616.61-053.2:575:576.5

It  should  be  noted  that  oxidative  stress,  as  a  universal  mechanism  of  tissue  hypoxia  at  the  cellular  level, accompanied by non-enzymatic free radical oxidation and accumulation of lipid peroxidation products (LPO) in the blood, has attracted particular interest among medical professionals in our time. Research in the last decade has shown that there are all reasons to consider the activation of free radical LPO as a nonspecifi c component of physiological and pathological reactions characterizing the stress of activation of homeostasis maintenance systems.The aim of stady to establish the relationship between the impact of LPO processes, antioxidant defense, and membrane destruction of renal epithelium in children with dysmetabolic nephropathy.Materials and methods. Two groups of examined children were formed from the examined group, including those  with  dysmetabolic  nephropathy  and  secondary  urinary  tract  infections:  Group  I  -  52  individuals  in  whom  dysmetabolic nephropathy was complicated by the superimposition of infl ammatory processes in the kidneys and urinary tract - complicated DN (I-UDN), and Group II - 56 children with uncomplicated course of DN (II-DN), (a total of 108 children). The control group consisted of 65 healthy children. In children of all groups, the indicator of LPO process activity and the indicator of catalase activity in blood and urine were determined as a mechanism for regulating the antioxidant system of the body.Results. Against the intensifi cation of lipid peroxidation and membrane destruction processes in the bodies of children  with  DN,  the  possibilities  of  antioxidant  protection  are  exhausted,  which,  in  turn,  leads  to  even  greater  intensity of the LPO process. The catalase activity indicator in urine is an informative, reliable, and sensitive marker not only for the result of the impact of epigenetic factors on a child’s body but also a prognostic marker for a more severe course of dysmetabolic nephropathy in children.Conclusions.The revealed facts allow us to assert that against the background of intensifi  cation of lipoperoxidation and  membrane  destruction  processes  in  the  body  of  children  with  DN,  the  possibilities  of  antioxidant  protection  are  depleted,  which  in  turn  leads  to  an  even  greater  intensity  of  the  process  of  lipid  peroxidation.  And  the  index  of  catalase  activity  in  urine  is  an  informative,  reliable  and  sensitive  marker  not  only  of  the  result  of  the  impact  of  epigenetic  factors  on  the  child’s  body,  but  also  a  prognostic  marker  of  a  more  severe  course  of  dysmetabolic  nephropathy in children.

616.61-053.2:575:576.5

The prevalence of dysmetabolic nephropathies in children is increasing from year to year, representing a significant problem in the overall structure of kidney diseases in pediatric age. Despite numerous studies dedicated to the issue of dysmetabolic nephropathies in children, the role of epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria remains insufficiently explored.
Aim — to identify the leading epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria in children. Materials and methods. The data from the medical histories and outpatient records of 173 children were studied. Each child was additionally
examined by narrow specialists of different profiles. Three groups were formed from the examined children: Group I — children with a complicated course of dysmetabolic nephropathy and a history of inflammatory processes in the urinary system (52 children), Group II — children with dysmetabolic nephropathy with persistent crystalluria (56 children) and the Control group, which included 65 healthy children.
Results. The most significant prenatal epigenetic factors are the threat of early miscarriage, gestosis of the first and second halves of pregnancy, maternal anemia during pregnancy, parental alcohol and tobacco use, mother's work on computer during pregnancy, presence of maternal
chronic diseases, parental exposure to industrial dust and noise, and heavy physical work of mother leading to fetal hypoxia.
Conclusion. The most significant postnatal epigenetic factors influencing children's susceptibility to a more severe course of dysmetabolic
nephropathy included low birth weight, early artificial feeding, frequent acute respiratory infections, atopic diathesis, and physiological jaundice
in the first year of life, as well as the presence of concomitant diseases such as chronic tonsillitis, dental caries, frequent acute respiratory infections, chronic gastritis, atopy, and chronic cholecystitis later in life. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of these institutions. The informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors. 


УДК 616.517-02: 616.72-002]-078.73-079.44

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.

BACKGROUND: A decrease in the incidence of syphilis has been observed in the world and in Ukraine in recent years. At the same time, an increase in cases of neurosyphilis is recorded. Diagnosis of neurosyphilis is quite difficult and based on the correct interpretation of the complex of various diagnostic tests.

OBJECTIVES: The paper is aimed to determine diagnostic potential of treponemal tests (TTs) and evaluate effectiveness of Treponema pallidum immunoblot (TPI) while research on cerebrospinal fluid (CSF) in differential diagnosis of neurosyphilis.

MATERIALS AND METHODS: The research object was CSF of patients with late forms of syphilis. The regulated serological and immunological methods in accordance with current guidelines and orders of the Ministry of Healthcare of Ukraine were used for laboratory diagnosis of neurosyphilis: Enzyme immunoassays (EIA), fluorescent treponemal antibody (FTA), T. pallidum hemagglutination assay (TPHA), and TPI.

RESULTS: Effectiveness of TTs in the diagnosis of neurosyphilis while research on 23 samples of CSF was carried out by the following methods: EIA (Immunoglobulin [Ig]M + IgG), FTA, andTPHA. The above-mentioned TTs used in serological diagnosis of CSF do not always meet the problem of confirming neurosyphilis diagnosis. According to these investigations, both positive and false positive results were obtained. In order to verify the diagnosis, a study on positive and false positive samples of CSF by TPI method was carried out. Positive results were obtained in 13 samples with the established duration of the disease.

CONCLUSIONS: TPI is an optimal treponemal immunological method of examination of CSF to diagnose neurosyphilis with a high degree of reliability. The use of TPI while research on CSF makes it possible to verify the diagnosis of neurosyphilis by differentiated detection of antibodies to the most immunogenic antigens of T. pallidum eliminating the subjective factor of the reaction and simplifies diagnostic procedure.

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.