Vol 80, No 1 (2025)

Background. Dapagliflozin is a drug from the group of type 2 sodium-dependent glucose transporter inhibitors (iNGLT2) and was previously intended only for the treatment of type 2 diabetes mellitus as monotherapy or combination therapy. According to the Clinical Guidelines, dapagliflozin is recommended for patients with chronic heart failure with reduced ejection function with persistent symptoms of heart failure despite therapy with ACE inhibitors, angiotensin II receptor anagonists, valsartan and sacubitril combination, beta-adrenoblockers and aldosterone antagonists to reduce the risk of cardiovascular death and hospitalizations for heart failure. Aims — comparative analysis of the efficacy of dapagliflozin in the treatment of chronic heart failure with reduced and preserved ejection function according to clinical trials data. Methods. Data from clinical trials of dapagliflozin efficacy in the treatment of CHF with reduced and preserved ejection fraction and including analysis of treatment data from 4744 and 6263 patients, respectively, served as materials for comparative analysis. The analysis was performed by statistically evaluating dapagliflozin for the primary endpoint (hospitalization for heart failure, seeking emergency care for heart failure) and for the total number of hospitalizations and cardiovascular deaths. Attribute statistics techniques were used as an analytical tool. Information on potential drug interactions was obtained from the specialized website Drugs.com. Results. The attributable efficacy for reduction in total hospitalizations and cardiovascular deaths for dapagliflozin was 7.72% (95% CI: 5.45–9.99) for patients with CHF with preserved ejection fraction and 7.40% (95% CI: 4.86–9.94). This rate is statistically significant for both groups. The population attributable efficacy rate was also statistically significant for both groups. The relative efficacy of dapagliflozin in reducing total hospitalizations and cardiovascular deaths was 1.12 (95% CI: 0.11–2.12) for patients with CHF with preserved ejection fraction and 1.11 (95% CI: 0.10–2.11) for patients with CHF with reduced ejection fraction. According to Drugs.com, 352 potential adverse interactions were identified for dapagliflozin, of which 1 was a dangerous clinical interaction. Conclusions. Dapagliflozin is an LP for which studies have been shown statistically significant reductions in total hospitalizations of patients with cardiovascular disease and cardiovascular deaths.

Background. Glutamate decarboxylase (GAD) antibody-spectrum diseases (GAD-ASD) are a group of relatively rare immune-mediated neurological disorders that most commonly present by such syndromes as cerebellar ataxia (СA), stiff person syndrome (SPS), limbic encephalitis (LE), epilepsy (E) and variants of their combination (overlap syndromes). The domestic literature contains descriptions of individual cases of GAD-ASD; cohort studies of GAD-ASD have not been conducted in Russia previously. Aims — to analyze clinical features and short-term outcomes in different phenotypes of GAD-ASD in a one-center cohort of Russian patients. Methods. The study was conducted between 2018 and 2024 at Research Center of Neurology (Moscow, Russia). The object of the study were 40 patients with a verified diagnosis of GAD-ASD. An assessment of the clinical picture, the results of blood and cerebrospinal fluid (CSF) laboratory tests, MRI and neurophysiological studies were carried out, the data of treatment and patient’s follow-up were analyzed. Results. Most patients were female (85%). The median age at symptom onset was 54 years (range: 18–74 years), the duration of the disease was 40.5 months (range: 1 month — 14 years). The diseases phenotypes were typical for GAD-ASD: SPS (42.5%), MA (30%), LE/E (15%), overlap syndrome (12.5%). GAD antibodies were detected in 100% of the blood and CSF samples examined. 1 case (SPS) corresponded to a “probable” paraneoplastic syndrome; 3 cases (LE, SPS, MA+E) were associated with COVID-19. 62.5% of patients had another concomitant autoimmune disease. Inflammatory changes in the CSF were rare: increased protein — 3.4%, oligoclonal bands — 10%. On brain MRI, focal changes were observed in 5%, signs of atrophy — in 20%. Immunotherapy was performed in 80% patients, in 80% of them — long-term immunosuppression. Treatment response was observed in 92.1% and didn’t differ among GAD-ASD phenotypes. 65.8% of patients achieved improvement with a decrease in disability, 1 patient (2.6%) achieved complete recovery. Conclusions. In Russia, a cohort of patients with GAD-ASD has been characterized for the first time. In Russian patients, disease phenotypes were typical for GAD-autoimmunity, the most common of which was SPS. Most patients respond to immunotherapy, but recoveries are rare, indicating a chronic course of GAD-ASD.

Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths in many countries worldwide, both in men and women, and these rates tend to increase. The probability of developing CRC is about 4–5%, and the risk of its development is associated with individual characteristics of the body, bad habits, age, chronic diseases, and lifestyle. The microbiome in general, and the microbiota of individual loci in particular, play a major role in maintaining homeostasis in the human body. There are a number of studies examining the relationship between the microbiota of various biotopes, including the intestine, and CRC. The purpose of this review is to summarize studies on the role of intestinal microbiota in the development of colorectal cancer. According to some authors, changes in the composition of the microbiota are a direct cause of CRC development. In turn, other studies suggest the opposite point of view: carcinogenesis is a direct cause of qualitative and quantitative changes in the composition of the intestinal microbiota. Despite this, the literature contains a large amount of data on the possible role of specific microorganisms, such as Fusobacterium nucleatum, Bacteroide fragilis, toxigenic strains of Escherichia coli and other representatives of opportunistic flora in the development of the oncological process. At the moment, there is insufficient data on both specific microorganisms and the microbiota in general to make a clear conclusion about their role in the development of CRC, so further studies of the mechanisms underlying these processes are needed.

