaluate the lung function features in men who are permanent residents of the Northeast of Russia before and after taking a dietary supplement containing omega-3 PUFAs.

Materials and methods. As part of comprehensive scientific monitoring of northern residents, 45 men aged 40.0 ± 0.8 years were examined and divided into two groups. The first group—the experimental group—received a dietary supplement in the form of re-esterified triglycerides for one and a half months, containing 1,200 mg of PUFAs, including 660 mg of eicosapentaenoic acid (EPA) and 440 mg of docosahexaenoic acid (DHA). The second group—the control group—did not receive any dietary interventions. Time-based, flow, and flow-volume features of lung function were studied using computer spirometry (KM AR 01 Diamant-S).

Results. Before the experiment, all parameters except peak expiratory flow rate were below normative values in both the experimental and control groups. The greatest deviation from the predicted levels was observed in indicators characterizing the patency of medium and small bronchi. According to the results of the experiment, no significant changes were identified. However, in individuals who took omega-3 PUFAs, a positive trend was observed towards an increase in vital capacity and forced expiratory volume in the first second (FEV₁), which is the primary indicator of possible obstructive airway disorders. For men in the control group, this trend was negative.

Conclusion. The study showed no significant differences in lung function after a 45-day intake of an omega-3 supplement. It is possible that even with a relatively high concentration of 1,200 mg of PUFAs, a longer period of supplementation is required for individuals without established lung diseases.  

Aim. To evaluate the territorial features of the main incidence and mortality indicators for malignant lymphomas in the population of the Amur Region from 2014 to 2023.

Materials and methods. This study used data from the official oncology service reports (Form 7, “Information on Malignant Neoplasms”) and mortality statistics from local branches of the Federal State Statistics Service, processed using standard oncology statistical software.

Results. In the Amur Region in 2023, there were 17.7% more new cases of malignant lymphomas registered compared to 2022. The average statistical incidence rate in 2023 among men was 2.09 ± 0.26 per 100,000 population (p = 0.190) (vs. 1.48 ± 0.25 in 2020), representing a growth rate of +108.4% since 2014. In the female population during the same year, this indicator decreased to 2.08 ± 0.37 per 100,000 (p = 0.918) (vs. 2.34 ± 0.31 in 2020), with a decline rate of –54.3% since 2014. In the structure of classical Hodgkin’s lymphoma forms, nodular sclerosis (70.3%) and mixed cellular lymphoma (23.7%) prevailed. Due to limited capacity of the oncology service in 2020–2023 under the challenging conditions of the COVID19 spread in the studied area, no actively detected cases were registered. The patient accumulation index dropped to 7.2 in 2023 (vs. 10.8 in 2021). The proportion of patients with stage I–II malignancy increased to 19.5% (vs. 12.8% in 2014), as did the share of advanced disease (20.7% vs. 2.9% in 2014). The number of morphological examinations matched the national average (100%). The average mortality rate among men was 0.55±0.07 per 100,000 population (p = 0.352) (vs. 0.51 ± 0.09 in 2020), exceeding that of women, which was 0.42 ± 0.08 (p = 0.317) (vs. 0.93 ± 0.23 in 2020). The number of patients followed for 5 years or more increased to 68.5% (vs. 56.4% in 2014), while the proportion of patients dying within the first year after diagnosis also rose to 29.0% (vs. 27.1% in 2014).

Conclusion. The insufficient level of preventive measures did not allow for more extensive active detection of malignant lymphomas between 2014 and 2023 and did not substantially improve the main indicators of medical care for this patient category in the region under study.  

Introduction. Cytomegalovirus (CMV) infection in pregnant women is deemed significant in affecting the cardiovascular system of their newborns. Despite the well-known cardiotropism of this pathogen, the characteristics of cardiac function in neonates with perinatal central nervous system (CNS) injury, whose mothers experienced reactivation of chronic CMV infection during pregnancy, have not been investigated to date.

Aim. To assess the state of cardiac function in newborns with cerebral ischemia, born to mothers with exacerbation of chronic CMV infection in the second trimester of pregnancy.

Materials and methods. The functional state of the heart was studied in 42 newborns from mothers with an uncomplicated pregnancy (control group) and in 67 newborns with perinatal brain damage from mothers who had exacerbation of chronic CMV infection in the second trimester of pregnancy (main group). Of these 67 newborns, 36 had grade I cerebral ischemia (first subgroup) and 31 had grade II cerebral ischemia (second subgroup).

