[Modern view on the complement system role in membranous nephropathy].

Membranous nephropathy (MN), an immune-mediated glomerular disease, is the most common cause of adult nephrotic syndrome. In MN, proteinuria is developed by podocyte damage due to the complement system activation in response to the subepithelial deposition of immune complexes containing various auto- and exogenous antigens. Membrane-attacking complex (MAC) is the terminal product of any complement pathways activation (classical, lectin or alternative) and plays the leading role in the complement-mediated podocytic damage. Thus far, the main pathway of complement activation leading to the formation of MAC in MN has not been established. The review highlights current evidence of various complement pathways activation in the development of MN, as well as recently established new molecular mechanisms of complement-mediated podocyte damage.

[ENDOMETRIOSIS AND PREGNANCY (REVIEW)].

The purpose of this review was to systematize the data on the effect of endometriosis on the fertility index, the course of pregnancy, and the modern diagnosis of changes the endometriotic implants during pregnancy. There are many factors that can potentially affect fertility in patients with endometriosis: anatomical changes in the pelvic floor, impaired transport function of the fallopian tubes due to the formation of adhesions, impaired steroid and folliculogenesis, anovulation and peritoneal changes that contribute to the formation of a harmful prooxidant microenvironment, which can affect the quality and quantity of oocytes and cause a violation of the susceptibility of the endometrium. If the patient with endometriosis still managed to get pregnant, then the problem of maintaining this pregnancy arises even more. The data indicate that pregnancy has a positive effect on the symptoms of endometriosis, and also has a beneficial effect on the growth rate and relapse rate of endometriosis, and may also cause a regression of the formed endometriotic implants. However, data on the effect of pregnancy on endometriosis are contradictory, and pregnancy in women with endometriosis does not always lead to the disappearance of symptoms and a decrease in the size of endometrioid lesions. Moreover, there is growing evidence that endometriosis can affect pregnancy outcomes. Currently, it is impossible to predict changes in the endometriotic implants due to insufficient knowledge about the pathogenesis of this disease. A deeper understanding of the pathogenesis should help prevent hasty obstetric decisions that can lead to iatrogenic diseases in newborns, and patients should be informed about possible complications during pregnancy when planning a birth.