The present study reports on the frequency and the spectrum of genetic variants causative of monogenic diabetes in russian children with non-type 1 diabetes mellitus. The present study included 60 unrelated russian children with non-type 1 diabetes mellitus diagnosed before the age of 18 years. Genetic variants were screened using whole-exome sequencing (WeS) in a panel of 35 genes causative of maturity onset diabetes of the young (ModY) and transient or permanent neonatal diabetes. Verification of the WeS results was performed using Pcr-direct sequencing. a total of 38 genetic variants were identified in 33 out of 60 patients (55%). The majority of patients (27/33, 81.8%) had variants in ModY-related genes: GCK (n=19), HNF1A (n=2), PAX4 (n=1), ABCC8 (n=1), KCNJ11 (n=1), GCK+HNF1A (n=1), GCK+BLK (n=1) and GCK+BLK+WFS1 (n=1). a total of 6 patients (6/33, 18.2%) had variants in ModY-unrelated genes: GATA6 (n=1), WFS1 (n=3), EIF2AK3 (n=1) and SLC19A2 (n=1). a total of 15 out of 38 variants were novel, including GCK, HNF1A, BLK, WFS1, EIF2AK3 and SLC19A2. To summarize, the present study demonstrates a high frequency and a wide spectrum of genetic variants causative of monogenic diabetes in russian children with non-type 1 diabetes mellitus. The spectrum includes previously known and novel variants in ModY-related and unrelated genes, with multiple variants in a number of patients. The prevalence of GCK variants indicates that diagnostics of monogenic diabetes in russian children may begin with testing for ModY2. However, the remaining variants are present at low frequencies in 9 different genes, altogether amounting to ~50% of the cases and highlighting the efficiency of using WES in non-GCK-ModY cases.

Results of the prospective study conducted to assess the perinatal risk factors contribution in the asthma phenotypes formation in childhood are presented. Of 712 children, which have been observed from the first wheezing onset in St Petersburg’s state ambulances, 238 children with bronchial asthma developed in later years of life were included in random sample. Bronchial asthma proceeded in the structure of atopic disease in 128 children (phenotype ABA), and as the part of the limited allergic lesion of respiratory tract - in 110 children (phenotype RBA). It was found that bronchial asthma in mother, especially mother’s asthma with the early age onset, pregnancy pathology and maternal Smoking during pregnancy are the most significant risk factors which contribute in formation of ABA asthma phenotype. Maternal Smoking during pregnancy increased the frequency of severe asthma with ABA phenotype in the offspring during next years of their life. Clinically, the ABA phenotype is characterized by more frequent debut at the age of 1 year and usually diagnosed before 7 years of age, the presence of food sensitization in 70-90 % of cases, and a high level of hyperimmunoglobulinemia E. Such triggers as the Cesarean delivery, absence of the breastfeeding and exposure to tobacco products in the first years of life are the most significant risk factors in formation of the RBA asthma phenotype. The absence of allergic diseases in both parents or allergic ллерголог in mothers, later age debut and diagnosis of asthma, extremely low frequency of food sensibilization (less than 15 %), high frequency of hyperresponsivity, and low frequency of hyperimmunoglobulinemia E, exceeds the norm in 2 times are the typical features of RBA asthma phenotype.

Bronchial asthma (BA) is a multifactorial disease, genetic factors play an important role in its etiopathogenesis. At the same time, data on associations of polymorphic variants of the estrogen receptor gene with BA are quite contradictory. Objective of this research was to study the peculiarities of allele polymorphism frequencies of ER1 and TNF-α genes and their combinations in patients with atopic BA depending on the disease severity. Materials and methods: in the course of a retrospective single-center comparative pilot study by PCR/RFLP analysis, the frequencies of alleles and genotypes for the ER1 and TNF-α genes were determined in 78 prepubertal children (9 [6–13] years) with atopic BA. The population comparison group included 115 people. Results: the study revealed that in BA patients with moderate severity, genotypes Xx (48% and 14%; OR=6,067 CI=[1,653–22,268]), and Pp (94% and 47%, respectively; OR=18,074 CI=[2,319–140,854]) of the ER1 gene were statistically significantly more common than in the comparison group. A statistically significant difference was found in the distribution of genotype combinations for the XbaI and PvuII polymorphisms of the ER1 and –308A genes>G of TNF-α gene polymorphism in patients with BA and in the comparison group (2=31,761, p=0,0043). The frequency of the combined a-PpXx genotype in BA patients was higher than in the comparison group (22% and 3%, OR=11,09, p<0,0001). Conclusion: associations were found between the severity of BA and the genotype of the ER1 gene. The revealed absence of associations of polymorphism of the ER1 gene and BA with gender is probably due to the fact that we observed the direct influence of genetic factors without the influence of hormonal background.

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