
The journal "Bulletin of physiology and pathology of respiration" is a periodical scientific and practical publication which systematically covers the most relevant fundamental and applied aspects of solving the most important problems of medicine and biology in the field of physiology and pathology of respiration. Special attention is paid to respiratory medicine, which is one of the most popular branches of medical knowledge in the world medical community due to the high and steadily increasing prevalence of respiratory diseases and the huge damage caused by respiratory diseases to society. The journal publishes the results of scientific research in the field of medicine, biology, and scientific technologies. Scientific articles (clinical and experimental studies); scientific reviews, lectures and reports; scientific reviews and reviews; information materials (coverage of conferences, symposia, congresses and plenums on topical issues of epidemiology, pathogenesis, diagnosis and treatment of respiratory diseases) are accepted for publication. All manuscripts submitted to the editorial office are reviewed by independent experts of the highest qualification. Medicine and biology are scientific areas in which expert evaluation of manuscripts is carried out. The editorial board consists of prominent Russian and foreign scientists. The target audience of the journal: researchers in the field of respiratory medicine, biology, physiology and pathophysiology of the respiratory system; pulmonologists and practitioners of various specialties.
Current issue
This year marks the 95th anniversary of the birth of the initiator, organiser and first director of the Institute of Physiology and Pathology of Respiration of the Siberian Branch of the Academy of Medical Sciences of the USSR – now the Far Eastern Scientific Centre for Physiology and Pathology of Respiration – Academician of the Russian Academy of Sciences Mikhail Timofeevich Lutsenko. The article is a biographical essay that outlines the key stages of his professional growth and highlights his outstanding achievements in managing medical science and training scientific personnel. It also presents the most significant results of his work in morphology, histology and pathological physiology.
LECTURES
This lecture summarises long-term clinical observations of children with various forms of chronic non-specific lung diseases (CNLD), which have enabled the author to formulate a concept of dysontogenetic disorders of the bronchopulmonary system arising at both prenatal and postnatal levels. Such disorders develop through biochemical, molecular and cellular changes triggered by a combination of exogenous and endogenous damaging factors – nutrient and essential-trace-element deficiency or imbalance, intrauterine viral infection and environmental exposures – that programme physiological and metabolic reactions from the earliest stages of bronchopulmonary organogenesis through to adult life. This approach opens up possibilities for a scientifically grounded primary prevention of dysontogenetically determined pulmonary pathology in children. The author presents a differential diagnostic algorithm for analyzing recurrent and chronic bronchopulmonary pathology.
ORIGINAL RESEARCH
Introduction. Cellular energy supply is a key aspect of their functioning, mediated by mitochondria. Despite reports of energy deficiency in COPD, we previously found an increase in mitochondrial membrane potential (ΔΨm) in the leukocytes of affected individuals. At the same time, increased expression of transient receptor potential channels TRPV1 was observed in COPD, raising questions about their potential role in regulating mitochondrial functions.
Aim. To assess ΔΨm and adenosine triphosphate (ATP) levels in peripheral blood mononuclear cells of COPD patients and to clarify the effect of the TRPV1 agonist capsaicin on ΔΨm.
Materials and methods. The study included 42 COPD patients of varying severity and 11 control subjects without signs of bronchial obstruction. All participants underwent spirometry and body plethysmography to assess lung function. The amount of ATP was measured by the luminometric method on a plate analyzer, with mean ATP content per cell calculated. ΔΨm was determined by flow cytometry using the ratiometric cationic carbonylcyanine dye JC-1. The dynamics of ΔΨm in response to TRPV1 activation by capsaicin were assessed and the results were expressed as a percentage of ΔΨm in unstimulated cells.
Results. It was found that the ATP content in the peripheral blood mononuclear cells of COPD patients was higher than in the control group (0.96 (0.36; 1.79) fmol/cell vs. 0.14 (0.11; 0.21) fmol/cell, p = 0.001). Capsaicin caused significant changes in ΔΨm in the mononuclear cells of COPD patients: 33.1 (-19.0; 86.0)% for lymphocytes and 48.2 (0.0; 126.7) % for monocytes (p = 0.001). However, ΔΨm did not differ significantly between COPD patients and the control group either at baseline or under capsaicin stimulation. In COPD patients with higher FEV1 values, ΔΨm was elevated in both lymphocytes (0.69 (0.64; 0.86) vs. 0.51 (0.35; 0.61), p = 0.004) and monocytes (0.28 (0.21; 0.37) vs. 0.18 (0.13; 0.29), p = 0.015).