Results. Compared to the control group, newborns in the first subgroup had lower Apgar scores at 1 minute (p < 0.001) and at 5 minutes (p < 0.001), as well as lower birth weight (p < 0.01). Although no significant differences were noted in the main clinical and functional parameters of the cardiovascular system, isolated cases of sinus arrhythmia and ST segment depression in leads V2 and V6 were observed. In the second subgroup, compared to both the control group and the first subgroup, Apgar scores at 1 minute (p < 0.001) and at 5 minutes (p < 0.001) were lower, as was birth weight (p < 0.01 and p < 0.001, respectively). In the second subgroup, when compared with the first, pallor (χ² = 3.99; p < 0.05), circumoral cyanosis (χ² = 3.96; p < 0.05), systolic murmur (χ² = 9.49; p < 0.01), tachycardia (χ² = 4.37; p < 0.05), incomplete right bundle branch block (χ² = 3.90; p < 0.05), moderate metabolic changes in the myocardium (χ² = 5.08; p < 0.05), and increased load on the right atrium (χ² = 4.66; p < 0.05) were more frequent.

Conclusion. In newborns with grade II cerebral ischemia born to mothers with exacerbation of chronic CMV infection in the second trimester of pregnancy, compared to newborns with grade I cerebral ischemia whose antenatal history was complicated by chronic CMV reactivation in the same gestational period, there is a more frequent occurrence of peripheral circulatory disorders, hypoxia, and cardiac dysfunction, increasing the load on the right atrium. These changes in clinical and functional features reflect the negative impact of the severity of perinatal brain injury on the conduction system and contractile function of the myocardium in newborns from mothers with CMV reactivation in the second trimester of pregnancy.  

Introduction. In the past decade, vascular growth factors and prostaglandins have been actively studied in the context of angiogenesis regulation and their role in pregnancy pathologies. A review of the current literature reveals a lack of data proving the involvement of vascular endothelial growth factor (VEGF) A and prostaglandin (PG) F2α in the pathogenesis of early pregnancy loss associated with exacerbation of cytomegalovirus (CMV) infection.

Aim. To investigate the levels of VEGF-A and PG F2α in peripheral blood and determine their prognostic significance in pregnancy loss during exacerbation of chronic CMV infection at 6–7 weeks of gestation.

Materials and methods. A case-control study was conducted, involving 65 pregnant women. The main group included 35 patients experiencing exacerbation of chronic CMV infection at 6–7 weeks of pregnancy. The control group consisted of 30 practically healthy women at 6–7 weeks of pregnancy. CMV infection was diagnosed by the presence of IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA) and the detection of CMV DNA by polymerase chain reaction (PCR). Serum VEGF-A and PG F2α levels were measured using ELISA.

Results. During exacerbation of CMV infection at 6–7 weeks of pregnancy, a decrease in VEGF-A concentration to 10.35 ± 0.05 ng/mL was observed, along with an increase in PG F2α levels to 1092 ± 13.33 pg/mL, compared to the control group values (16.56 ± 0.04 ng/mL and 720 ± 9.21 pg/mL, respectively). To analyze the selected evaluation criteria, a discriminant function with a probability of differences of at least 95% was determined. A discriminant equation was derived for this study, which has the form: PI = -231.377 + 13.694 × VEGF-A + 0.052 × PG F2α, where PI is the discriminant function with a threshold value of -32.92. When PI is equal to or greater than the threshold value, it is possible to predict the risk of pregnancy loss at 6–7 weeks of gestation during an exacerbation of cytomegalovirus infection. A PI less than the threshold value indicates the absence of such a risk during this period of pregnancy.

Conclusion. The obtained results confirm the pathogenetic significance of VEGF-A and PG F2α dysregulation in the development of pregnancy loss during CMV infection exacerbation at 6–7 weeks. These findings may serve as the basis for expanding diagnostic and therapeutic approaches in this pathology.  

Introduction. Primary cardiac lymphoma is an extremely rare malignant neoplasm. Diagnosis is often delayed because clinical manifestations are nonspecific and, in most cases, appear only at the terminal stage of the disease.

Aim. To present a clinical case of primary cardiac lymphoma.

Materials and methods. A concise literature review of cardiac lymphomas is provided, followed by a clinical case from the authors’ practice.

Results. The disease had a prolonged course, initially masquerading as ischemic heart disease. Due to arrhythmias, the patient underwent a cardiac ultrasound examination, which first revealed a tumor in the right heart chambers. During surgery, a tumor of the right ventricle infiltrating the right atrium was confirmed; however, given the extent of the lesion, the case was deemed incurable. Histological and immunohistochemical (IHC) analyses established the diagnosis of diffuse large B-cell lymphoma of the heart, which was subsequently confirmed on autopsy.

