В эпоху расшифровки человеческого генома и неуклонного роста числа социально значимых заболеваний особенно актуальны разработка, совершенствование и внедрение в клиническую практику новых методов диагностики. Под воздействием генетических факторов, внешней среды, изменения характера питания происходит стремительный рост распространенности аллергических заболеваний [1,2]. Их патогенез изучен достаточно глубоко, однако до настоящего времени некоторые вопросы остаются неясными или являются дискуссионными. Диагностика причинно-значимых продуктов при пищевой аллергии сложна, требует инвазивных вмешательств, что особенно затруднительно в младших возрастных группах [3,4]. Доказано, что аллергические заболевания, начавшись в раннем возрасте, негативно влияют на физическое, нервно-психическое развитие детей, ухудшают качество их жизни, способствуют развитию дефицитных состояний, в том числе тяжелых [3].Наиболее встречаемое проявление пищевой аллергии у детей грудного возраста -гиперчувствительность к белкам коровьего молока [1,3,5]. Основной задачей терапии при данной патологии является правильно подобранная на длительное время элиминационная диета [5,6]. Согласно последним достижениям нутригеномики, характер питания может оказывать существенное влияние на течение патологических про- © Коллектив авторов, 2016Адрес для корреспонденции: Шуматова Татьяна Александровна -д.м.н., проф., зав. кафедрой педиатрии Тихоокеанского государственного медицинского университета Приходченко Нелли Григорьевна -к.м.н., доцент кафедры педиатрии Зернова Екатерина Сергеевна -аспирант кафедры педиатрии Ефремова Ирина Владимировна -аспирант кафедры педиатрии Шишацкая Светлана Николаевна -к.м.н., доцент кафедры педиатрии Ни Антонина Николаевна -д.м.н., проф. кафедры педиатрии Григорян Ламара Артуриксовна -к.м.н., доцент кафедры педиатрии Катенкова Элина Юрьевна -к.м.н., доцент кафедры педиатрии 690002 Владивосток, пр. Острякова, д. 2

Summary: The study represents a review of publications covering molecular entity of intestinal permeability and changes causing its disorders. The current concepts on intestinal barrier, tight joints (TJ) and intestinal permeability under normal and pathological conditions are covered. Special attention has been given to molecular unions of tight joints; a role of dysregulation of the components of the TJ complex in the formation of oral tolerance and food allergy is disclosed. It is shown that the assessment of the intestinal epithelial barrier condition can be a significant diagnostic criterion to control the disease and to assess the effectiveness of treatment.

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Introduction. In the Russian Federation, the number of new cases of congenital malformations and chromosomal abnormalities reported among children from birth to 14 years of age each year is over 1,000 per 100,000 population. Therefore, the urgency of the problem of diagnosis and prevention of congenital malformations does not admit of doubt.Purpose of the study. To study the influence of antenatal risk factors on the formation of the urinary system’s congenital malformations in children.Materials and methods. The study carried out by the “case – control” method. The main group included 126 mothers who gave birth to children with kidney and urinary tract defects, and the control group included 40 women with healthy children. The assessment of the results reliability the obtained carried out by calculating the odds ratio with a 95% confidence interval.Results. The most significant factors in the formation of malformations of the urinary system were: the age of mothers over 35 years old (OR 3.264, 95% CI: 1.079–9.875), a burdened obstetric history (OR 2.380, 95% CI: 1.012–5.594), a burdened gynecological anamnesis (OR 2.825, 95% CI: 1.319–6.051), preeclampsia (OR 2.910, 95% CI: 1.057–8.010), exacerbation of opportunistic infections during pregnancy (OR 2.833, 95% CI: 1.103–7.280), the presence of chronic placental insufficiency (OR 3.413, 95% CI: 1.405–8.290), passive smoking during pregnancy (OR 2.711, 95% CI: 1.110–6.618), a burdened nephrological history in the mother (OR 3.462, 95% CI: 1.148–10.442), the presence of neurocirculatory dystonia (OR 4.703, 95% CI: 1.062–20.822). The work revealed the role of folate metabolism genes polymorphisms in the formation of kidney defects. In addition, a reliable relationship between the development of kidney and urinary tract defects with the absence of pregravid preparation was found, as well as untimely intake of folic acid preparations.Conclusions. The study made it possible to identify the most significant factors of the antenatal period, influencing the development of congenital malformations of the urinary system. The results obtained must be taken into account at the stages of planning pregnancy in an outpatient setting.

Study Objective: To find the diagnostic and pathogenetic significance of endogenous proteins in infants and toddlers with urinary tract infections (UTIs). Study Design: controlled clinical trial. Materials and Methods. We examined 34 children with UTIs aged 29 days to 2 years 11 months and 29 days. The control group included 20 healthy children. All subjects underwent measurement of serum hepatic and intestinal fatty acid-binding proteins (L-FABP, I-FABP), bacterial membrane permeability-increasing protein (BPI), as well as urinary I-FABP and zonulin using the enzyme-linked immunosorbent assay (ELISA) method. Study Results. Children with UTIs demonstrated significantly increased L-FABP and I-FABP levels vs. controls (798.89 ± 171.69 ng/mL vs. 175.86 ± 23.07 ng/mL; 92.37 ± 18.53 ng/mL vs. 19.21 ± 4.94 ng/mL, respectively, р < 0.05). BPI levels were also significantly higher (105.03 ± 38.18 ng/mL) in children with UTIs (р < 0.05). Urinary I-FABP concentration was significantly different from that in healthy children (0.11 ± 0.04 pg/mL vs. 0.039 ± 0.009 pg/mL, р < 0.05). Zonulin levels were also higher (3.15 ± 0.64 ng/mL vs. 0.12 ± 0.04 ng/mL, р < 0.01). Conclusion. The study allowed clarifying the pathogenic significance of increased intestine permeability in development of inflammations and identifying early markers of kidney nd urinary tract damages (L-FABP, I-FABP, BPI). Increased urinary I-FABP and zonulin levels can predict UTIs in infants and toddlers. Keywords: fatty acid-binding protein, membrane permeability-increasing protein, urinary tract infections.