Conclusion. We found no evidence of energy deficiency in mononuclear cells from COPD patients, however, in patients with severe and very severe ventilatory impairment, some decrease in ΔΨm may occur without affecting ATP production. Increased ATP production in COPD may be mediated by increased TRPV1 expression and could play a pathological role by activating purinergic signaling.
Introduction. Chronic obstructive pulmonary disease (COPD) is a common disorder and the third leading cause of death globally. It may be characterized by impaired phagocytosis and efferocytosis, which contributes to chronic nflammation and increases the risk of bacterial respiratory infections. Previously, we established hyperexpression of TRPV1 channels in monocytes and macrophages of patients with COPD.
Aim. To study the phagocytic activity of monocytes in patients with COPD and to evaluate the effect of the TRPV1 agonist capsaicin on the efficiency of phagocytosis in vitro.
Materials and methods. The study included 42 patients with COPD of varying severity and 11 control subjects. Phagocytic activity of monocytes was tested by flow cytometry using competent E. coli XL1-Blue cells transformed with pTurboGFP-B plasmid.
Results. The results of the study showed no statistically significant differences in the initial phagocytic activity of monocytes between patients with COPD and healthy volunteers (78.6 (73.4–87.4) % vs. 84.8 (65.6–88.3) %, p = 0.77). Exposure to capsaicin caused significant inhibition of E. coli phagocytosis in both groups: in COPD patients (from 78.6 (73.4–87.4) % to 64.4 (55.9–71.8) %, p < 0.001) and in the control group (from 84.8 (65.6–88.3) % to 71.4 (65.7–74.0) %, p < 0.01). Moreover, the degree of phagocytosis suppression under the influence of capsaicin was higher in COPD patients compared to the control (–17.5 (–24.9; –13.1)% vs. –9.4 (–16.4; –3.3)%, p = 0.03). However, after exposure to capsaicin, there were also no significant differences in the level of phagocytosis between the study groups.
Conclusion. Thus, our data indicate that monocytes from COPD patients do not exhibit significant abnormalities in phagocytic activity in vitro. Stimulation of TRPV1 with capsaicin results in statistically significant inhibition of E. coli phagocytosis in both groups, with a more pronounced decrease observed in COPD, which confirms the role of this receptor in modulating the immune functions of monocytes, given the increased expression of TRPV1 and the presence of endogenous activating stimuli..
Introduction. Disruption of the interactions among parameters of oxidative homeostasis, cell signalling and cellular energetic status leads to failure of adaptive mechanisms, which favours progression of pathological changes in asthma.
Aim. To determine the character of intersystem interactions in mild and moderate controlled and partially controlled asthma.
Materials and methods. The study enrolled 244 patients with asthma and 60 conditionally healthy subjects. Twenty-five parameters were assessed: expression of interleukin-4 receptors, interleukin-6 receptors (IL-6R), Toll-like receptors (TLR) 2 and 4; the mitochondrial membrane potential coefficient (cMMP) of CD4+ and CD8+ cells; levels of malondialdehyde (MDA), 8-hydroxy-2'-deoxyguanosine (8-OHdG), thioredoxin-1 (Trx-1), total antioxidant activity (TAA), glutathione (total, oxidised and reduced), interleukin-4 and interleukin-6; and the fatty-acid composition of leukocyte mitochondrial membranes. Intersystem interactions were analysed with Terentyev’s correlation pleiad method.
Results. Application of the Terentyev algorithm identified four groups of the most strongly linked indicators for each asthma cohort. In mild controlled asthma, the predictors were Trx-1 level and the MDA/TAA ratio, whereas in mild partially controlled asthma they were Trx-1 and 8-OHdG levels. In moderate controlled asthma, Trx-1 level and the cMMP of CD4+ cells oc-
cupied the central positions within the correlation pleiads. Five predictors were defined for moderate partially controlled asthma: 8-OHdG, cMMP of CD4+ cells, total antioxidant activity, and expression of IL-6R and TLR2 on CD4+ cells. Progression of asthma was accompanied by an increase in the power and robustness of the pleiads.
