BackgroundAtrial fibrillation (AF) is one of the widest spread forms of arrhythmia, which is associated with the increased mortality and thromboembolic complications. To date, the involvement of renin‐angiotensin‐aldosterone system and immunomediators of inflammation into the mechanisms of development and maintenance of isolated AF is not clear. Specificity of their changes with respect to the latent myocarditis at AF is not proved.MethodsIn 96 patients with persistent isolated atrial fibrillation (IsAF), scheduled for radiofrequency ablation and endomyocardial biopsy (EMB), and in 20 healthy volunteers (HVT), levels of plasma tumor necrosis factor‐α (TNF‐α), interleukin (IL)‐1β, IL‐6, IL‐8, IL‐10, fatty acid‐binding protein (FABP), neopterin, C‐reactive protein (CRP) were determined by ELISA, level of aldosterone and the renin activity were determined by radioimmunoassay. Results were compared between the study and HVT groups and related to the EMB data.ResultsEndomyocardial biopsy revealed lymphocytic myocarditis in 29%, immunohistochemical signs of viruses' persistence in the myocardium—in 43.8% of patient. We formed 4 subgroups: «myocarditis», «fibrosis», «virus positive», «virus negative». In the group «myocarditis», level of IL‐6 was significantly higher than in group «fibrosis» (P < .01). ROC analysis showed its sensitivity 75%, specificity 75% (AUC = 0.759, Cutoff Value > 1.6 pg/mL, P < .01). In the group «virus positive», level of neopterin was significantly higher than in group «virus negative» (P < .01), with sensitivity 51%, specificity 84% (AUC = 0.675, Cutoff Value > 13.2 nmol/L, P < .01).ConclusionLevels of plasma IL‐6 and neopterin may serve as a marker of latent viral myocarditis in IsAF.

The object of the study: to study the dynamics of erythrocyte parameters in 2nd and 3rd year students with different levels of physical activity.Materials and methods: the venous blood of 56 students served as the material: 29 girls and 27 boys aged 18 to 22 years. With the help of a questionnaire, all the subjects were divided into 3 groups depending on the level of physical fitness (LPF). The red blood cells (RBC) and mean corpuscular volume (MCV), the concentration of hemoglobin (HGB), hematocrit (HCT), the mean cell hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), the red cell distribution of width (RDW) were determined.Results: the highest values of indicators HGB, RBC and HCT were observed in students with high LPF. The highest values were recorded of the MCV, MCH, MCHC and RDW With an average LPF. High values of HGB, RBC and HCT with high LPF and indicators of the MCV, MCHC and RDW with average LPF prevailed in the 2nd year. Young men had an increase in the values of HGB, RBC, HCT, MCH with low LPF and an increase in MCV and RDW at an average level in the 3rd year. Statistically significant differences were found between the 2nd and 3rd year girls in terms of RDW with an average LPF.Conclusion: with an increase in LPF, there is an increase in erythrocyte parameters. The dynamics of erythrocyte parameters depends on the level of physical activity, gender and the course of study.

Objective. To study the features of local and systemic production of interleukin-19 in patients with atherosclerosis.Material and Methods. The study comprised a total of 46 patients (26 women and 20 men) treated for arterial hypertension in the therapeutic department of Republican Clinical Hospital named after G.Y. Remishevskaya. The mean age of subjects was 63.4 ± 3.2 years. The control group included 40 patients (23 women and 17 men aged 44.7 ± 5.5 years) who did not have atherosclerosis. Samples of atherosclerotic plaques and venous blood were examined. Atherosclerotic plaques were obtained by endarterectomy and then subjected to homogenization followed by enzymatic hydrolysis for 1 h at 37 °C with collagenase IV in the presence of proteinase III inhibitors. The serum levels of cytokines (in the control group and in patients with atherosclerosis) and in the atherosclerotic plaque homogenate (in patients with atherosclerosis) were determined by ELISA. To assess the cytokine-producing capacity of blood leukocytes and white blood cells isolated from atherosclerotic plaques, spontaneous and phytohemagglutinin (PHA)-induced cytokine production was determined when the cells were cultured in RPMI-1640.Results. The serum levels of IL-19 did not significantly differ between the patients with atherosclerosis and the control group. A statistically significant two-fold increase in the spontaneous expression of IL-19 by blood leukocytes was observed in the group of patients with atherosclerosis in comparison with the control group. When comparing the contents of IL-19 in blood serum and atherosclerotic plaque homogenate in patients with atherosclerosis, no statistically significant differences were found (p = 0.182). The level of PHA-induced IL-19 production by the atherosclerotic plaque white blood cells was significantly lower than that of blood leucocytes.Conclusion. The study showed that the reserve capacity for IL-19 synthesis in the atherosclerotic plaque white blood cells decreases leading to the progression of inflammation. The obtained results suggest that IL-19 plays the anti-atherogenic role and its production is involved in the maintaining the mechanisms for down-regulation of inflammation in atherosclerotic plaques.

