Results of comprehensive ELISA tests of blood serum for the presence of IgM-, IgA-, and IgG-antibodies to herpes simplex virus types 1 and 2, cytomegalovirus, Epstein-Barr virus, human herpesvirus 6, human herpes virus 8 type, Chlamydia trachomatis in 38 patients with uveal melanoma are presented. The polymerase chain reaction was used to detect DNA of these pathogens in tumor biopsies, vitreous body of 10 enucleated eyes, as well as in plasma IgG-antibodies to HHV 6 were revealed in 50% of patients; IgG-antibodies to HHV 8, in 5.3% of patients. Among the 16 patients with uveal melanoma at advanced stages, 6 patients had antibodies indicative of EBV reactivation (1.2-3.3). Chlamydia trachomatis genome was detected in both biopsies; in one of them, in conjunction with EBV and CMV DNA . Tissue samples from the identified infectious agents were related only to the spindle-cell histologic type AB of uveal melanoma. In plasma, genomes of pathogens were not determined. The results indicate the presence of infectious agents in patients with uveal melanoma and require further study of the pathogenetic role of infections in the pathogenesis of uveal melanoma.

Coronaviruses (CoV) are a large group of RNA viruses that are pathogenic to animals and humans. Until the end of the 20th century, human CoV were known as pathogens of seasonal mild respiratory diseases. In the last 20 years new CoVs caused three outbreaks of severe acute respiratory diseases with a predominant lesion of the lower respiratory tract: SARS-CoV — the causative agent of the severe acute respiratory syndrome (SARS) in 2002–2003; MERS-CoV that induced Middle East respiratory syndrome (MERS) in 2012 and SARS-CoV-2 the causative agent of the coronavirus disease-19 (COVID-19), a pandemic of which began in China in late 2019 and is ongoing. The review presents current data on SARS-CoV-2, ways of contagion, transmission routes, detection time in the body, the role of asymptomatic virus carriers in the epidemic process. Advantages and disadvantages of the main laboratory methods of COVID-19 diagnosis are described: polymerase chain reaction (detection of viral RNA) and serological tests (detecting IgG-and IgM-specific antibodies). The data on conjunctivitis, the main currently known ocular symptom of COVID-19, are summarized. The role of the tear and eye discharge as a possible source of infection is discussed, as well as the role of the eye as the entrance gate of the virus with the subsequent development of respiratory infection. The high professional risk of ophthalmologists being infected through close contact with the patient during the examination is outlined. A system of complex protection of ophthalmologists against contagion during examination of patients, proposed in some countries, is presented.

Резюме. Эндогенные увеиты (ЭУ) у детей -многофакторное заболевание, угрожающее зрительным функциям глаза и снижающее качество жизни пациента. Пролиферативный синдром (ПС) с развитием спаек, помутнений стекловидного тела, эпиретинальных и преретинальных мембран -одно из наиболее тяжелых осложнений ЭУ, его патогенез не ясен. Среди многочисленных триггерных факторов предполагается роль инфекций, в частности вирусов группы герпеса человека. Цель -определить возможную роль Herpes simplex viruses type 1 (HSV-1), Herpes simplex viruses type 2 (HSV-2), Epstein-Barr virus (EBV) и Cytomegalovirus (CMV) в патогенезе ПС у детей с эндогенными увеитами. Обследовано 112 пациентов в возрасте от 3 до 17 лет (средний возраст 10 лет) с наличием явлений пролиферации разной степени выраженности (93 пациента) и без них (19 детей). В иммуноферментном анализе выявляли IgM, IgG-антитела (маркеры хронической и активной инфекции) к HSV-1/2, EBV и CMV. Достоверное повышение частоты ПС в группе инфицированных по сравнению с неинфицированными детьми выявлено только при EBVинфекции (р = 0,03) и не отмечено при инфекциях, вызванных HSV-1/2 (р > 0,05) и CMV (р > 0,05). Однако возникновение ПС у пациентов, не инфицированных EBV, указывает на наличие и других факторов, способствующих пролиферации при интраокулярном воспалении. У 28 детей одновременно в сыворотке крови в рамках мультиплексного анализа определяли содержание IL-8 и IL-6. IL-8 выявлен в сыворотках всех обследованных, при этом наблюдались большие колебания его индивидуальных уровней (5,6-2743 пг/мл). Отмечена тенденция к усилению системной продукции IL-8 у пациентов с более интенсивными явлениями пролиферации и наличием серологических маркеров реактивации EBV. IL-6 в сыворотке крови обнаружен почти в 2 раза реже IL-8 -у 55% обследованных (разброс индивидуальных показателей 1,3-35,5 пг/мл). Корреляции между степенью выраженности пролиферативного синдрома, активностью EBV-инфекции и системным уровнем IL-6 не установлено. Необходимы дальнейшие исследования для оценки роли EBV в патогенезе пролиферативного синдрома при эндогенных увеитах у детей, так как подтверждение выявленных тенденций может служить обоснованием для включения в комплексную терапию противогерпетических препаратов. увеит, пролиферативный синдром, Ключевые слова: вирус

