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The aim of the work was to study the characteristics of vaginal microbiota in women suffering from bronchial asthma, depending on the specific features of the course of pregnancy and to determine the levels of umbilical cord blood cytokines in children born to such mothers in order to identify the epigenetic factors contributing to early realization of the atopic phenotype. Patients and methods. 37 pregnant woman-baby pairs were examined. The main group included pregnant women suffering from bronchial asthma. The comparison group consisted of 24 healthy pregnant woman-baby pairs. Cord blood cytokines were studied in newborns. The quantitative and qualitative assessment of vaginal flora was carried out by the polymerase chain reaction (PCR) method. In the examined samples, control material samples (CMS) were tested, total bacterial mass (TBM), absolute counts of microorganisms were determined, followed by calculation of relative values. Also, the relative quantitative indicators of microbiota were calculated, reflecting the ratio of the number of specific microorganisms to total bacterial mass. Umbilical cord blood samples were examined for cytokines (TGF-β1, IL-10, IL-13 and IFN-γ) by ELISA in 15 babies of the main group and 24 babies of the comparison group. Discussion and conclusions. The studies conducted are demonstrative of the fact that certain features of the course of pregnancy such as threatened miscarriage or preeclampsia are the factors affecting the composition of vaginal microbiota of a pregnant woman. A shift in the ratio of the main microaerophilic bacteria of vaginal secretion toward Gardnerella vaginalis and a decrease of Lactobacillus sp. might impair the development of fetal and infant intestinal microbiocenosis. At the same time, the microbiota of the newborn is similar to that of the mother and is closest to vaginal microbiota. Normally, it is characterized by predominance of such microorganisms as Bifidobacterium longum and Bifidobacterium infantis, Bacteroidetes, Lactobacillus sp., Prevotella, Atopobium, which determine the direction of the immune response and the formation of tolerance in infancy. Conclusion. Changes in vaginal microbiota and intestinal microbiocenosis of a baby might become the epigenetic factor that triggers allergic inflammation even in utero, as evidenced by the imbalance of the main pro and anti-inflammatory cytokines (IL-13 and IL-10), the increased contents of which in the umbilical cord blood reflect the systemic response of the body to tissue and organ damage, and serves as one of the indicators of the intensity and duration of prenatal allergic inflammation, as well as progression of the disease. Higher levels of IL-13 and IL-10 in the umbilical cord blood might be regarded as a marker of the intrauterine onset of allergic inflammation in children with an allergic family history. Key words: allergy, pregnancy, vaginal microbiota, children, cytokines

Objective. To study the features of the cytokine status of neonates born to obese mothers. Patients and methods. The study included 56 full-term neonates born to mothers with normal body mass index (BMI = 18.5- 24.9 kg/m2) (n = 24) and with obesity (BMI ≥30 kg/m2) (n = 32). Both groups had no gender-related differences; there were 60 and 58% of boys, (p > 0.05), 40 and 42% of girls, respectively, (p > 0.05). Levels of TNF-α, TGF-β, IL-18, IL-13, IL-10, and IFN-γ in umbilical cord blood were determined by a quantitative enzyme-linked immunosorbent assay (ELISA). Results. Compared with children born to mothers with normal BMI, children born to obese mothers had increased levels of TNF-α (4.94 ± 3.55 (n = 24) and 12.75 ± 10.80 (n = 32) pg/mL, respectively) and IFN-γ (7098.14 (n = 24) and 25536.38 ± 9541.82 (n = 32) pg/mL, respectively) in umbilical cord blood serum. Conclusion. Maternal overweight and obesity are associated with increased levels of TNF-α and IFN-γ in umbilical cord blood serum in children, which confirms previous observations of immune dysregulation in offspring of obese mothers, providing a potential link with increased incidence of chronic inflammatory diseases and obesity in children. The mechanisms of this effect require further investigation. Key words: maternal obesity, cytokine status, umbilical cord blood, neonates, TNF-α, TGF-β, IL-18, IL-13, IL-10, IFN-γ

The paper presents a brief review of the primary and recurrent disability of persons under the age of 18 in the Voronezh Region in comparison with data on the Central Federal District and the Russian Federation. The article draws attention to the urgency of the comprehensive approach to diagnostics and development of measures of multilevel prevention and medical and social rehabilitation of patients and disabled persons with this pathology. It highlights the great importance of rehabilitation and habilitation for the formation or recovery of their social and professional status.

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