EXPERIMENTAL GESTATIONAL DIABETES DISRUPTS THE FORMATION OF IMMUNE TOLERANCE IN OFFSPRING.

OBJECTIVE: The aim: To analyze the mRNA gene expression level of Aire, Deaf1, Foxp3, Ctla4, Il10, Nlrp3 and distribution of NLRP3+-cells in mesenteric lymph nodes (MLNs) of the offspring of rats with GD, both untreated and treated with glibenclamide and in conditions of insulin oral tolerance formation. PATIENTS AND METHODS: Materials and methods: The study involves 160 male rats, one- or six-month-old. The mRNA genes expression was studied by real time quantitative poly¬merase chain reaction. Structure of Nlrp3+ -cells population was studied by histological sections of MLNs. RESULTS: Results: We observed AIRE gene repression, reduced mRNA levels of Deaf1 and the transcription factor Foxp3 in offspring of rats with GD. This was accompanied by inhibition of IL-10 gene expression and negative costimulatory molecules Ctla4. The development of the experimental GD was accompanied by transcrip¬tional induction of the Nlrp3 gene in MLNs of descendants. The administration of glibenclamide to pregnant female rats with GD inhibited the transcription of the Nlrp3 gene only in one-month-old offspring (5.3-fold) and did not change it in six-month-old animals. In offspring of rats with GD, the density of the NLRP3+-lymphocyte population in the MLNs increased, more pronounced in one-month-old animals. The administration of glibenclamide to pregnant rats with GD reduced the number of NLRP3+ -lymphocytes only in one-month-old offspring (by 33.0 %), whereas this index in six month-old offspring even increased. CONCLUSION: Conclusions: Experimental prenatal hyperglycemia leads to increased proinflammatory signaling and violation of peripheral immunological tolerance formation more pronounced at one month of life.

EVALUATION OF EFFICACY OF EXTRACORPOREAL SHOCK WAVE THERAPY IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC NON-BACTERIAL PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME.

OBJECTIVE: The aim: Study of hemodynamics of the prostate and evaluation of the ef f ectiveness of extracorporeal shock wave therapy (ESWT) in the complex treatment of patients with chronic prostatitis with non-inf l ammatory chronic pelvic pain syndrome (NCPPS), (NIH III B). PATIENTS AND METHODS: Materials and methods: There were 63 patients with NCPPS aged 29 to 45 years, with a disease duration of more than 3 years and low ef f i cacy of treatment against the background of standard therapy. All patients received standard therapy according to the clinical protocol. The main group (33 men - group II), against the background of standard therapy, received a course of ESWT, followed by a comparative assessment of clinical results regarding to the group of patients (30 men - group I) who received only standard therapy after the course, and after 3 and 6 months after treatment. RESULTS: Results: According to the results of transrectal ultrasonography in Doppler mode, a marked decrease in volumetric blood fl ow in the prostate gland of patients was observed. The use of ESWT against the background of standard treatment contributed to a longer and more stable clinical ef f ect, with a signif i cant improvement in hemodynamic parameters in the prostate unlike the results in the group of patients receiving only standard therapy. CONCLUSION: Conclusions: Signif i cant disorders of prostate hemodynamics were found in patients with NCPPS. Use on the background of standard treatment of ESWT in these patients is pathogenetically justif i ed with a lasting and stable clinical ef f ect.

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review).

The final stage of the diagnostic of primary hyperaldosteronism is to identify the causes of excessive secretion of aldosterone and determination of its variants. Based on the analysis of literature data, the diagnostic value, sensitivity and specificity of the methods of radiation diagnostics for primary hyperaldosteronism were assessed: ultrasound, computed tomography, magnetic resonance imaging, photon emission tomography, magnetic resonance spectroscopy, scintigraphy with iodine radiopharmaceuticals. The causes of false-positive and false-negative evaluations of changes in adrenal glands in the application of these diagnostics have been analyzed. There are many genetic and morphological studies when searching the literature data on the principles and methods of distinguishing the nosological forms of primary hyperaldosteronism based on the results of the aldosterone level estimation in the separated blood from the central veins of both adrenal glands or segmental veins of one gland with subsequent determination of the concentration gradient. It was noted that topical diagnostics and, especially, the determination of nosological forms of primary hyperaldosteronism are complex and expensive, but their results allow choosing an appropriate treatment approach for each particular case.

Peculiarities of Uterine Cavity Biocenosis in Patients with Different Types of Endometrial Hyperproliferative Pathology.

The peculiarities of the microbiocenosis of the uterine cavity in 184 patients of reproductive age with different types of endometrial hyperproliferative processes were studied: Group 1, n=60, non-atypical endometrial hyperplasia (NAEH); Group 2, n=62, endometrial polyps (EPs); Group 3, n=62, NAEH + EPs. Correlation analysis of the degree of association between different biological media (uterus and genital tract) was carried out. Contamination of the uterine cavity by bacterial flora was diagnosed in all groups of patients examined. Anaerobic flora was about 30% while bacteria of the genus Bacteroides were the most common. Among aerobic organisms, representatives of the Enterobacteriaceae family and coccal flora are noted. The widest was the spectrum of isolated microorganisms in patients of group 2 (with endometrial polyps). A strong positive correlation was established between indices of genital tract contamination and the uterine cavity by coccal flora, Escherichia coli, and anaerobic organisms. The findings suggest dysbiotic changes and the presence of a chronic inflammatory focus in the endometrium, which pathogenetically substantiates the application of anti-inflammatory therapy in such patients.