Summary. The aim is to assess the presence of specific markers in patients with thymus-independent and thymus-dependent myasthenia gravis for choosing treatment tactics. Materials and methods. The presence of specific markers was assessed in 138 patients with thymus-independent (M – myasthenia gravis without thymus changes) and thymus-dependent (MH – myasthenia gravis with thymus hyperplasia, MT – myasthenia gravis with thymoma) for the choice of treatment tactics. We used methods of enzyme immunoassay, spectrophotometry, light and fluorescence microscopy. Results and discussion. The relationship between the clinical phenotypes of myasthenia gravis and the variants of HLA leukocyte antigen diplotypes was revealed: in young patients with thymus-independent myasthenia gravis (M), a high heterogeneity of the genotypic markers HLA-DR (DR1, DR2, DR3, DR5, DR7) was observed. Patients with thymus-dependent myasthenia (MT) had only the HLA DR2 and HLA DR7 diplo- and haplotypes. The presence of HLA DR2 and HLA DR7 haplotypes and certain changes in the complex of biomarkers (anti-nuclear antibodies, innate immunity and humoral sensitization) in some young patients with M with disease progression led to the development of myasthenia gravis with thymoma (MT) at an older age. Conclusions. The prognosis of the progression of myasthenia gravis and the development of remission can be made using genomic (the presence of certain HLA-DR haplotypes) and molecular (anti-nuclear antibodies ANA, different fractions of medium molecular weight peptides, circulating immune complexes) biomarkers, that can be used for the choice of treatment tactics.

Recently, nanobiotechnology has been developing intensively; therefore, various properties of nanoparticles, which depend on their origin, concentration, and size, are of interest. It is known that CeO2 nanoparticles cause a positive biological effect. These particles are able to penetrate through biomembranes. At the same time, there are assumptions about a high degree of biological risks when using nanomaterials, and it is obvious that the biosafety of nanomaterials is decisive in the development of new products, including for medicine. The cytotoxicity of samples of cerium salts and cerium dioxide nanoparticles of different sizes was assessed at different concentrations using D. viridis. The cytotoxicity level by morphological and functional disorders of D. viridis was investigated, as determined by the change in cell shape, accumulation of inclusions, loss of flagellum, change in nature and movement, the formation of micro- and macroaggregates by D. viridis cells and exometabolite release. The cytotoxicity coefficient was calculated as a quotient of total detected changes divided by their number. It was shown that cerium salts (cerium (IV) ammonium nitrate and cerium (III) chloride) had pronounced cytotoxicity, which exceeded cytotoxicity values of the control by 7 and 6 times, respectively. Cerium dioxide nanoparticles with a size of 6 nm at a concentration of 0.01 M showed intermediate cytotoxicity, which exceeded control values by 3.5 times, and after the effect of nanoparticles with a size of 2 nm at a concentration of 0.1 M, the cytotoxicity coefficient corresponded to control values. The addition of inactivated blood serum to the incubation mixture resulted in a decreased cytotoxic effect of cerium dioxide. The use of D. viridis as a test system will supplement the arsenal of biotesting tools for nanomaterials and the study of the mechanisms of their effect.

The aim: To evaluate the relationship of certain alleles of HLA class II leukocyte antigens and the profile of antibodies to various subunits of nicotinic acetylcholine receptors (nAChR), the level of Treg lymphocytes and the serum concentration of anti-inflammatory IL-10 for various clinical myasthenia gravis phenotypes. Materials and methods: We examined 217 patients with thymus-independent myasthenia (n = 42) and thymus-dependent myasthenia, among them patients with thymus hyperplasia (n = 108) and thymoma (n = 67). We used the following methods: ELISA, flow cytometry, light and fluorescence microscopy. Results: Certain genomic (polymorphism of leukocyte HLA-DR antigens) and epigenomic (antibodies to α1 and α7 nAChR subunits, expression of Treg lymphocytes and concentration of cytokines) predictors were identified for various myasthenia phenotypes. The presence of HLA haplotypes DR2 and DR7 in some young patients with M with disease progression led to the development of myasthenia gravis with thymoma (MT) at an older age. The presence of α7 nAChR subunit on thymocyte mitochondria was revealed, which is an additional autoimmune target for autoantibodies in patients with myasthenia gravis. An increase in the concentration of cytokines (IL-4, IL-8, IFN-γ) in all patients with myasthenia gravis was revealed. Conclusions: Estimate the features of the formation of various variants of the immune response in thymus-independent and thymus-dependent myasthenia gravis is a necessary condition for targeted immunocorrection or surgery.