Conclusion. Analysis of intersystem interactions in asthma showed that parameters reflecting the intensity of destructive processes, activation of the inflammatory arm of the immune system and destabilisation of signalling interactions take the leading positions within the pleiads. Disease progression and reduced control destabilise intersystem regulatory processes.
Introduction. According to current research, the novel coronavirus infection (COVID-19) has an adverse impact on pregnancy and its outcomes. However, data on the causes of preterm birth in women who had COVID-19 during the current pregnancy remain insufficient.
Aim. To determine serum concentrations of 8-isoprostane and 12-hydroxyeicosatetraenoic acid (12-HETE) as predictors of preterm birth in pregnant women with COVID-19.
Materials and methods. This prospective comparative study involved three groups of pregnant women. The main group (n = 42) included patients diagnosed with moderately severe COVID-19 (community-acquired pneumonia) and threatened preterm labor. The comparison group (n = 51) comprised patients with moderately severe COVID-19 (community-acquired pneumonia) but with-out threatened preterm labor. The control group (n = 35) consisted of patients without threatened preterm labor and no history of COVID-19, either previously or at the time of examination. Diagnosis was confirmed by detecting SARS-CoV-2 RNA in oropharyngeal and nasopharyngeal swabs by polymerase chain reaction (PCR), as well as current clinical and radiological criteria of viral lung involvement using specialized imaging methods (as indicated). Serum 8-isoprostane was measured by enzyme-linked immunosorbent assay (ELISA) with Cayman Chemical (USA) reagent kits, and 12-HETE was determined using Enzo Life Sciences (USA) reagent kits.
Results. In the main group, the median serum 8-isoprostane concentration was 381.85 (375.43–388.30) pg/mL and 12-HETE was 8.73 (8.48–8.81) ng/mL – both higher than in the comparison group (200.00 (185.33–210.99) pg/mL and 2.99 (2.31–3.41) ng/mL) and the control group (178.20 (173.35–184.00) pg/mL, p< 0.001; 2.22 (1.96–2.35) ng/mL, p< 0.001, respectively). Based on discriminant analysis, a mathematical model was developed to calculate a prognostic risk index for preterm birth (PRIPB): PRIPB = -7.607 + 0.022 × 8-isoprostane + 0.309 × 12-HETE. The threshold PRIPB value was 3.244. A PRIPB ≥3.244 indicates a high risk of preterm birth, meaning higher PRIPB values are directly proportional to the risk of preterm birth. A PRIPB < 3.244 suggests no risk of preterm birth. Among 38 women in the main group, the predicted outcome matched the actual result in 90 % of cases.
Conclusion. For the first time, an elevated level of 12-HETE was identified alongside an increase in 8-isoprostane in women with COVID-19 during the third trimester of pregnancy. In patients with moderately severe COVID-19, serum concentrations of 8-isoprostane and 12-HETE appear to be markers of preterm birth risk.
Introduction. Exacerbation of chronic cytomegalovirus (CMV) infection in pregnant women is often accompanied by disruptions of the protein-synthesizing and pigment functions of the liver in their newborns. These functions regulate growth and inactivate toxic forms of bilirubin, which affect the functional state of the central nervous system. Despite this, the relationship between ultrasound and biochemical indicators of the liver in varying severities of cerebral ischemia in offspring of mothers who experienced an exacerbation of CMV infection has not been studied to date.
Aim. To provide a morphofunctional characterization of the liver in varying severities of cerebral ischemia in full-term newborns from mothers with an exacerbation of chronic CMV infection in the second trimester of pregnancy.
Materials and methods. We investigated the ultrasound features of the liver and gallbladder, along with levels of total protein, albumin, and total, indirect, and direct bilirubin in the cord blood serum of 43 newborns with an uncomplicated antenatal history (control group) and 69 newborns with cerebral ischemia that developed on the background of chronic CMV infection exacerbation in their mothers at 21–24 weeks of gestation (main group). Among those with perinatal lesions of the central nervous system, 37 newborns presented with Grade I cerebral ischemia (first subgroup), and 32 newborns presented with Grade II cerebral ischemia (second subgroup).
