Vol 7, No 3 (2017)

Numerous modern basic research done undeniable fact that neutrophilic granulocytes (NG) are key effector and regulatory circuits both innate and adaptive immunity, and play a crucial role in the pathogenesis of a wide range of diseases. NG have potent receptor repertoire, providing a connection between them, cells of the immune system, as well as communication with endothelial cells, epithelial and other tissues. NG inducing stimuli activate and promote the translocation of cytoplasmic granules and vesicles surface molecules on the cytoplasmic membrane the secretion of a large spectrum of pro-and anti-inf lammatory, immunoregulatory cytokines, colony, angiogenic factors and fibrogenic, TNF superfamily members, chemokines, regulatory protein, etc. Chromatin nuclei NG capable of restructuring under the influence of inducing stimuli, which is associated with the expression of multiple cytokine genes. NG receiving complex cytokine inf luence not only acquire new features, but also in various stages of activation and differentiation processes involved in intracellular intraphagosomalis degranulation and killing of implementing elimination microorganisms and extracellular neutrophil degranulation in the formation neutrophil extracellular traps (NET), while this dying through NETosis. Features NG phenotype and their functional properties, demonstrate the existence of subpopulations of NG with different capabilities: equipment of different receptor, the ability to restructure chromatin expressing cytokine genes and secrete cytokines to implement the contents of the granular system, produce reactive oxygen species, implement cytotoxicity form NET. In our opinion, there subpopulation NG: regulatory; suppressor; proinf lammatory — initiating an inf lammatory response; inf lammation with a positive potential microbicidal (antibacterial, antiviral, antifungal); inf lammatory cytotoxic potential of the negative  — “aggressive”; anti-inf lammation regulating regression; antitumoral — TAN1; pro-tumoral — TAN2; hybrid, combining the characteristics of NG and dendritic cells. The absence of adequate response, or hyperactivation blockade NG functions leads to the development of low-intensity infectious and inf lammatory diseases, do not respond to conventional therapy of autoimmune diseases/chronic immune-dependent processes. Remodeling dysfunctions NG — the key to new immunotherapeutic strategies.

Phylogeographical and philodinamic studies have shown that the hepatitis C virus began to circulate in the human population about 500–2000 years ago on the A frican continent and only in the 20th century, this virus received the ubiquitary distribution. According to WHO in the world more than 71 million people are chronically infected by the hepatitis C virus, more than half of them live in A frica and South-East Asia. At the same time, the actual prevalence of hepatitis C in most countries of sub-Saharan A frica, including the Republic of Guinea, remains poorly understood.

The aim of this study was to evaluate the occurrence of serological and molecular markers of hepatitis C on a random small selection of blood samples obtained from healthy adults of the Republic of Guinea.

Materials and methods. Serum and plasma blood samples obtained from thirty one healthy adults of 24–71 years old of the Republic of Guinea were examined. Blood samples were collected in 2015–2016 years. The serum samples were analyzed for the presence of total anti-HCV (IgG+IgM),  of specific antibodies to the core, the NS3, the NS4 and the NS5B HCV proteins, of core antigene with “DS-ELISA-ANTI-HCV-GM”, “DS-ELISA-ANTI-HCV-SPEKTRE-GM”, “DS-ELISA-HCV-Ag” detection kits (RPC “Diagnostic Systems”, Russia), respectively. RNA HCV were detected by RT-PCR with detection kit “A mpliSens HCV-FRT” (CRIE, Moscow) and by nested-PCR using the primers from 5’UTR region. HCV genotypes were determined by RT-PCR  with detection kit “A mpliSens HCV-genotype FRT” (CRIE, Moscow) and by phylogenetic analysis based on the 5’UTR region.

Results and discussion. In this pilot study, the presence of HCV markers was confirmed in 3 (9.68%, 95% CI 3.35–24.90) of 31 examined persons. Two of them had RNA HCV. Based on the phylogenetic analysis of the 5’UTR region of the HCV genome, the isolate obtained from person No. 5 belonged to genotype 1, and the isolate obtained from person No. 6 belonged to genotype 2. The obtained results together with the analyzed literature data indicate a significant burden of hepatitis C in the Republic of Guinea, and also indicate the need to develop both an algorithm of diagnostic criteria and the improvement of diagnostic test systems for mass screening of the A frican population in order to establish the proportion of persons involved in epidemic process.

