Антенатальный период - короткий, но один из самых важных в жизни индивидума. Именно он является первым этапом существования человека, определяющим благополучие в последующем, которое зависит от экологической и социальной ситуации, состояния здоровья матери к моменту зачатия и на протяжении всей гестации. При их нарушениях развивающаяся ишемия плаценты сопровождается различными патогенетическими процессами, стимулирующими состояние хронического воспаления, активацию иммунных клеток, апоптоз трофобластов, присутствующих в децидуальной оболочке. Чрезмерная активация этих механизмов приводит к аномальной плацентации с нарушением инвазии, ремоделирования сосудов и микроциркуляции плаценты, что приводит к одному из самых сильных стрессов, лежащих в основе гипоксически-ишемического поражения головного мозга у плода и новорожденного. The antenatal period is short, but one of the most important in the life of an individual. It is he who is the first stage of human existence, determining well-being in the future, which depends on the ecological and social situation, the state of health of the mother at the time of conception and throughout gestation. With their violations, the developing ischemia of the placenta is accompanied by various pathogenetic processes that stimulate the state of chronic inflammation, activation of immune cells, apoptosis of trophoblasts present in the decidua. Excessive activation of these mechanisms leads to abnormal placentation with impaired invasion, vascular remodeling and microcirculation of the placenta, which leads to one of the most severe stresses underlying hypoxic-ischemic brain damage in the fetus and newborn.

Objective. To develop prognostic criteria for the chronic course of cytomegalovirus infection by studying disorders of the regulation of the immune response in children of the first year of life against the background of hypoxic-ischemic CNS damage.Materials and methods. 108 newborns with cytomegalovirus infection occurring against the background of perinatal hypoxicischemic lesions of the central unequal system were examined. All observed patients at 1 and 3 months of life conducted an immunological examination, including the determination of T and B-lymphocytes. Determination of the population and subpopulation composition of peripheral blood lymphocytes, activation markers was carried out by the method of one- and twoparameter phenotyping using reagents from Immunotex (France), FITC (fluorescein isothiocynate) — labeled with CD3+, CD4+, CD8+, CD20+ and PE (phycoerythrin) — labeled CD28+, CD40+. The results were recorded on a BECKMAN COULTER EPICSXL-II flow cytometer (USA) using standard protocols. The observation groups consisted of 78 children (72.2%) with an acute course of the disease (Group 1) and 30 children (27.3%) with a chronic course (Group 2).Results. Of the totality of the studied parameters of the cellular and humoral parts of the immune system, statistically significant for the prognosis of the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage were found: CD8, CD40, CD3+CD28+, CD20+CD40+. Using the PolyAnalist 3.5 Pro CNS package, systems of inequalities were obtained and a formula for predicting the chronic course of cytomegalovirus infection in children in the first year against the background of perinatal hypoxic-ischemic CNS damage was calculated.Conclusion. A statistically significant relationship was found between the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage and the level of CD20, CD4, costimulatory molecules CD3+CD28–, CD20+CD40+. The proposed diagnostic rules can be considered screening markers for the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage in newborns, which makes it possible to start specific therapy in a timely manner.

The problem of intrauterine growth retardation is currently relevant, as it is one of the causes of neonatal morbidity and mortality. Purpose. To study the course of the neonatal period and evaluate the content of arginine and glutamic acid in full-term newborns depending on the severity of intrauterine growth retardation.Material and methods. 78 full-term newborns with intrauterine growth retardation according to hypotrophic type were examined. The content of glutamic acid and arginine in blood serum was determined in the early neonatal period by capillary electrophoresis using an unmodified quartz capillary (Kapel-105, Lumeks, St. Petersburg, Russia).Results. Markers of the formation of a severe degree of intrauterine growth retardation were identified: increased levels of glutamic acid and arginine, taking into account impaired cerebral blood flow in the early neonatal period. A model is proposed for predicting the persistence of a severe degree of intrauterine growth retardation in newborns by the end of the neonatal period.Conclusion. The proposed diagnostic criteria make it possible to start specific therapy in a timely manner in order to prevent the formation of a severe degree of intrauterine growth retardation.

