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Psoriasis is a life-long chronic autoimmune disease characterized by thick scaly skin lesions and often associated with severe arthritis. At the present stage, psoriasis is considered to be a systemic disease that affects not only skin but also joints of patients and is accompanied by possible development of typical comorbid states (cardiovascular pathology, chronic inflammatory intestinal canal diseases, and metabolic syndrome).
Objective — to improve the diagnosis of arthropathic psoriasis (AP) taking into account some of the most important indicators of the immune-endocrine system and features of the disease course to specify their role in the pathogenesis of the disease and to develop the system of integrated therapy.
Materials and methods. A total of 178 AP patients have been systematically examined that had varying severity of process development, generalization and intensity of skin and osseous-articular apparatus damage, the presence of associated pathology. Additional instrumental studies, determination of biochemical, serological parameters and an assessment of stress-induced immune-endocrine system have been conducted in AP patients. The content of trigger cytokines (IL-1, IL-8, IL-17, IL-22) in blood serum, stress hormones (ACTH, cortisol), cellular and humoral immunity condition (CD3+, CD4+, CD8+, CD16+, CD22+, IgM and IgG levels) have been studied.
Results and discussion. The clinical course and characteristic features of AP instrumental tests are extremely versatile. Regardless of the disease duration period, we have detected in blood serum of AP patients probable decrease in parameters of cellular immunity (CD3+, CD4+, CD8+-fraction of T-lymphocytes, CD22+-fraction of B-lymphocytes) and compensatory increase in CD16+ of T-cells, decrease in parameters of cytokines (IL-1, IL-8, IL- 17, IL-22), stress hormones (cortisol, immunoglobulins IgM, IgG, and CIC), which indicates tension of their stress-induced mechanisms even despite occasional clinical stabilization of skin and articular process. We have offered and tested regiments to treat AP patients, which involve differential application within the integrated therapy of nonsteroidal anti-inflammatory medications (etoricoxib 30—60 mg 1 time daily/diclofenac 75 mg daily), diseasemodifying medications (sulfasalazine ЕН from 500 mg to 2 g daily/methotrexate 7.5—10 mg/week), lyophilised dialysate of leukocytes.
Conclusions. The analysis of specific features of the AP clinical course and data of integrated studies allows identifying the probability of manifestation or persistence of the pathological psoriatic articular process. The improvement of AP patients diagnostics taking into account some of the most important indicators of the immune-endocrine system and specifics of the disease course contributed to the improved therapy and mended quality of life of patients.

A capability for effective tissue reparation is a living requirement for all multicellular organisms. Bone exits as a precisely orchestrated balance of bioactivities of bone forming osteoblasts and bone resorbing osteoclasts. The main feature of osteoblasts is their capability to produce massive
extracellular matrix enriched with calcium phosphate minerals. Hydroxyapatite and its composites represent the most common form of bone mineral providing mechanical strength and significant osteoinductive properties. Herein, hydroxyapatite and fluorapatite functionalized composite scaffolds based on electrospun polycaprolactone have been successfully fabricated. Physicochemical properties, biocompatibility and osteoinductivity of generated matrices have been validated. Both the hydroxyapatite and fluorapatite containing polycaprolactone composite scaffolds demonstrated good biocompatibility towards mesenchymal stem cells. Moreover, the presence of both hydroxyapatite and fluorapatite nanoparticles increased scaffolds’ wettability. Furthermore, incorporation of fluorapatite nanoparticles enhanced the ability of the composite scaffolds to interact and support
the mesenchymal stem cells attachment to their surfaces as compared to hydroxyapatite enriched composite scaffolds. The study of osteoinductive properties showed the capacity of fluorapatite and hydroxyapatite containing composite scaffolds to potentiate the stimulation of early stages of
mesenchymal stem cells’ osteoblast differentiation. Therefore, polycaprolactone based composite scaffolds functionalized with fluorapatite nanoparticles generates a promising platform for future bone tissue engineering applications.

