[Serum neurofilament light chains in assessing the course of multiple sclerosis]. / Syvorotochnye legkie tsepi neirofilamentov v otsenke techeniya rasseyannogo skleroza.

OBJECTIVE: To study a role of serum neurofilament light chains (sNFL) in assessment of course and progression of multiple sclerosis (MS) in the population of patients with MS in the Tomsk region. MATERIAL AND METHODS: The study involved 93 patients with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) (nRRMS=75, nSPMS=18). The study was carried out in a two-stage design: the first stage was a cross-sectional study for the entire sample; the second stage was a prospective observation with two visits for patients with relapse. sNFL concentration was determined by solid-phase ELISA. RESULTS: There was no statistically significant difference between RRMS and SPMS, and relapse and remission groups in terms of sNFL levels. Patients with a MS duration exceeding 14 years had higher rates of sNFL than those with a shorter duration (p=0.02). The subjects of the second study stage showed a decrease in sNFL from 2.05 (1.86; 2.19) pg/ml to 1.92 (1.87; 2.04) pg/ml (p=0.005), and slowdown in sNFL reduction correlated with the severity of cognitive impairment (k=0.52; p<0.05). CONCLUSION: Dynamic monitoring of sNFL allows the evaluation of the activity of the disease, as well as making an assumption about the compensatory possibilities of subsequent recovery.

[Clinical factors and response to therapy with disease-modifying drugs for multiple sclerosis: the experience of the Tomsk region]. / Klinicheskie faktory i otvet na terapiyu preparatami, izmenyayushchimi techenie rasseyannogo skleroza: opyt Tomskoi oblasti.

OBJECTIVE: To investigate a disease-modifying drugs (DMD) response in multiple sclerosis (MS) in the Tomsk region population and detect clinical factors associated with the treatment response. MATERIAL AND METHODS: A 5-year prospective clinical study included 363 MS patients of the Tomsk region taking DMDs of the «first-line¼ and «second-line treatments¼. The response to DMDs therapy and the impact of MS clinical characteristics on response to treatment were assessed. RESULTS: Clinical factors associated with resistance to DMD are male gender, partial reduce of the MS onset symptoms, short period of the first remission, severe neurological impairment, high relapse rate and disease progression rate. CONCLUSION: Clinical features of MS are crucial factors associated with DMD response and should be used to prescribe DMD. This factor assessment can improve efficacy of the personalized MS treatment.

[The present-day epidemiology: challenges of public health and possibilities to settle them: the publications review].

Actually, the epidemiology is a dynamically developing medical science located at the intersection of social and biological branches of knowledge and bio-informatics. The new sources of data, the new methods create unique opportunities for epidemiologist. The number of epidemiological studies carrying out at the junction of several adjacent disciplines is increasing that requires harmonious interaction of specialists of different branches of medical knowledge. The change of the structure of global mortality towards chronic non-communicable diseases significantly affected the vector of epidemiological studies. Many interventional epidemiological projects are targeted to evaluation of effectiveness of new methods of prevention of cardiovascular, metabolic and oncological diseases. However, in recent years, the fight against unremembered infections affecting about 1 billion of people and taking away lives of 0.5 million people annually gained new importance. The current COVID-19 pandemic also affected epidemiology of communicable and chronic non-communicable diseases. Great attention is also currently attended to studying influence of social, economic and environmental factors on human health. The increase of average life expectancy of population contributes to development of epidemiology of the elderly. The new projects are initiated in the field of pharmacoepidemiology targeted to studying effectiveness of medications. The review of national and foreign publications considering current trends and achievements in the field of epidemiology. The reference retrieval engines such as PubMed, Google Scholar, CyberLeninka were used. The current directions of epidemiological research are analyzed. The challenges and development prospects of development of modern epidemiology are highlighted.

[BDNF gene RS6265 polymorphism in patients with multiple sclerosis of Tomsk region]. / Polimorfizm RS6265 gena BDNF v populyatsii bol'nykh rasseyannym sklerozom Tomskoi oblasti.