Results. In comparison with the control group, the first subgroup of the main group demonstrated statistically significantly lower Apgar scores at 1 and 5 minutes, as well as lower birth weight. No significant differences were found in liver size, frequency of high echostructural density areas in the parenchyma, small inclusions, increased echogenicity of portal tract structures and gallbladder body deformation, or levels of total protein, albumin, total, indirect, and direct bilirubin. In the second subgroup, compared to both the control group and the first subgroup, there were lower Apgar scores at 1 and 5 minutes and lower birth weight, along with an increased incidence of elevated echogenicity of the liver parenchyma, enhanced signals of portal tract structures, small inclusions, and gallbladder deformation. These newborns also showed decreased total protein and albumin, and increased total, indirect, and direct bilirubin.
Conclusion. In full-term newborns from mothers with exacerbation of chronic CMV infection in the second trimester of pregnancy, Grade II cerebral ischemia, compared to Grade I under similar antenatal conditions, is characterized by more pronounced echostructural changes, decreased protein levels, and increased total and indirect bilirubin concentrations. This reflects the negative impact of intrauterine hypoxia and postnatal asphyxia on the morphofunctional state of the liver in newborns whose mothers experienced an exacerbation of chronic CMV infection in the second trimester of gestation.
Introduction. Human papillomavirus (HPV) infection adversely affects female reproductive function, increasing the risks of pregnancy loss and obstetric complications.
Aim. To analyze the prevalence of HPV infection in women of reproductive age and determine its influence on the course and outcome of pregnancy.
Materials and methods. A prospective comparative study enrolled 50 women of reproductive age. Clinical and anamnestic data, pregnancy course and outcomes were analyzed retrospectively. HPV DNA genotyping and quantification, together with detection of concomitant viral and bacterial infections, were performed by real-time polymerase chain reaction. Cervical intraepithelial neoplasia (CIN) was confirmed by cytological, colposcopic and histological examinations.
Results. Genotyping showed HPV type 51 in30 % of women, type 16 in 28 %, type 68 in 16 %, type 18 in 12 %, and types 6 and 56 in 10 %. Types 11, 26, 31, 33, 35, 39, 44, 45, 52, 53, 59, 66 and 73 were found in 4% of patients. Multiple-type infection occurred in 30 % of women. High viral load was recorded in 60 %, moderate in 34 % and low in 6 %. Among sexually transmitted infections, Chlamydia trachomatis was diagnosed in 12 %, cytomegalovirus in 14 % and genital herpes in 4 %. Histology confirmed CIN I in 26 % of women, CIN II in 20 %, CIN III in 14 %, anogenital condylomatosis in 34% and cervical-canal polyps in 8 %. CIN I was associated with type 51 in 8 %, type 18 in 6 %, type 68 in 6 %, type 6 in 4 % and type 56 in 4 %; CIN II with type 16 in 10 %, type 51 in 8 %, type 68 in 4 % and type 66 in 4 %; CIN III with type 16 in 8 % and type 44 in 4 %. Vaginal-microbiome analysis revealed absolute normocenosis in 44 % of patients, conditional normocenosis in 24% and pronounced dysbiosis in 32 %. Absolute normocenosis was significantly more common in mono-infection (p < 0.001), whereas conditional normocenosis and pronounced dysbiosis predominated in mixed infection (p < 0.001 for both). Further analysis showed unexplained infertility in 16 % of patients. Pregnancy ended in spontaneous miscarriage in 14 % of women (41.4 % associated with mono-infection, 28.6 % with mixed infection). Missed miscarriage was diagnosed in 22 % of women (81.8 % mono-infection, 18.2 % mixed infection). Third-trimester chronic placental insufficiency occurred in 86 % of women (58.1 % mixed infection, 41.9 % mono-infection). Fetal growth restriction was noted in 9 % (60 % mixed infection, 40 % mono-infection). Threatened preterm labour was observed in 14 % (28.6 % mono-infection, 71.4 % mixed infection). Preeclampsia developed in 75 % of patients with mono-infection and 25 % with mixed infection. Oligohydramnios was found in 6 % of women with mixed infection and polyhydramnios in 2 %. Pregnancy was terminated in the second trimester for fetal central-nervous-system malformations in 6 % of patients.