Summary. Goal. Investigation of the interactions of coagulation, anticoagulant and fibrinolytic systems with factors of immunoresistance in hepatosplenomegaly syndrome (SHSM). Materials and methods. Materials — сells and blood serum of 58 patients with SHSM against the background of liver cirrhosis complicated by portal hypertension, with the etiological factor — HCV / HBV virus infection (group I, 22 people) and the etiological factor — CMV / VEB virus infection (group II, 36 people), who were admitted to the hospital for bleeding from esophageal varicose veins. Methods - photometric on a biochemical analyzer Stat Fax 1904 Plus (USA). (C3 and C4 components of complement, antithrombin III and plasminogen, concentration of circulating immune complexes (CIC), determination of the coagulation time of venous blood Lee-White, calculation of the prothrombin index, fibrinogen content by the Rutberg gravimetric method. Protein C activity (PrS) by the clotting method on a coagulometer K 3002 Spectramed (Poland). Peripheral blood platelet counts were performed using immersion microscopy according to the Fonio method. Results. Multidirectional changes in the functions of the hemostasis system were revealed: a decrease in antithrombin III activity, protein C content, fibrinogen concentration, a decrease in plasminogen activity, a decrease in platelet counts, an increase in platelet antibodies, an increase in the concentration of the C3 component and a decrease in the C4 component of complement. Conclusions. Hemorrhagic and thrombotic complications of HCV, life-threatening and affecting the tactics and results of surgical and minimally invasive treatment, can occur both in the HCV group on the background of HBV/HCV viral hepatitis, and in the HCV group on the background of herpes virus CMV/VEB infection, but in group I both hemorrhagic and thrombotic complications were dominated by plasma risk factors for and in group II - platelet and immunological (complement component C3) risk factors for hemorrhagic complications, plasma factors of thrombotic complications.

Summary. Introduction. The combination of pathogenetic factors of the main surgical pathology, multiple organ dysfunction, acute respiratory distress syndrome and cytokine storm against the background of SARS-Cov-2 infection justifies the relevance of this study. Materials and methods. We examined 13 patients with acute COVID-19 and 29 patients with SARS-Cov-2-associated urgent surgical pathology. Investigated the concentration of C-reactive protein (CRP) by latex agglutination, C3 and C4 components of the complement by immunoturbidimetry, the content of interleukins IL-6 and IL-18 by ELISA, determination of autoantibodies by luminescence microscopy. Results. In patients with SARS-Cov-2-associated urgent surgical pathology, certain patterns of changes in the markers under study were revealed: in all examined groups of patients, an increased concentration of C-reactive protein was observed, which indicated a systemic inflammatory response both in the acute and in the postcovid period. In the postcovid period of viral infection, the most significant are the high frequency of the maximum increase in the concentration of CRP, C3- and C4-complement components, and a significant or moderate increase in the content of interleukins IL-6 and IL-18, more pronounced than in the acute period of infection. The maximum increase in pro-inflammatory cytokines was found in patients with abdominal surgical pathology against the background of COVID-19 (postcoid period), while in the acute period of COVID-19, an increase in the concentration of IL-6 had no diagnostic value. A cytokine storm was detected in 20.5% of the examined patients with COVID-19-associated urgent surgical pathology. Conclusions. For COVID-19-associated surgical pathology, the formation of autoimmune conditions is characteristic, which is expressed in the presence of a wide range of autoantibodies to nuclear structures. Thus, for the prevention and complex treatment of COVID-19-associated urgent surgical pathology, it is advisable to use personified step-by-step immunotropic therapy.