The aim of the study was to examine the relationship of the phenotype and metabolism of neutrophils in patients with widespread purulent peritonitis (WPP) in the dynamics of the postoperative period. The study involved 27 patients with acute surgical diseases and injuries of abdominal organs complicated by WPP. Blood sampling was performed prior to surgery (pre-operative period) and at 7, 14 and 24 day post-operative period. As controls 67 respect healthy people were examined. Research blood neutrophilic granulocytes phenotype was performed by f low cytometry using a direct immunof luorescence whole peripheral blood. The levels of surface receptor expression was assessed by the mean f luorescence intensity. The NADand NADP-dependent dehydrogenases activity in the blood neutrophils studied using bioluminescence method. It was found that in patients with WPP in the preoperative period in the peripheral blood increased content of CD62L⁺-, HLA-DR⁺and CD64⁺-neutrophils. High levels of CD62L+-cells stored within 24 postoperative days, whereas the amount of HLA-DR⁺and CD64⁺-neutrophils on 24 postoperative day is reduced to the level of controls. The dynamics of changes in the content of CD64⁺-cells in the peripheral blood of patients with WPP corresponds to the expression level of CD64-receptor on the membrane of neutrophilic granulocytes. The metabolism of blood neutrophils in patients with WPP in the preand postoperative period is characterized by high intensity of the substrate stream on the citric acid cycle, low activity of NADP-dependent glutamate dehydrogenase and aerobic reaction of lactate dehydrogenase. In the preoperative period and within 14 days of the postoperative period in neutrophil granulocytes of the patients revealed high activity of anaerobic lactate dehydrogenase reaction characterized by increased activity of anaerobic glycolysis. In the late postoperative period the intensity of anaerobic energy in the neutrophils of patients with WPP was reduced to the control level. The final stage of post-operative treatment the metabolism in the blood neutrophils of patients with WPP is also characterized by the activation of the pentose phosphate cycle, low activity of malate-aspartate shunt mitochondria and high intensity of the substrate interaction between citric acid cycle and reactions of amino acid metabolism. Using correlation analysis set dysregulation between phenotype and the system of intracellular metabolism of neutrophils which can be determined by the migration of activated cells in the inf lammatory focus as well as changes in the activity of intracellular enzymes under different regulatory factors and including postoperative therapy methods peritonitis.

Aim. To evaluate the efficacy and safety of the generic drug Wartocid® (Imiquimod cream 5% for external use) in patients with external anogenital (venereal) warts (AGW).

Materials and methods. The single-blind comparative, randomized, placebo-controlled clinical trial included 50 women aged 18 to 60 with an established clinical diagnosis of AGW in the vulva and perianal region. Patients in group 1 received placebo cream for external use, while patients in group 2 received therapy with Wartoсid in a daily dose of 10 mg cream/cm²  of skin area. The drug was applied every other day until the complete disappearance of AGW, but in any case, not more than 16 weeks. A follow-up was carried out for 4 more weeks. The study evaluated the dynamics of subjective and objective symptoms, the presence and the frequency of relapses, and the percentage of full treatment of AGW.

Main results. Treatment with Wartoсid resulted in a complete cure of AGW in 16% of patients, and a reduction in the focus area of AGW in 36% of patients. Against the background of the placebo no dynamics of the disease were reached. Neither serious adverse events nor clinically significant changes in blood tests, urine or serum biochemical parameters in any of the patients who received treatment with Wartoсid were observed.

Conclusion. The generic drug Wartocid has been proved to be effective and safe for AGW treatment and its effectiveness is similar to the original drug Aldara® (Imiquimod cream 5% for external use).