Conclusion. HPV mono-infection in women of reproductive age is associated with infertility, early pregnancy loss (spontaneous and missed miscarriage) and preeclampsia. HPV combined with other sexually transmitted infections increases the risk of chronic placental insufficiency, fetal growth restriction and preterm birth.
Introduction. The problem of HIV-associated tuberculosis (TB) remains relevant at both the international and national levels. Co-infection poses additional challenges for healthcare systems, as well as national and regional economics.
Aim. To perform a comparative analysis of the epidemiological situation regarding HIV-associated tuberculosis in the Republic of Crimea (RC) and the Russian Federation (RF) during the period 2019–2023.
Materials and methods. The study utilized official statistics on the incidence of TB and HIV infection, as well as the incidence, prevalence, and mortality of HIV-associated TB from 2019 to 2023 in the RC and RF, provided by the Crimean Republican Clinical Center of Phthisiology and Pulmonology and the AIDS Prevention and Control Center. Statistical analysis and visualization were conducted using Microsoft Excel LTSC. The normality of distributions was tested using the Shapiro–Wilk W-test, and central tendencies of independent samples were compared using Wilcoxon W-test in Medstat software.
Results. During 2019–2023, the average incidence rate of HIV-associated TB in RC statistically significantly exceeded the national level by 1.4 times. There was a declining trend in co-infection incidence rate in RF. In the region after incidence decrease in 2019-2022 the growth rate in 2023 was recorded. No statistically significant differences between the average prevalence of HIV-associated TB in the RC and RF during the study period were found. A stable trend of prevalence reduction was observed in RC and RF with a higher rate in the region. In 2019-2023, the ratio of HIV-associated TB and TB without HIV incidence in RC and RF did not differ on average. In RF the ratio dynamics was minimal, in RC there was a high variability. Over the analyzed period, the proportion of HIV-associated TB patients among all TB patients increased in both the RF and RC, though the growth rate in the region was three times higher than the national average. The mortality rate from HIV-associated TB in the RC was significantly higher (1.5 times) than the national average. A declining trend was noted in the RF, while the RC exhibited an overall decline with fluctuating dynamics.
Conclusion. The increased incidence of HIV-associated TB observed in the RC in 2023 against a backdrop of declining trends from 2019 to 2023 may be explained by improved case detection following the resumption of regular medical examinations after COVID-19 lockdown restrictions. The relatively high prevalence of HIV-associated TB in the region is possibly related to artificial retention of patients in the "active" group under dispensarysupervision. The higher mortality from HIV-associated TB in the RC may indicate insufficient anti-epidemic measures aimed at preventing fatal outcomes in co-infected patients.
Introduction. The coexistence of asthenia and chronic respiratory diseases substantially affects patients’ overall well-being, work capacity, treatment adherence and quality of life. Nevertheless, published data on the prevalence
of asthenia in chronic non-infectious lung diseases (CNLD) remain scarce.
Aim. To assess the prevalence of asthenic syndrome among patients with CNLD living in Krasnoyarsk.
Materials and methods. A clinic-based study was carried out in outpatient polyclinics in Krasnoyarsk from July to August 2023. We enrolled 381 patients diagnosed with chronic obstructive pulmonary disease (COPD), asthma, or their combination, and 60 conditionally healthy subjects. Asthenia was evaluated with the Multidimensional Fatigue Inventory (MFI-20) and the Fatigue Severity Scale (FSS). Twenty-five clinical and laboratory parameters were recorded.
Results. Asthenic syndrome was diagnosed in 142 (37.5 %) patients with chronic respiratory diseases. All asthenic patients were divided into three groups: group 1 –81 patients with asthma (51 women, 30 men; median age 56 [39;68]), group 2–42 patients with COPD (13 women, 29 men; median age 57.5 [49;67]), and group 3–19 patients with both COPD and asthma (12 women, 7 men; median age 67 [52;17]). Patients with combined COPD and asthma showed a significantly higher frequency of all asthenia subtypes – general asthenia, reduced activity, decreased motivation, physical asthenia and mental asthenia (all p < 0.05) – than patients with a single disease.
Conclusion. Signs of asthenic syndrome were detected in nearly 40 % of patients with CNLD, a rather high figure. Despite the study’s limitations, the findings underline the clinical importance of assessing asthenia in this patient population.
