The relationship between the gut microbiota and chronic insomnia remains understudied. The aim of this paper was to investigate changes in the taxonomic composition of the gut microbiota and their associations with the levels of cortisol, melatonin and IL6 in patients with chronic insomnia. Our comparative prospective cross-sectional study enrolled 55 patients with chronic insomnia, who formed the main group (female patients: 58.2%, male patients: 41.8%; mean age 31.6 ± 7.4 years), and 50 healthy volunteers, who comprised the control group (females: 68.0%, males: 32.0%; mean age 33.2 ± 6.6 years). The taxonomic composition of the gut microbiota was profiled using 16S rRNA gene sequencing. Plasma cortisol and IL 6 and urine melatonin were measured by means of ELISA. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). In patients with chronic insomnia, the abundance of Faecalibacterium (p = 0.048), Prevotella 9 (p < 0.001) and Lachnospira (p = 0.036) was lower, whereas the abundance of Blautia (p = 0.012) and Eubacteriumhallii (p = 0.003) was higher than in healthy volunteers. Significant correlations were established between the levels of IL6 and the abundance of Faecalibacterium (r = –0.44; p = 0.001) and Blautia (r = 0.42; p < 0.001), as well as between cortisol concentrations and the abundance of Lachnospira (r = –0.41; p = 0.048). The abundance of Faecalibacterium and Blautiaс was correlated with higher PSQI (r = –0.47, p = 0.001; r = 0.45, p < 0.001, respectively). Our study contributed to the pool of data about changes in the gut microbiota and their associations with some endocrine and inflammation markers in patients with chronic insomnia. These data can be exploited to propose new strategies for the diagnosis and personalized treatment of insomnia aimed at normalizing the patient’s gut microbiota.

Gut microbiota is an essential element of maintaining the immune homeostasis, including in individuals with COVID-19. The study was aimed to assess taxonomic changes in the gut microbiota and their relationship with the disease severity and the levels of IL6, IL10, IL17, and TNFα in patients with COVID-19. A total of 110 patients with COVID-19 (index group) and 98 individuals with no COVID-19 (control group) were enrolled to the comparative cross-sectional study. The gut micribiota composition was determined by shotgun sequencing. Blood serum levels of IL6, IL10, IL17, and TNFα were assessed by enzyme-linked immunosorbent assay. The following significant changes in the gut microbiota composition were observed in patients with COVID-19 in contrast to controls: decreased abundance of B. adolescentis (p = 0.048), E. rectale (p = 0.036), F. prausnitzi (p = 0.0002), B. dorei (p < 0.001), and increased abundance of R. gnavus (p = 0.012), Сl. hathewayi (p = 0.003), E. faecium (p = 0.0003). Correlations were established between the abundance of B. dorei and the IL6 levels (r = 0.49; p = 0.034), the abundance of F. prausnitzii and the levels of IL10, IL17 (r = 0.44; p = 0.001 and r = –0.52; p < 0.001, respectively). The abundance of R. gnavus correlated with the TNFα levels, and the abundance of E. faecium was related to the levels of IL6 (r = 0.47; p = 0.002) and TNFα (r = 0.56; p = 0.001). The relationship between the abundance of B. dorei, F. prausnitzii, E. faecium and the higher SHOKS-COVID clinical assessment scale scores was also revealed (r = –0.54; p = 0.001, r = –0.60; p < 0.001 and r = 0.67; p = 0.005, respectively). Targeted correction of gut microbiota may improve the COVID-19 treatment efficacy.

Currently, the issue of the relationship between gut microbiota and juvenile idiopathic arthritis (JIA) is still relevant. The study was aimed to assess alterations in the gut microbiota taxonomic composition and estimate the relationship between these alterations and cortisol, melatonin, and TNFα at the genus level in patients with JIA. The comparative cross-sectional study involved 65 patients with JIA (index group) and 60 healthy children (control group). The gut microbiota taxonomic composition and plasma levels of cortisol, melatonin, and TNFα were assessed. The following alterations of the gut microbiota taxonomic composition were found in patients with JIA: the significantly decreased abundance of Anaerostipes (р = 0.042), Lachnospira (р = 0.034), Roseburia (р = 0.002), Coprococcus (р = 0.014), Dialister (р = 0.003) and the increase in the abundance of Ruminococcus (р = 0.012). There were significant correlations of cortisol levels with the abundance of Lachnospira (r = –0.44; p = 0.001), melatonin concentrations and the abundance of Coprococcus (r = –0.48; p = 0.023), the levels of TNFα and the abundance of Ruminococcus (r = 0.52; p = 0.001). The association of the Lachnospira, Roseburia, and Ruminococcus abundance with the higher DAS28 scores was discovered (r = –0.57; p = 0.002; r = –0.44; p = 0.002; r = 0.54; p = 0.032, respectively). The findings provide additional information about the features of gut microbiota alterations and their correlation with some hormone and inflammatory biomarkers associated with JIA, that could provide the basis for further research and possibly for new approaches to treatment of this disorder.