In this work, the results of a comprehensive laboratory examination of 37 children with retinoblastoma were described. The presence of Igm-, IgA, - IgG- antibodies to the herpes simplex virus types 1 and 2, cytomegalovirus (СMV), epstein-Barr virus (eBV), human herpes virus (HHV) type 6, Toxoplasma gondii, mycoplasma hominis and ureaplasma urealyticum in the serum was tested using ELISA. In the polymerase chain reaction the DNA of these pathogens were detected in the blood plasma of 18 patients and tumor biopsy specimens from 10 eyes. The results showed that children with RB were predominantly infected by the herpesviruses, among which prevailed CMV. in 4 of 5 enucleated eyes the DNA of herpesvirus [CMV (2 eyes), EBV (1 eye), HHV 6 (1 eye)] and ureaplasma urealyticum (1 eye) were also present in tumor tissue. Nucleic acid of infectious microorganisms were considerably more often detected in the tumor tissue than in plasma (5 of 10, 1 of 18, respectively; p = 0.023), suggesting thereby the presence of the virus in the eye and its adverse role in the pathogenesis of the RB.

The immune response to any antigen includes the induction of effector and regulatory T lymphocytes. In tumors, an imbalance in the subpopulation of lymphocytes is noted. Ophthalmotropic pathogens of herpes virus infections play a role in the etiopathogenesis of some oncological processes in the tissues of the eye. Their “cancer modulating” role is to regulate the functions of immunocompetent cells by viruses and reprogram it in the direction of greater progression of tumor growth. The aim of our study was a comparative analysis of the content of effector subpopulations of blood lymphocytes in patients with uveal melanoma during activation and the chronic course of herpes virus infection. The study involved 141 people: with uveal melanoma 70 patients, with corneal ulcers and involvement of the uveal tract - 38 patients and 33 healthy donors. Immunophenotyping was performed by flow laser cytofluorimetry using a monoclonal antibody system to differentiate lymphocyte subpopulations. IgM and IgG antibodies to herpes virus infections were determined in an enzyme-linked immunosorbent assay (ELISA) on an automatic ELISA analyzer "Lazurite" (USA) with diagnostic kits of CJSC Vector-Best (Koltsovo). The results of the study showed that the absolute number of blood lymphocytes (CD45 +) in patients with uveal melanoma, regardless of the presence of active or chronic herpes virus infection, did not differ from the values in healthy donors. In patients with corneal ulcers involving the uveal tract, an increase was noted. A decrease in the relative and absolute content of T cells (CD3+) was revealed in patients with uveal melanoma during activation and the chronic course of herpes virus infection. An increase in the absolute content of CD3 + was noted in patients with active and chronic herpesvirus infection in patients with inflammatory lesions of the eye. There was no difference in the relative and absolute contents of the subpopulation of CD3 + CD4 + helpers / inducers upon activation of herpes virus infections in tumor. With corneal ulcers - a significant increase in the absolute content of CD3 + CD4 + helpers / inducers with active and chronic infection. In chronic herpes virus infection, an increase in the relative and absolute number of cytotoxic T-lymphocytes (CD3 + CD8 +) with uveal melanoma was revealed. With active infection, a decrease in the relative number of T-lymphocytes (CD3 + CD8 +) in the tumor was noted. With corneal ulcers involving the uveal tract, an increase in the absolute content during activation and chronic infection and a decrease in the relative content compared to the norm were determined. When analyzing the “double positive” T cells in a tumor, an increase in relative and absolute indices was observed in chronic and active infection with herpes viruses. The same trends were observed with inflammatory eye diseases. Analysis of the content of B-lymphocytes (CD19 +) in blood with melanoma showed an increase in the absolute number during activation and the chronic course of herpes virus infection. When analyzing the indicators of the absolute and relative content of B-lymphocytes (CD19 +) with inflammation of the membranes of the eyes, their increase was revealed regardless of activation or chronic infection. The relative number of natural killers (CD16 + CD56 +) of blood with uveal melanoma increased with infection activation. In inflammatory eye diseases, a decrease in the relative content of natural killers (CD16 + CD56 +) was found in chronic infection and active herpes virus infection. With melanoma, no changes in the index of the ratio CD4 + / CD8 + were detected, with ulcerative lesions of the cornea involving the uveal tract, its increase was noted in acute and chronic infections with herpes virus infections. (p <0.05). Thus, our own studies suggest a deep suppression of the immune system of the body of patients with uveal melanoma, which does not allow the activation of antiviral protection. Tumor causes multidirectional shifts in the relative and absolute content of lymphocytes during activation and chronic infection with herpes virus infections. The results obtained are important for the development of personalized approaches to the prognosis and treatment of patients with uveal melanoma.