Атеросклероз является одной из основных причин смертности населения как в России, так и во всем мире. Проблема атеросклероза изучается с различных сторон, и до сих пор некоторые вопросы атерогенеза остаются до конца не раскрытыми. Одним из перспективных направлений исследований является изучение атеросклеротических бляшек. В связи с чем целью данной статьи является анализ современных данных о составе и основных функциях иммунокомпетентных клеток, входящих в состав бляшки. Для этого был проведен поиск результатов фундаментальных и клинических исследований в базах данных PubMed и РИНЦ. В статье преимущественно уделяется внимание данным, полученным в течение двух последних лет, которые представлены в основном в зарубежных публикациях. В обзоре приведен перечень иммунокомпетентных клеток, входящих в состав атеросклеротических бляшек, а также обсуждается их роль в атерогенезе. Показано, что клеточный состав бляшек неоднороден: преобладающими популяциями являются макрофаги и лимфоциты, но также встречаются дендритные клетки, нейтрофилы и натуральные киллеры. Роль различных типов клеток в формировании атеросклеротических поражений сосудов все еще продолжает изучаться. На начальных этапах формирования атеросклеротических изменений стенок сосудов принимают участие в основном клетки врожденного иммунитета, такие как макрофаги и дендритные клетки. Их активация приводит к инфильтрации субэндотелиального пространства Т-и В-лимфоцитами. Среди клеток адаптивного иммунитета в составе бляшек преимущественно преобладают CD8+ Т-лимфоциты. Дальнейшее изучение клеточного состава бляшек позволит прогнозировать стадию развития атеросклероза и исход вызываемых им осложнений. Ключевые слова: атеросклероз, атеросклеротические бляшки, иммунный ответ, макрофаги, лимфоциты. CELLULAR STRUCTURE OF ATHEROSCLEROSTIC PLAGUES

Objective: The purpose of the study was to analyze the association of allelic polymorphism of IL1В gene C>T loci -31 and +3953 with atherosclerotic changes of artries in patients with Metabolic Syndrome (MS). Materials and Methods: The main group of the study included 30 consecutive patients (24 women and 6 men, mean age - 51.7±2.2 years), for examination and treatment in the therapeutic Department of the Republican clinical hospital named "G. YA. Remishevskaya" (Abakan) about arterial hypertension or suspicion of type 2 diabetes. The criteria for inclusion in the core group included: compliance with the MS criteria according to the IDF criteria (2006); and the presence of ultrasound markers of Atherosclerosis (AS) according to the study of brachiocephalic arteries (presence of Atherosclerotic Plaques (ASP) and stenosis ≥30%). The control group included persons who underwent a planned medical examination in the Republican clinical hospital name "G. YA. Remishevskaya" (Abakan). A total of 35 patients (26 women and 9 men, mean age 44.7±1.5 years) were selected. The study involved the Russian population (Caucasians) living in the territory of the Republic of Khakassia. All the necessary examination and data collection were conducted including anamnestic data, anthropometric examination (measurements of length and body mass, waist circumference) body mass index, laboratory examination of blood biochemical parameters (glucose and lipid) and instrumental examination (blood pressure measurement, conducting ECG and ultrasound the brachiocephalic arteries). Single-nucleotide polymorphisms (SNP) of the promoter region of the IL1B gene at position-31C/T (rs1143627) and polymorphism in the coding part of the gene in exon 5 +3953C/T (rs 1143634) were studied by restriction analysis of amplification products (RFLP analysis). Results: The risk of development of AS in patients with MS may be higher in carriers of genotype TT (OR = 1,76; 95% CI: (0,96-3,24)) or T allele (OR = 1,44; 95% CI: (0,82- 2,53)) IL1В gene in the polymorphic locus of the T-31С and genotype CT (OR = 1,85; 95% CI: (0,92-3,37)) or T allele (OR = 1,35; 95% CI: (0,63-2,89)) IL1В gene in the polymorphic locus of C + 3953T. The most common combination of gene polymorphisms IL1В was haplotype (-31) ТC/(+3953)СС in both the groups surveyed (40.6% to 36.8%, respectively). Variant (-31)TT/(+3953)CT in the main group was found significantly more often (15.8%, at χ2= 4.92, at p=0.03) than in the control group (3.1 %). The value of the odds ratio in this case was 3.99 (95% CI: (1.08-14.79), which indicates the risk of AS development against the background of MS in carriers of combined genotype inheritance (-31)TT/(+3953) CT. Conclusion: The risk of development of AS in the background of MS is increased in carriers of combinations of SNPs (-31)TT/(+3953)CT IL1В gene responsible for hyperproduction of this cytokine. In this connection, further studies of the association of genes with MS and AS components should focus on intergenic interactions.