In accordance to Rome IV Criteria irritable bowel syndrome (IBS) is classified into four subtypes: IBS with predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), with mixed bowel habits (IBS-M) or IBS, unsubtyped. Some authors distinguish a post-infectious subtype of IBS, in which an acute episode of infectious gastroenteritis is a trigger of the disorder. In all the other cases, mostly psycho-emotional stress is the trigger factor, with this variant being defined as stress-associated subtype of IBS.  

Aim: to study the peculiarities of the formation and course of IBS in children, depending on the trigger factor. A total of 54 patients aged 6-12 years with a verified diagnosis of IBS according to Rome criteria IV have been examined. The trigger factor of the onset of IBS was established by the interrogation of patients and their parents. The levels of trait anxiety and somatization were assessed by Children's Form of the Manifest Anxiety Scale (CMAS) questionnaire and Somatoform Symptom Screening (SOMS) test respectively. The Catechol-O-methyltransferase (COMT) gene val158met polymorphism was estimated by the polymerase chain reaction. Enzyme immunoassay Ridascreen Calprotectin (R-Biopharm AG, Germany) was used for the quantitative determination of calprotectin in stool samples.

Results. We have diagnosed post-infectious subtype of IBS in 30 children. In this group we have found significantly higher concentration of fecal calprotectin (60.0 (35.6; 129.0) vs 31.2 (21.1; 58.7 mkg/g of feces)), which is consistent with pathogenesis of this subtype of IBS. On the contrary, we have discovered that psycho-emotional stress was the trigger factor of the onset of IBS in 22 patients (stress-associated subtype of IBS). Children with stress-associated IBS had higher levels of trait anxiety (25.1±5.7 vs. 18.7±6.4) and somatization (11.1 ± 4.0 vs. 8.6 ± 3.1) in comparison to patients with post-infectious subtype of the disorder. Furthermore, the analysis of the COMT gene polymorphism revealed, that almost the half patients (48%) with stress-associated IBS had 472 AA (Met/Met) genotype. Met/Met carriers have genetically determined low enzymatic activity of COMT, which may lead to decreased elimination of catecholamines and is associated with chronic stress. In contrast, only 31% of children with post-infectious subtype of IBS were found to have 472 AA (Met/Met) genotype.

Conclusions. Our study suggests that not only predominant bowel habit, but also trigger factor in the development of IBS determine the heterogeneity of the disorder. This approach may be used for classification of IBS in children, as it dictates treatment strategy.

Multisystem inflammatory syndrome in children (MIS-C) associated with Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) usually develops 1-1.5 months after mild or asymptomatic COVID-19 in countries with high incidence. MIS-C has a polymorphism of clinical manifestations, which include prolonged fever, polymorphic rash, non-purulent conjunctivitis, pneumonia complicated by distress syndrome, myocarditis, coronary artery disease, toxic shock syndrome, limb edema, polyserositis, severe abdominal syndrome with diarrhea and others. Establishing this diagnosis requires significant efforts to rule out diseases of other etiology. The aim of our study was to analyze the clinical and laboratory features of children with MIS-C associated with SARS-CoV-2 and severe abdominal syndrome. Six children with MIS-C associated with SARS-CoV-2 and severe abdominal syndrome were hospitalized in Lviv Regional Children’s Clinical Hospital “OHMATDYT”, Ukraine, from April 2020 to September 2021. For differential diagnosis IgM, IgG to SARS-CoV-2 by ELISA, RNA to SARS-CoV-2 by PCR, bacteriological tests of blood, urine and feces were performed. Furthermore, the diagnostic work up included chest radiography, echocardiography, ultrasound of the lungs and abdominal organs. Laboratory findings revealed an increase in the normal value of inflammatory markers and high levels of IgG to SARS-CoV-2. Administration of intravenous immunoglobulin at a dose of 1 to 2 g/kg body weight per day prevented further coronary artery disease in patients and provided regression in already affected coronary arteries. At the same time, regression of abdominal syndrome was observed. Early diagnosis of MIS-C in patients with SARS-CoV-2 and severe abdominal syndrome allows to define the appropriate treatment strategy.