OBJECTIVE: To study the effect of the RS6265 polymorphism of BDNF gene on the risk of development, main clinical characteristics and DMT response in MS patients in Tomsk region. MATERIAL AND METHODS: The study group included 321 patients, the control group consisted of 266 healthy volunteers. Deoxyribonucleic acid (DNA) was isolated from venous blood using the standard phenol-chloroform method. Genotyping was carried out by real-time polymerase chain reaction (PCR) using competing TaqMan probes complementary to the polymorphic nucleotide sequence. RESULTS: Carriage of the C allele and CC genotype of the RS6265 polymorphism of the BDNF gene was found to be a factor determining a more favorable MS course. CONCLUSION: Carriers of the indicated genotype had a low rate of MS progression, a lower frequency of relapses and a less pronounced degree of disability with a comparable MS duration, and significantly more often demonstrated a more optimal response to first and second line of DMT.

[Prognostic markers of multiple sclerosis]. / Prognosticheskie markery rasseyannogo skleroza.

Multiple sclerosis (MS) is a chronic autoimmune disease with a high degree of heterogeneity due to course and prognosis. More than half of MS patients do not discuss their long-term prognosis with the doctor. At the same time, most patients consider the importance of personalized prognosis for decisions in family planning, career, and medical interventions. Clinical markers are used to determine the prognosis in routine clinical practice. However, it is nominally divided into positive and negative factors. It allows making a general conclusion about the MS prognosis. Neuroimaging and biological markers are used mostly for research purposes. But also they are already actively used in clinical trials for endpoint`s investigation. The review describes studies investigating prognostic clinical, neuroimaging, and biological markers.

Trends in Population-Based Studies: Molecular and Digital Epidemiology (Review).

The development of high-throughput technologies has sharply increased the opportunities to research the human body at the molecular, cellular, and organismal levels in the last decade. Rapid progress in biotechnology has caused a paradigm shift in population-based studies. Advances in modern biomedical sciences, including genomic, genome-wide, post-genomic research and bioinformatics, have contributed to the emergence of molecular epidemiology focused on the study of the personalized molecular mechanism of disease development and its extrapolation to the population level. The work of research teams at the intersection of information technology and medicine has become the basis for highlighting digital epidemiology, the important tools of which are machine learning, the ability to work with real world data, and accumulated big data. The developed approaches accelerate the process of collecting and processing biomedical data, testing new scientific hypotheses. However, new methods are still in their infancy, they require testing of application under various conditions, as well as standardization. This review highlights the role of omics and digital technologies in population-based studies.

[Evaluation of serum neurofilament light chains levels for diagnosis, treatment monitoring and prognosis in multiple sclerosis]. / Primenenie otsenki urovnia syvorotochnykh legkikh tsepei neirofilamentov v diagnostike, monitoringe lecheniia i prognoze pri rasseiannom skleroze.

Pathophysiological processes in multiple sclerosis frequently not diagnosed by clinicians become available for analysis only on the basis of paraclinical data (biomarkers). Nowadays neurofilament light chain can be defined as a promising biomarker for multiple sclerosis (MS). Neurofilaments are a structural part of normal neuronal processes consisting of light, intermediate and heavy chains. However, a damage of neurons such as neurodegeneration or axonal damage causes the escape of neurofilaments into extracellular space. Cutting-edge highly sensitive methods make it possible to detect neurofilament light chains not only in the cerebrospinal fluid but also in the blood serum thus opening the opportunities to utilize them in routine diagnosis in clinical practice. This review comprises existing data on the possible opportunities for research of serum neurofilament light chains in terms of exacerbations, effectiveness of basic therapy, assessment of individual disability, the atrophy of central nervous system structures. Also, there is some information on comparison of two methods: routine MRI of the brain with the contrast agents and detection of serum neurofilament light chains.