Conclusion. In this scenario, primary cardiac lymphoma mimicked ischemic heart disease and arrhythmias. Echocardiography in such patients allows for early suspicion of a cardiac tumor. A definitive diagnosis can only be made following histological and immunohistochemical examination of biopsy or surgical material. 

Introduction. One of the most common complications of the novel coronavirus infection (COVID-19) involves respiratory system disorders, particularly bronchial obstruction.

Aim. To highlight the importance of vigilance regarding the onset of respiratory diseases, including asthma, in the post-COVID period.

Results. This article describes a clinical case of newly diagnosed severe asthma in a 35-year-old patient following COVID-19. A notable feature of the patient’s condition was prolonged eosinophilia. Sensitization to inhalant allergens was ruled out by a negative Phadiatop ImmunoCAP screening test. Despite receiving a fixed triple combination of an inhaled corticosteroid, a long-acting β₂agonist, and a long-acting anticholinergic agent, the patient’s disease remained uncontrolled with persistent airway obstruction. A genetically engineered biological therapy was subsequently prescribed, resulting in a marked clinical improvement.

Conclusion. This clinical case illustrates a manifestation of post-COVID syndrome—new-onset asthma. Timely diagnosis enables the prompt selection of appropriate therapy, improving the patient’s quality of life and facilitating a return to normal daily activities.  

An analysis and systematization of scientific literature on the combination of asthma and COVID-19 was conducted using the scientific databases PubMed/MEDLINE and eLIBRARY.RU. The data on the relationship between asthma and COVID-19 are shown to be contradictory. The mechanism of inflammation development and its characteristics in the new coronavirus infection are discussed. The significant role of natural killer (NK) cells and T-natural killer (T-NK) cells in the pathogenesis of the disease is emphasized. The importance of the type of inflammation in asthma in the risk of SARS-CoV-2 infection is concluded. Information on the dual nature of the data regarding the use of inhaled corticosteroids in the treatment of asthma in patients with COVID-19 is presented. The authors conclude that the results of current research do not allow a definitive conclusion to be drawn about a higher predisposition to SARS-CoV-2 infection or more severe COVID-19 in asthma patients, nor about the negative impact of COVID-19 on the course and control of asthma.  

The aim of this review was to analyze and summarize the current literature on the role of atypical respiratory pathogens (Mycoplasma pneumoniae and Chlamydia pneumoniae) in the development of airway hyperresponsiveness in children. The article presents the main mechanisms through which M. pneumoniae and Ch. pneumoniae can damage respiratory epithelial cells and contribute to the formation of bronchial hyperresponsiveness. It is shown that epithelial damage occurs both directly, through the depletion of nutrient resources, oxidative stress, and disruption of repair mechanisms, and indirectly, through immune mechanisms, including the production of specific immunoglobulin E antibodies and cytokine imbalance. Key characteristics of atypical pathogens leading to severe complications are highlighted, including: the production of the community-acquired respiratory distress syndrome (CARDS TX) toxin by M. pneumoniae, and the production of lipopolysaccharides and heat shock protein 60 (HSP60) by Ch. pneumoniae. A separate section is dedicated to the ability of atypical pathogens to form biofilms to enhance survival and pathogenicity. It is emphasized that damaged epithelium, in turn, induces the production of pro-inflammatory mediators, thereby exacerbating airway inflammation and contributing, in some cases, to the development of bronchial hyperresponsiveness. The authors believe that elucidating the mechanisms by which atypical pathogens damage the respiratory tract will facilitate the development of new approaches to the diagnosis, prevention, and treatment of respiratory diseases in children.  

Papillomavirus infection (PVI) is widespread worldwide and ranks first among sexually transmitted infections. This article presents data on the prevalence and epidemiology of PVI. Particular attention is paid to the main mechanisms of pathogenesis and to how human papillomavirus (HPV) evades the host immune response. The role of the vaginal microbiome composition and its influence on the likelihood of infection and the maintenance of PVI persistence is emphasized. A significant part of the work is devoted to the impact of HPV on the human reproductive system, including the possibility of conception, pregnancy maintenance, and neonatal outcomes. The current frequency of reproductive disorders associated with PVI underscores the relevance of this topic. In conclusion, the necessity of further research on PVI is highlighted, as it will enable a more detailed understanding of HPV’s influence on the stages and outcomes of pregnancy.