Aim: to determine the concentration of mold spores and causative allergens of pollen-producing grasses in the cities of Southern Russia and to assess the prevalence of multisensitization in patients with severe allergic respiratory diseases, taking into consideration mold specific IgE results. Patients and Methods: from 2018 to 2020, concentrations of airborne allergens were evaluated in Stavropol, Krasnodar and Rostov-on-Don according to international techniques, using Burkard and Lanzoni volumetric spore and pollen traps. The levels of non-bacterial allergen- specific IgE were evaluated by allergen component testing in 143 patients (69 children and 74 adults) with allergic rhinitis and atopic asthma. Results: the results of aeropalynology studies demonstrated a high concentration of mold spores in the atmospheric air of all the studied cities co-occurring with seasonal increases in pollen allergen concentrations in the atmospheric air. The South of Russia is characterized by the year-round presence of mold allergens with sporulation peaks in July, August and September. The peak utilization of healthcare services coincided with the maximal concentration of plant pollen and mold spores. The results of comprehensive allergy diagnostic testing suggest that there is a predominance of patients with multisensitization (71%), including sensitization to pollen and mold spore allergens. As a result of the overlapping of the peaks of spreading airborne pollen allergens and mold sporulation, a frequent use of short-acting emergency β2-agonists and more calls for ambulance service are reported. Conclusion: the predominance of patients with multisensitization leads to the development of severe allergic respiratory diseases. Measures of timely management and prevention are needed for such patients. A daily monitoring of sporulation levels and pollen allergens in the air may help to avoid contacts with high concentrations of causative allergens and to implement the necessary preventive measures. The annual aeropalynology monitoring will provide an opportunity to predict allergen concentrations in the atmospheric air during the current year and to develop a statistically significant monitoring model in the future. KEYWORDS: molds, ragweed, aeromycology, aeropalynology, allergens, allergen component testing. FOR CITATION: Ukhanova O.P., Bogomolova E.V., Budnikov P.V. et al. Mycotic risk factors for the development of severe respiratory allergosis in the population of southern Russia. Russian Medical Inquiry. 2023;7(2):65–74 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-65-74.

Цель: исследовать роль дофамина в развитии гиперандрогенной дисфункции яичников у девочекподростков.У 125 обследуемых девочек-подростков 15-17 лет с проявлениями андрогенной дермопатии (акне, гирсутизм) и нарушением ритма менструаций по типу олиго-и аменореи исследовались показатели дофамина, андрогенов, гонадотропинов и половых стероидов в крови. Контрольную группу составили 20 здоровых девочек-подростков.В ходе проведенного исследования было выявлено, что во II клинической группе, в которую вошли обследуемые с клиническими проявлениями андрогенной дермопатиии нарушениями менструального цикла, по сравнению представителями I группы,имеющими только проявления андрогенной дермопатии, отмечено достоверное увеличение секреции дофамина. Нами установлена положительная корреляция гормона с андрогенами, лютеинизирующим гормоном и отрицательная-с эстрадиолом, что указывало на факт влияния дофамина на систему «гипоталамусгипофиз-надпочечники-яичники».Изменения функционирования дофаминергической системы у девочек-подростков с нарушениями менструального цикл, корреляция гормона садреналовыми андрогенов, гонадотропными гормонами гипофиза и половыми стероидами подтверждает патогенетическое участие дофамина в формировании гиперандрогенной овариальной дисфункции. Возможными механизмами, приводящими кнарушению функции яичников, при гиперандрогении являются чрезмерная активация гипоталамо-гипофизарно-надпочечниковой оси, десинхронизация продукции гонадотропинов и соответственно дисбаланс половых стероидов. Ключевые слова: дофамин, гиперандрогения, девочки-подростки, овариальная дисфункция.