Background. Primary open-angle glaucoma (POAG) occupies a leading place among the causes of vision loss and blindness. According to the literature, the immunopathogenesis of POAG is associated with inflammatory processes, the development of which involves factors of innate immunity. In isolated articles, the development of this pathology is associated with NLRP3 inflammasome and oxygen explosion. However, there are practically no studies that reveal the issues of the mutually conditioning effect of the inflammasome and the factors involved in the process of oxidative stress and endothelial dysfunction. Aims — to study the association of polymorphic markers rs5351 of the EDNRB gene, rs7525979 of the NLRP3 gene at various stages of primary open-angle glaucoma. Methods. Peripheral blood of 141 patients with POAG and 97 patients with cataract was used. After DNA isolation, a polymerase chain reaction was performed in real time. The frequency of occurrence of alleles and genotypes in the study groups was calculated using the χ² criterion, the Fisher exact criterion and the Mann–Whitney criterion.The results with p < 0.05 were considered statistically significant. To quantify the relationship between the occurrence of POAG in patients and the carrier of an unfavorable polymorphic marker, the odds ratio and 95% confidence interval were calculated. Results. The main group and the comparison group were identified. Among the patients of the main group, depending on the stage of POAG, 4 subgroups were identified. Relative to the comparison group, the T allele and the heterozygous genotype of the polymorphic marker rs7525979 NLRP3 were associated with the risk of POAG, aggravating the I and IV stages of the disease, while the homozygous CC genotype played a protective role, especially with respect to the I and IV stages of POAG. The C allele was associated with stage IV OAG and played a protective role for patients with stage II OAG. Allele A rs5351 EDNRB played a protective role for patients with POAG, homozygous genotype GG was associated with the risk of POAG, heterozygous genotype played a protective role. Homozygous genotype AA increased the risk of developing stage I POAG, homozygous genotype GG increased the risk of stage IV POAG. Conclusions. alleles and genotypes of the EDNRB and NLRP3 genes can be considered as factors affecting the probability of occurrence of POAG. In this paper, we studied 2 polymorphic markers in 2 genes of innate immunity factors and found that they are associated with the development of POAG, as well as some of them are associated with a certain stage of POAG. These data can be used for diagnostic purposes as prognostic markers and in the development of immunomodulatory therapy for the prevention of POAG development and the progressive course of this disease.

This article discusses the role of phospholipids as a key component of high-density lipoproteins (HDL) involved in the reverse transport of cholesterol from cells with its subsequent excretion from the body. The results of the phospholipidation research on the capacity of HDL cholesterol efflux from macrophages, as well as an assessment of the hypolipidemic and antiatherogenic effects of phospholipids on an atherosclerosis rabbit model at the functional and morphological levels are presented. In phase I clinical trial the safety of the oral administration of the innovative water-soluble pharmaceutical form of phosphatidylcholine in healthy volunteers was proven. In a double-blind, placebo-controlled phase II-III clinical trial in patients with combined hyperlipidemia its efficacy in achieving of the non-HDL cholesterol and triglycerides therapeutic target and safety with long-term oral administration was demonstrated.

February 18, 2025 marks the 100th anniversary of the creation of the first Endocrinological Research Centre in Russia (the State Research Center of the Federal State Budgetary Institution “National Medical Research Center for Endocrinology” of the Russian Ministry of Health, Moscow). Over its 100-year history, the Centre has gone through stages of development from an “organotherapeutic laboratory”, the Institute of Organotherapeutic Preparations, the Institute of Experimental Endocrinology and Hormone Chemistry to the powerful State Scientific Center for Endocrinology — a leader in fundamental and applied scientific research in the field of endocrine diseases, a coordinator for the organization of endocrinological services and implementation of advanced technologies throughout the country. The hundred-year history of the ENC is reflected in the fate of its directors — world-famous scientists, starting from the founder of the entire endocrinological service of the country, Professor Vasily Dmitrievich Shervinsky.

The termination of vaccination after the elimination of smallpox currently, it has led to the fact that a significant part of the population has become highly susceptible to orthopoxvirus infection, including those with a zoonotic reservoir. Of these infections, the greatest danger to public health is monkey pox. The purpose of this review is to evaluate of potential danger of monkey pox proliferation in non-endemic territories in conditions of a decrease in the level of anti-inflammatory herd immunity the largest outbreak of monkey pox in the entire history of observations started in May 2022, spread to all inhabited continents is considered. Possible causes of the outbreak (a new path of pathogen transmission, the appearance of the monkey pox virus in the course of natural evolution of the variant, characterized by new properties, a decrease in the level of anti-inflammatory herd immunity) are analyzed.

On December 2, 2024, Nikolai Nikolaevich Yakhno, an outstanding scientist and the largest world-renowned specialist in the field of neurology, Honored Scientist of the Russian Federation, Academician of the Russian Academy of Sciences, celebrated his 80th birthday.

On December 5, 2024, Elena Andreevna Korneva, an outstanding world-renowned scientist, the largest specialist in the field of immune system physiology, one of the largest organizers of science in the country, the founder of a new scientific field, Neuroimmunophysiology, Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, celebrated her 95th birthday.

On October 6, 2024, an outstanding Soviet and Russian cardiac surgeon, clinician, teacher, scientist, who developed new unique directions in restorative, vascular and cardiac surgery, Deputy Director General for Surgery, Head of the Department of Cardiovascular Surgery of the Federal State Budgetary Institution "National Medical Research Centre of Cardiology Named After Academician E.I. Chazov" of the Ministry of Health of the Russian Federation, professor, Academician of the Russian Academy of Sciences Renat Suleimanovich Akchurin passed away.