Aim. To study the frequency of polymorphic gene variants encoding proteins of renin-angiotensin system [AGT Thr174Met (rs 4762), AGT Met235Thr (rs699), AGTR1 A1166C (rs5186)], endothelial factors [NOS3 C786T (rs2070744)], and folate cycle enzymes [MTHFR C677T (rs1801133)] in patients with various ischemic stroke severity. Methods. 98 patients with ischemic stroke verified by magnetic resonance imaging and computed tomography scan of the brain, were examined. The severity of stroke was assessed by National Institutes of Health Stroke Scale. The allelic variants of genes were typified by polymerase chain reaction with the detection of amplification products in the «real time» mode. Results. The analysis of genetic polymorphism frequency of renin-angiotensin system did not reveal statistically significant differences in the study groups. The polymorphism of NOSC786T gene in the study was also not associated with the severity of ischemic stroke. Among the studied polymorphic variants, only the C677T polymorphism of MTHFR gene was revealed to be reliably associated with severe course of acute cerebral ischemia. Conclusion. C677T polymorphism of MTHFR gene is reliably associated with severe course of acute cerebral ischemia; carriage of 677T allele of MTHFR gene in the studied category of patients can cause an increased level of homocysteine and have an adverse effect on the course of acute cerebral ischemia.

Адрес для переписки:Баранова Надежда Ивановна ГБОУ ДПО «Пензенский институт усовершенствования врачей» Министерства здравоохранения РФ 440060, Россия, г. Пенза, ул. Стасова, 8а. Тел./факс: 8 (8412) 43-43-57. E-mail: giuv@sura.ru Address for correspondence: Baranova Nadezhda I. Penza Institute of Postgraduate Medical Education 440060, Russian Federation, Penza, Stasova str., 8a. Phone/Fax: 7 (8412) 43-43-57. E-mail: giuv@sura иммунология, 2015. Т. 17, № 2. С. 167-172. doi: 10.15789/1563-0625-2015-2-167-172 © Баранова Н.И. и соавт., 2015 Immunologiya, 2015, Vol. 17, no. 2, pp. 167-172. doi: 10.15789/1563-0625-2015 Резюме. Проведено обследование 50 пациентов с хронической аутоиммунной крапивницей (ХАК) и 48 пациентов с хронической идиопатической крапивницей (ХИК). Изучено содержание цитоки-нов IL-4, IL-10 и IL-17A в сыворотке, в спонтанной и индуцированной продукции клетками крови, а также полиморфизм генов цитокинов IL-4 (С-589Т), IL-10 (G-1082А), . Не обна-ружено различий при изучении показателей IL-4 в зависимости от генетических вариантов изуча-емых полиморфизмов у больных ХАК и ХИК. Выявлено повышение показателей IL-10 у больных ХИК, которое не имело взаимосвязи с генотипом IL-10 (G-1082A). Повышенные показатели IL-17A у пациентов с ХАК ассоциировались с гомозиготным носительством АА по сравнению с контрольной группой и гетерозиготным носительством GA по сравнению с группой ХИК. Выявленные различия полиморфизма генов цитокинов при ХАК и ХИК свидетельствуют о различиях молекулярно-генети-ческих основ формирования изучаемых форм ХК.

Rhinitis is a socially significant and widespread disease. Often, various forms of rhinitis are combined, and thus cause severe clinical manifestations, insufficient effectiveness of drug treatment, as well as difficulties in differential diagnosis. It is known that a significant number of patients have a combination of allergic rhinitis (AR) with chronic rhinosinusitis of bacterial etiology. This condition is based on a chronic multifactorial inflammatory process of the nasal mucosa, which determines the steady progression of the disease. Of interest is the study of a number of allergo-immunological parameters in nasal secretions in order to assess local inflammation and changes in mucosal immunity in allergic rhinitis in combination with chronic rhinosinusitis of bacterial etiology (AR with HRSBE). Mucosal immunity and biological mediators determine local inflammation and pathophysiological response to etiological factors in the immunopathogenesis of AR with CRSBE. The work carried out the determination of the level of cytokines: IL-4, IL-10, TGF-â1, IFNã spontaneous and induced; immunoglobulins: IgA, IgM, IgG, sIgA in nasal secretions; leukotrienes: LT C4/ D4/E4 and LTB4 in plasma and total IgE in serum in patients with AR with moderate-severity HRSBE without exacerbation. It has been shown that the leading role in the formation of the inflammatory process in AR with CRSBE belongs to cytokines: IL-4, IL-10, TGF-â; immunoglobulins: IgM, sIgA; leukotrienes: LT C4/D4/E4 and LTB4 and total IgE. Induced cytokine production largely reflects the reserve capabilities of immunocompetent cells in response to the action of a pathogenic factor. The results obtained are associated with the persistent course of allergic and infectious inflammation and the progression of the disease. Thus, cytokines: IL-4, IL-10, TGF-â1; immunoglobulins: IgM, sIgA, IgE total and LT C4/D4/E4 and LTB4 make a significant contribution to pathogenetic mechanisms, determining the clinical course of AR with CRSBE, and can serve as biological markers of the activity of the pathological process. Undoubtedly, the immune mechanisms in the combined pathological inflammatory reaction from the mucosa in AR with HRSBE are complex and multifaceted. A personalized approach to the treatment of patients with AR with CRSBE is determined by the severity and intensity of the inflammatory reaction, as well as mucosal mucosal immunity disorders. The study of the role and significance of the production of leading cytokines, immunoglobulins in nasal secretions, as well as leukotrienes and total IgE in the blood will help the doctor in determining the tactics and duration of pharmacotherapy.

The aim of the research. To study the role of fi laggrin protein in pathogenesis of atopic dermatitis (AD) exacerbation during gestation and to evaluate the effectiveness of the “emollient + topical antipruritic agent” combination therapy. Material and methods. A total of 110 female patients were examined. Among them, 70 were pregnant women with exacerbation of AD, 20 were non-pregnant women with AD exacerbation and 20 were healthy pregnant women. The AD severity was assessed using a point scale – the SCORAD index. Pruritus characterisation was performed using the 5-D Itch Scale by Elman. The serum filaggrin protein level was measured by ELISA. The efficacy of the combination therapy was assessed aft er treatment and included evaluation of AD severity, pruritus, and filaggrin protein levels. Statistical processing of the results was carried out using the Statistica 6.0 application soft ware package. Results. As the result of the study, it was found that the serum filaggrin level was higher in pregnant women with exacerbated AD than in the group of non-pregnant women with exacerbated AD (Mann-Whitney test, p = 0.007) and healthy pregnant women (Mann-Whitney test, p = 0.001). Filaggrin levels decreased after combination therapy. Pruritus evaluation revealed no significant difference between the groups with exacerbated AD (Mann-Whitney test, p = 0.221). After treatment, a significant decrease (Mann-Whitney test, p = 0,001) in itching was noted in the group of pregnant women with AD exacerbation. The mean value of the SCORAD index before and after treatment in the group of pregnant women with AD decreased significantly (Mann-Whitney test, p = 0.001). Conclusion. According to the data obtained, the level of filaggrin in pregnant women with exacerbation of AD is significantly higher than in the control groups. Against the background of combination therapy, there is positive dynamics of the clinical course of AD, as well as a decrease in the level of filaggrin in the blood serum. Further research in this area is required.