CYP2C9 and VKORC1 genotyping for the quality of long-standing warfarin treatment in Russian patients.

A total of 263 warfarin naive patients with indications to long-term anticoagulation were included in prospective multicenter study and randomized into Pharmacogenetics and Standard dosing groups. The loading warfarin dose in Pharmacogenetics group was calculated by Gage algorithm and corrected starting on day 5 of treatment according to INR. In Standard dosing group warfarin initial dose was 5 mg and starting on day 3 of treatment it was titrated according to INR. Pharmacogenetics dosing in comparison with prescription of starting dose of 5 mg decreased major bleedings (0 vs. 6, p = 0.031), time to target INR (11 [9-14] vs. 17 [15-24] days, p = 0.046), and frequency of INR fluctuations ≥4.0 (11% vs. 30.9%, p = 0.002). The advantages of the pharmacogenetics dosing were mainly achieved due to the patients with increased warfarin sensitivity.

Correlation of Immune Responses Mediated by T Helper 1 and 2 in Children with Viral Encephalitises.

This work deals with the problem concerning the mechanisms of triggering the demyelinating process by viruses as the consequence of molecular mimicry between viral antigens and the immunodominant region of the myelin basic protein with the subsequent involvement of reactions, mediated by T helper cells 1 and 2. Special emphasis is made on the new data indicating that reagin mechanisms play an active role in the development of neuropathology, corresponding to the results obtained by the authors in the study of humoral response in multiple sclerosis patients. Thus, the presence of pronounced total and specific IgE response was established to myelin basic protein, correlating with more severe clinical manifestations of the disease. Taking into account the viral nature of the demyelinization, the authors studied a number of humoral characteristics of immune response, indicating the degree of the involvement of T helper cells 1 and 2 into the pathogenesis of acute viral encephalitises. The determination of these characteristics was carried out with the use of original methods developed by the authors. The analysis of the results obtained in this study revealed the obvious presence of relationship between the involvement of autoimmune and atopic response in children with acute viral encephalitises and the manifestation of molecular mimicry of corresponding viruses with the immunodominant region of myelin basic protein. The most prognostically unfavorable group was the group of children having rubella, adenovirus and herpetic encephalitises.