To evaluate the effectiveness of alpha-glutamyl-tryptophan as a cytoprotector in comparison with the control group (placebo) as part of the complex therapy of chronic atrophic H. pylori (HP)-associated gastritis. A total of 121 patients with chronic atrophic HP-associated gastritis were observed in 3 research centers. Before and after treatment blood test “Gastropanel”, stomach endoscopy with biopsies of atrophied mucosa for histological examination, rapid urease test for H. pylori detection, and daily pH-metry were performed. After HP eradication, according to randomization, the study drug (n = 61) or placebo (n = 60) was administered twice a day, in the morning 20–30 minutes before meals and in the evening before bedtime for 28 days. Alpha-glutamyl-tryptophan intake is associated with a statistically significant increase in acidity index according to pH-metry (p = 0.001), an increase in the ratio of pepsinogen I/pepsinogen II (p = 0.003), decrease in the level of gastrin-17 (p = 0.005), increase in the number of glands per 1 mm2 of the gastric mucosa (р = 0.028). Alpha-glutamyl-tryptophan in the treatment of chronic atrophic HP-associated gastritis has a superior regenerative effect compared with placebo, and promotes the restoration of acid-forming and pepsin-forming functions of the stomach.

Despite all efforts of the world community, the COVID-19 pandemic remains one of the main epidemiological challenges of our time. Even with its widespread distribution, the infection may have certain local features due to social, geographic, and climatic factors. Objective: to study collective immunity to SARS-CoV-2 in the population of the Republic of Tajikistan.A cross-sectional, randomized study of herd immunity was carried out according to a program developed by Rospotrebnadzor and the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The ethics committees of the corresponding entities approved the study: Tajik Ministry of Health and Social Protection; and the St. Petersburg Pasteur Institute (Russia). Based on questionnaire results, 4,022 people were selected, representing 0.15% (95% CI: 0.14-0.15) of the total population randomized by age and region. In subsequent laboratory analysis, 3682 people took part. The distribution and quantitative content of antibodies (Abs) to viral nucleocapsid (N Ag) and receptor binding domain (RBD Ag) were determined by ELISA. When questioned, a history of SARS-CoV-2 vaccination was indicated by 69.7% (95% CI: 68.2-71.2) of the volunteer cohort. Vector vaccines were most frequently used (50.6%; 95% CI: 48.7-52.5), with whole-virion inactivated preparations in second place (23.0%: 95% CI: 21.4-26.6) and mRNA vaccines in third place (21.0%; 95% CI:19.4-22.6).The cohort (n = 3682) featured 27.5% men and 72.5% women. The overall seroprevalence was 98.5% (95% CI: 97.7-99.2) in men and 99.4% (95% CI: 99.0-99.6) in women (differences statistically insignificant). Overall seroprevalence in the cohort was 99.2% (95% CI: 98.8-99.4) and ranged from 97.2 to 100% in certain subgroups. Asymptomatic seropositivity in the whole cohort was 98.4% (95% CI: 97.6-99.1). As a result of a mandatory vaccination program introduced in Tajikistan under a COVID-19 Emergency Project, the level of herd immunity among vaccinated individuals reached 99.5% (95% CI: 99.1-99.7), which is similar to the level reached in the cohort as a whole.The epidemic situation that developed in Tajikistan by mid-March 2022 was characterized by an almost absolute level of herd immunity, as evidenced by an absence of detected overt COVID-19 cases since the end of February (2022).

Prevention of gastric cancer, both primary and secondary, is an extremely important component of the management of gastroenterological patients. The correct collection of anamnesis with an assessment of the hereditary (family) cancer risk, the action of risk factors (eating disorders, habitual/chronic intoxication, obesity, Helicobacter pylori infection, etc.), as well as the use of gastroprotectors (in particular, the drug Regastim Gastro), especially in persons with potentially precancerous the condition is chronic atrophic gastritis. According to the data of a double-blind placebo-controlled randomized study Regastim Gastro (active ingredient alpha-glutamyl tryptophan) in the treatment of chronic atrophic gastritis, it was found that this drug has a powerful anti-inflammatory effect and regenerative activity. Taking the drug Regastim Gastro, compared with placebo, statistically significantly contributed to a decrease in the number of inflammatory infiltration cells per 1 mm2 of the gastric mucosa. Regastim Gastro decreases in eosinophilic (3 times) and neutrophilic (4 times) infiltration of the gastric mucosa and also reduced the number of macrophages, lymphocytes and plasmocytes. In addition to anti-inflammatory properties, the drug also had a pronounced regenerative effect. Taking of Regastim Gastro statistically significant (p=0.028) increases in the number of glands per 1 mm2 of the gastric mucosa by 26.1% compared with the initial screening indicators. In the group of patients taking placebo, on the contrary, there was a further progression of the pathological process, accompanied by a decrease in the number of glands per 1 mm2 of the gastric mucosa after the end of treatment in comparison with the initial indicators. After the course of therapy, the number of glands per 1 mm2 of the gastric mucosa in patients taking the drug Regastim Gastro was statistically significantly higher in comparison with the results in the placebo group (p=0.013). After the course of Regastim Gastro, there was an improvement in acid production: a shift in the acidic side of the average pH value (1.6 times) and an increase in the value of the acidity index, both when compared with the initial values (5.4 times) and in comparison with the placebo group (2.9 times). The intake of Regastim Gastro to patients with gastritis, both H. pylori (+) and H. pylori (-) before the development of atrophy of the gastric mucosa can reduce the inflammatory factor, prevent the occurrence of atrophy and may have maximum anti-carcinogenic action.

No abstract

Aim. To analyze the anti-inflammatory efficacy of Regasthym Gastro (alpha-glutamyl-tryptophan) in the treatment of patients with chronic atrophic gastritis according to endoscopic and morphometric studies. Materials and methods. As part of a double-blind placebo-controlled study, the results of gastroscopy and histological (morphometric) studies were retrospective analyzed in 80 patients diagnosed with chronic atrophic gastritis associated with Helicobacter pylori in exacerbation: 43 patients took Regasthym Gastro, 37 patients placebo. The conclusions of the gastroscopy were structured in the form of a standardized scale, which included an assessment of criteria in points (from 0 to 3): thickness of folds, hyperemia, edema of the gastric mucosa, the signs of atrophy, metaplasia; the severity of the erosive process. The sum of points according to all criteria was used to assess the dynamics of the inflammatory process: positive dynamics; lack of dynamics; the pathological process is progressing. The results of the endoscopic examination were compared with morphometry data (the number of inflammation pool cells per 1 mm2 of gastric mucosa). Statistical processing of the results was carried out using the Statistica 12 application software package. Results. According to the gastroscopy, before therapy, hyperemia of the gastric mucosa was present in 82.5%, edema in 53.8%, erosion in 17.5%, signs of metaplasia in 12.5% of patients. After therapy with the investigated drug a statistically significant decrease in the severity of edema of the gastric mucosa (p=0.008), the total set of signs of acute inflammatory process (p=0.006), a decrease in the proportion of outcomes with negative dynamics of the inflammatory process (p=0.038) was revealed. Statistically significant (p0.05) correlations were found between gastroscopy data of inflammation and the number of neutrophil, eosinophil granulocytes, macrophages and lymphocytes per 1 mm2. Conclusion. Regasthym Gastro contributes to a significant decrease in the severity of the inflammatory process according to the evaluation of the results of gastroscopy and morphometry. It is possible to recommend the inclusion of this drug in the complex therapy of chronic gastritis to increase the effectiveness and reduce the risks of progression of inflammation.