One of the features of rheumatoid arthritis, as a multiple-factor disease, is the presence of somnological disorders. The aim of the paper is to study the efficacy of synthetic melatonin in insomnia correction and melatonin effect on clinical parameters and quality of life in patients with rheumatoid arthritis. Materials and Methods. The study involved 89 patients, aged 18–45 years old with verified rheumatoid arthritis. The authors used a questionnaire technique to identify subjective sleep quality, the Insomnia Severity Index; Ritchie index, Visual analog scale; TSQM1.4; MOS SF-36. Results. The use of synthetic melatonin for insomnia correction in patients with rheumatoid arthritis improves the basic sleep characteristics. The most pronounced changes were observed in the following parameters “quality of sleep”, “duration of sleep” and “frequency of nocturnal awakenings”; positive dynamics of the Ritchie index: reduction of morning stiffness, severity of articular and algetic index. High values of treatment persistence can be considered as significant results of the study. In the course of treatment, there was a significant improvement in the indicators of psycho-emotional status, vitality and algia impact on daily activities. There was a tendency towards a decrease in the quality of life assessment due to the reversed insomnia 30 days after the end of therapy. Conclusion. The use of synthetic melatonin in patients with rheumatoid arthritis improves the basic sleeping characteristics, indirectly affects the basic clinical manifestations of the underlying disease and improves the quality of life. At the same time, the therapeutic effect is short-term: the results of dynamic monitoring of the quality of life 30 days after the end of therapy indicated a decrease in both mental and physical components, which was caused by the reversed insomnia and, as a consequence, a general deterioration in the somatic and mental state. Keywords: rheumatoid arthritis, insomnia, synthetic melatonin, treatment. Одной из особенностей ревматоидного артрита как полифакторного с точки зрения характера клинических проявлений заболевания является наличие сомнологических нарушений. Цель – изучение эффективности синтетического мелатонина в коррекции инсомнии и его влияния на клинические показатели и качество жизни больных ревматоидным артритом. Материалы и методы. В исследовании приняли участие 89 больных в возрасте от 18 до 45 лет c верифицированным ревматоидным артритом. В работе использовали анкетную методику выявления субъективных характеристик сна, опросник Insomnia Severity Index; индекс Ричи, Visual analog scale; опросник TSQM1.4; MOS SF-36. Результаты. Применение синтетического мелатонина для коррекции инсомнии у больных ревматоидным артритом позволяет улучшить основные характеристики сна. Наиболее выраженные изменения наблюдались по параметрам «качество сна», «продолжительность сна» и «частота ночных пробуждений»; по показателям индекса Ричи (сокращение продолжительности утренней скованности, выраженности суставного и алгического индекса). Значимым результатом исследования можно считать высокие значения приверженности терапии. На фоне лечения достоверно улучшились показатели психоэмоционального статуса, жизненной активности и влияния алгии на повседневную деятельность. Через 30 дней после завершения терапии регистрировалась тенденция к снижению оценки качества жизни, обусловленному реверсированием инсомнии. Выводы. Применение синтетического мелатонина у больных ревматоидным артритом позволяет улучшить основные характеристики сна, опосредованно влияет на базовые клинические проявления основного заболевания и способствует повышению уровня качества жизни. В то же время терапевтический эффект является краткосрочным: результаты динамического мониторинга качества жизни спустя 30 дней после завершения терапии свидетельствовали о снижении как психического, так и физического компонента, что преимущественно было обусловлено реверсированием инсомнии и, как следствие, общим ухудшением сомато-психического состояния. Ключевые слова: ревматоидный артрит, инсомния, синтетический мелатонин, лечение.

Dyssomnic disorders (DD) associated with juvenile rheumatoid arthritis (JRA) are some of the most common conditions that are difficult to endure and that lead to deconditioning. This study aimed to assess prevalence and structure of DD, their relationship with clinical picture peculiarities and contribution to deterioration of the quality of lives of JRA patients. At the 1st stage, we assessed prevalence of DD in a continuous sample of JRA patients and healthy children aged 8–16 years. At the 2nd stage, we assessed DD structure, features associated with gender and age, connections to the key clinical characteristics of JRA and quality of life of the patients. In the context of the study, we used the SDSC sleep quality scale, the PedsQL 4.0 quality of life model, and the Ritchie index. DD develop in JRA patients 3.3 times more often than in healthy children (in 178 (72.3%) and 93 (22.2%) children, respectively). The DD registered were sleep initiation and maintenance disorders (54 cases, 22.0%), respiratory disorders (32 cases, 13.0%), sleep-to-wakefulness transition disorders (31 cases, 12.6%), excessive sleepiness disorders (38 cases, 15.4%), combinations thereof (23, 9.3%). Girls had sleep initiation and maintenance disorders more pronounced (p = 0.003), boys were more prone to excessive sleepiness (p = 0.008). The severity of DD increases with patients' age (r = 0.69; p = 0.001) and JRA onset age (r = 0.71; p = 0.001); they are also more severe in polyarticular JRA patients (r = 0.32; p = 0.048). We have clarified the relationship between DD and indicators of inflammatory (r = 0.56; p = 0.001) and Ritchie indices (r = 0.44; p = 0.005), duration of morning stiffness (r = 0.49; p = 0.029). The proven connection between DD and JRA entails the need for routine checks for DD in such patients, and, when discovered, DD should call for personalized therapeutic and diagnostic approach rather than be regarded as one of the JRA syndromes.