Aim. To investigate the frequency and features of infectious complications in patients with chronic lymphocytic leukaemia (CLL) treated at the Order of the Badge of Honour Irkutsk Regional Clinical Hospital (Irkutsk, Russian Federation) from 2012 to 2023.
Materials and methods. We reviewed 490 medical records and outpatient charts of patients with CLL followed by haematologists at the hospital during 2012–2023. Four hundred patients received protocol-based chemotherapy (PBC); 202 of them were diagnosed with various infectious complications. These 202 patients were divided into three groups: group 1 – 71 patients who received PBC in 2012–2015; group 2 – 64 patients treated in 2016–2019; group 3 – 67 patients treated in 2020–2023.
Results and discussion. The most common infectious complications were bacterial pneumonia (31.7 %), infections of the upper respiratory tract, trachea and bronchi (28 %), urinary-tract infections (11.6 %) and coronavirus disease 2019 (COVID-19)-associated pneumonias in 2020–2023 (20.7 %). The highest number of infectious events occurred in relapsing patients at the terminal stage of the disease. From 2020 to 2023 the incidence of bacterial pneumonias and infections of the upper respiratory tract, trachea and bronchi decreased, which is attributed to the introduction of targeted drugs that can be administered in day-hospital or outpatient settings.
Conclusion. The findings provide new information that can be used to prevent infectious complications during protocol-based therapy for CLL and to develop effective prophylactic measures.
Aim. To assess the effect of health resort treatment combined with grape polyphenols on lipid metabolism and systemic inflammation markers in patients with asthma after COVID-19.
Materials and methods. Patients with asthma and a history of COVID-19, undergoing health resort treatment at the I. M. Sechenov Research Institute of Health Resort Studies and Physiotherapy (Yalta), were divided into two groups. Group 1 included 48 patients who, in addition to standard health resort therapy, received a grape polyphenol concentrate. Group 2 comprised 45 patients treated exclusively with standard health resort therapy. Before and after treatment, the following assessments were performed: anthropometry (height, weight, body mass index [BMI]), pulse oximetry (SpO2), spirometry with measurement of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), a 6-minute walk test, and blood analyses of C-reactive protein (CRP), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides.
Results. In asthma patients with post-COVID who received grape polyphenol concentrate during health resort treatment, significant changes were observed in BMI, lipid profile, and CRP levels. In Group 1, the mean BMI decreased from 29.4 kg/m2 at admission to 29.0 kg/m2 at discharge (p = 0.04). HDL rose from 1.4 to 1.9 mmol/L (p = 0.01). LDL dropped from 3.5 to
3.0 mmol/L (p = 0.03), triglycerides from 1.1 to 0.9 mmol/L (p = 0.04), and CRP from 3.8 to 2.9 mg/L (p = 0.01). No significant changes in lipid profile were observed in Group 2.
Conclusion. Health resort treatment supplemented by grape polyphenol preparations helps correct lipid imbalance and reduce systemic inflammation in patients with asthma who have recovered from COVID-19.
Aim. To compare the effectiveness of sip-feeding (SF) and computerized electroacupuncture (CEA) in the comprehensive treatment of patients with exacerbation of asthma with a predominance of allergic components.
Materials and methods. The study involved 60 patients with asthma exacerbation. The distribution of patients by disease severity: mild asthma – 9 patients, moderate asthma – 26 patients, severe asthma – 25 patients. In all cases, exacerbations were mild or moderate. Patients were divided into groups 1, 2, and 3 (20 patients each). All patients received standard drug treatment for asthma exacerbation. Patients of group 1 additionally received SF, consisting of five intakes of 200 ml of nutritional formula "Ensure 2" (Abbott, USA); patients of group 2 additionally received a course of CEA; patients of
group 3 received only standard drug therapy. The study design included two control points (CP): CP No. 1 – baseline, CP No. 2 – at the end of the SF course in group 1, after completion of the CEA course in group 2, and after 5 days in group 3. Spirometry was performed at all CPs.