This paper describes results of comparison of genetic sequences of inf luenza viruses obtained from clinical samples (nasopharyngeal swabs) and viruses isolated on MDCK cells and in developing chick embryos. The obtained data shows that 1–2x fold passaging of inf luenza viruses in MDCK cells does not lead to additional mutations in the genome of the inf luenza virus, and the genetic material of this virus is identical to the genetic material from the clinical sample. When passaging viruses in chick embryos within 1–2 passages, the genetic material of the virus differs from the genetic material from the clinical sample, because of mutations in the receptor region of hemagglutinin, leading to aminoacid substitution Q223R. The mutation Q223R changes the receptor specificity of hemagglutinin from human-type receptors (α-2.6-sialic acids) to avian receptors (α-2.3-sialic acids). The data obtained coincide with the data of Japanese researchers who showed that a similar substitution in the hemagglutinin gene was detected in Japanese strains of inf luenza virus subtype A (H1N1) pdm09, passaged in chick embryos for 1–2 passages. With their further passaging in chick embryos, the number of acquired mutations in the surface proteins of these viruses increases. Thus, we have shown that for the genetic analysis of epidemic-relevant strains of inf luenza viruses for routine epidemiological surveillance tasks, the use of direct sequencing of clinical samples containing the genetic material of viruses makes it possible to obtain the most reliable data, to increase their efficiency, since it saves time normally spent on virus isolation procedure. If preliminary isolation of viruses is necessary, for example, if it is not possible to carry out full genome amplification from a clinical sample (low content of the material, presence of polymerase chain reaction inhibitors), virus isolation on MDCK cells with a minimal amount of passage is optimal, which is used in practice of epidemiological surveillance.

Inf luenza and acute respiratory viral infections (ARVI) account for up to 90% of the total reported infectious morbidity annually in Russia. The economic damage from these infections reaches 86% of the economic losses associated with infectious diseases. As a result of antigenic drift or a shift, new variants of the inf luenza virus, including pandemic strains, appear. In 2009, an inf luenza pandemic arose due to the shifter version of the inf luenza A (H1N1) pdm09 virus. This virus caused epidemic rises of inf luenza in the world in subsequent years.

The aim of the study was to describe the epidemic process of inf luenza in January–March 2016 in St. Petersburg.

Materials and methods. The incidence of inf luenza and acute respiratory viral infections in St. Petersburg was recorded according to statistical coupons by age groups of the population. Examined nasopharyngeal f lushes received no later than 3–4 days from the onset of the disease, and in case of a lethal outcome — sectional material (bronchi, trachea, lungs, spleen tissues). The detection of RNA of inf luenza viruses was carried out in RT-PCR (Amplicenc Inf luenza virus A/B, Amplicenc Inf luenza virus A/H1-swine-FL, Amplicenc Inf luenza virus A типа-FL,  «Interlabservice», Moscow). Isolation of inf luenza viruses from the clinical material was carried out on culture by the MDSC cell. Isolates were typed in RTGA with diagnostic sera to reference and epidemic inf luenza viruses. Isolation of inf luenza viruses from the clinical material was carried out on culture by the MDSC cell. Isolates were typed in RTGA with diagnostic sera to reference and epidemic inf luenza viruses.

Results. In 2016, the incidence of inf luenza in St. Petersburg was 81.38 per 100 000 population and was 4.1 times higher than the incidence rate in 2015. The epidemic rise in the incidence of inf luenza and ARVI began with the 3rd calendar week, lasted 6 weeks, with a peak incidence at the 5th calendar week. In total, 398 675 people (7.6% of the population) were ill during this period, including adults — 184 658 (4%), children 0–14 years old — 214 017 or 31.5% of this age group. The greatest number of cases among children was registered in the group of 3–6 years — 87 766 (41.0%). Among the ill children, 86.2% attended pre-school children’s institutions (kindergartens). During the epidemic recovery in 2016, inf luenza viruses were detected in 297 people (46.2%): the inf luenza A (H1N1) virus pdm09 in 97.1% of cases, A (H3N2) — 0.6%, B — 2.3%. There were 102 deaths from complications after the inf luenza, including 101 cases of inf luenza A (H1N1) and A (H3N2) inf luenza A (H1N1) pdm09 confirmed by PCR. Among the dead 101 adults (including 2 pregnant women) and one child. All of them were not vaccinated against the f lu earlier. All deceased adults suffered from chronic physical illnesses.