Results. The values of forced expiratory volume in one second (FEV1) in patients who underwent a CEA course were significantly higher compared to patients in group 3. In group 1, after five SF procedures, higher increases in FEV1 and FVC were registered compared to group 3. Data analysis showed that patients with high total immunoglobulin E (IgE) levels had a more pronounced improvement in bronchial patency after SF. After the SF course in group 1, among patients with baseline IgE ≤ 500 IU/L, the FEV1 increase was 5 (3; 6.5) %, whereas in patients with IgE > 500 IU/L, it was 11 (8; 14) %.
Conclusion. The use of CEA in patients with asthma exacerbation and a pre-
dominant allergic component provides additional improvement in bronchial patency. The inclusion of SF in comprehensive therapy is associated with the greatest improvement in FEV1 in patients with baseline total IgE levels above 500 IU/L compared to other patients.
SELECTED REPORTS
Introduction. Over the past decades, rapidly changing demographic patterns have made thalassemia a relevant clinical issue in regions where this disease was previously uncommon.
Aim. To present clinical cases of the rare for Russia condition, beta-thalassemia minor.
Materials and methods. Two clinical observations of beta-thalassemia minor that had long been masked as iron deficiency anemia are described in patients who self-identify as ethnically Russian.
Results. Both cases featured mild hypochromic, microcytic anemia. The anemia was initially misclassified as iron deficiency, leading to unwarranted iron therapy and subsequent iron overload. Detection of elevated ferritin levels ruled out true iron deficiency. Hemoglobin electrophoresis and molecular genetic testing subsequently confirmed beta-thalassemia
minor. When these examinations were extended to relatives, several family members were found to carry the same diagnosis.
Conclusion. Although uncommon, thalassemia can occur in the Russian population owing to intensive migration and the influx of mutations. Beta-thalassemia minor is indistinguishable from iron deficiency anemia on routine complete blood count alone. Fractional hemoglobin analysis is a preliminary diagnostic tool for beta-thalassemia, while definitive confirmation and genotypic clarification require molecular genetic testing of the HBB gene. Timely identification of carriers can prevent diagnostic errors, avoid unnecessary drug therapy, and reduce the risk of complications.
REVIEWS
In recent years, increasing attention has been paid to the role of the small airways (SA) in the pathophysiological and clinical aspects of asthma. The article summarizes the main methods for assessing impaired SA function—spirometry, body plethysmography, impulse oscillometry, fractional exhaled-nitric-oxide analysis, inert-gas washout tests and computed tomography—and notes the absence of a single standard technique for identifying SA dysfunction. The pathogenetic mechanisms underlying SA dysfunction in asthma are discussed, with an emphasis on the key roles of cytokines, eicosanoids (polyunsaturated-fatty-acid metabolites) and plasmalogens in the complex network of mediators that regulate chronic airway inflammation. The potential for correcting SA dysfunction with modern pharmacological agents aimed at restoring lung function is considered. The studies analyzed highlight the importance of early evaluation of SA status and identification of triggers that drive SA dysfunction in asthma.
At present, the impact of electronic cigarettes on human health is being actively investigated. The liver is a vital multifunctional organ whose function can be impaired by various toxic factors such as alcohol or traditional cigarette smoking. In this review, we examine and synthesize current scientific literature on the effects of electronic cigarettes on the liver, drawing on publications retrieved through Google Scholar, Elsevier, and PubMed. The review discusses how certain chemicals found in e-cigarette liquids and their derivatives act on the liver, the relationship between e-cigarette use and oxidative-stress parameters, their influence on mitochondria, and changes in organ-specific enzymes that serve as biomarkers of liver injury. Histopathological alterations detected in liver tissue after exposure to electronic cigarettes are described, and differences between nicotine-containing and nicotine-free e-liquids are considered. The possible role of vaping in the development of liver diseases in humans including acute non-infectious toxic hepatitis and non-alcoholic fatty liver disease is explored. On the basis of available scientific evidence, we conclude that electronic cigarettes are not harmless and exert a significant negative effect. At the same time, further studies on the impact of electronic cigarettes on the liver and other organs and systems are warranted.
ANNIVERSARIES
On April 30, Tatiana Aleksandrovna Gvozdenko, Doctor of Medical Sciences, Professor of the Russian Academy of Sciences, Director of the Vladivostok branch of the Federal State Budgetary Scientific Institution "Far Eastern Scientific Center of Physiology and Pathology of Respiration" − Research Institute of Medical Climatology and Rehabilitation, celebrated her anniversary.