ABSTRACT. The high frequency of hyperplastic processes of the endometrium (EН), the lack of proper effectiveness of hormonal therapy, and the possibility of their malignancy place EH among the most relevant issues in modern medicine. The clinical significance of EH lies in the fact that they are one of the most common causes of uterine bleeding and hospitalization of women. It is known that along with hormonal disorders, other activators of proliferative activity, such as growth factors, proliferation and apoptosis markers, and extracellular matrix components, play a significant role in the development of EН. The study investigated the immunohistochemical markers in the endometrial tissue of reproductive-aged women with endometrial hyperplasia without atypia who were diagnosed with recurrent hyperplasia without atypia after 6 months of continuous therapy with a daily dose of 200 mg of progesterone. The following markers were selected for the study: PR, ER, p21, dcl-2, KI-67, eNOS, cycl-D1, BAX, b-catenin, E-cadgerin і Caspasa3, whose expression was examined by immunohistochemical methods before and after therapy. The control group consisted of women with secretory changes in the endometrium. The expression of receptors for PR, ER, p21, dcl-2, KI-67, eNOS, cycl-D1, BAX, b-catenin, E-cadgerin і Caspasa3 was studied primarily in women with non-neoplastic endometrial lesions (hyperplasia without atypia) and may be of greater significance in predicting the risk of progression and recurrence. Objective. The aim of the study was to determine changes in the expression of immunohistochemical markers in the endometrium in cases of hyperplasia without atypia before and after the use of progesterone therapy, and to identify the most predictive markers for therapy response. Results. The histological examination revealed significant changes in the endometrial biomarkers after therapy in women with no response to the treatment. The expression of receptors in the endometrium after therapy showed the following indicators: ER: a 20 % increase in glandular cells compared to baseline and a 63.3 % increase compared to the control group. In stromal cells, there was a 63.3% increase compared to baseline. PgR: An 85 % decrease compared to baseline. An 85 % decrease compared to the control group. p21: A 114 % increase in glandular cells compared to baseline and a 5% increase in stromal cells. Overall, there was a 29.3 % increase in expression compared to the control group. bcl-2: An 80 % decrease compared to baseline in glandular cells and a 90 % decrease compared to baseline in stromal cells. Ki-67: A 114 % increase compared to baseline in glandular cells and an expression more than 67% higher than the control group. eNOS: A 69 % increase compared to baseline in glandular cells and an 85% increase compared to baseline in stromal cells. Cyclin D1: A 15% increase compared to baseline in both glandular and stromal cells. BAX: A 10 % increase compared to baseline in both glandular and stromal cells. Beta-catenin: Remained stable compared to baseline in both glandular and stromal cells. E-cad: A 50% increase compared to baseline in glandular cells and a 60% increase compared to baseline in stromal cells. Caspasa3: Showed a 76 % increase compared to baseline and an 80 % increase after therapy in stromal cells, which may be associated with increased apoptosis processes. Conclusions. 1. Markers ER, PgR, b-catenin, p21, cyclin D1, Ki-67, Caspase-3 demonstrated differences between the non-glandular endometrium (EH) group and the control group in the glandular component, and ER, PgR, b-catenin in the stromal component (all p<0.05). This provides a basis for their use as primary diagnostic markers. 2. Markers ER, b-catenin, p21, cyclin D1, Ki-67, eNOS showed differences between the NGE group after treatment and the control group in the glandular component, and ER, b-catenin, and eNOS in the stromal component (all p<0.05). This supports their use as primary diagnostic markers. 3. Markers PgR, Ki-67, Caspase- 3, eNOS demonstrated differences between the NGE group before therapy and the control group in the glandular component, and eNOS in the stromal component (all p<0.05). This indicates their potential as primary diagnostic and prognostic markers. 4. Bcl-2 and BAX markers did not show statistically significant differences in the study groups, suggesting their inability to be used individually as diagnostic or prognostic markers for endometrial hyperplastic processes. Interpretation of the expression results of these markers should consider them in conjunction with other indicators.

ABSTRACT. Alopecia areata is an immune-mediated disease resulting from the interaction of genetic factors and exogenous triggers, leading to the activation of the Janus Kinases - Signal Transducer and Activator of Transcription signaling pathway, the formation of non-specific autoimmune inflammation and disruption of immune tolerance of hair follicles. Alopecia areata has an unpredictable course with a non-scarring type of hair loss, it can affect the hair part of the head and/or hair in other areas, it can be manifested by damage to the nail plates. The psychotraumatic impact of this disease can be compared to the consequences of life-threatening or disabling diseases. For this reason, the degree of negative impact of alopecia areata on the quality of life may not correlate with the objective condition of patients, which is often not taken into account in the diagnosis and treatment of the disease. Despite the variety of treatment options available, achieving effective and safe disease control is not always straightforward. Treating patients with alopecia areata and comorbid conditions can be particularly challenging and may require close collaboration between specialists from various fields. For these and other reasons, there is significant dissatisfaction among patients regarding alopecia areata and its treatment. The systematic organization, unification, and adaptation of modern knowledge about alopecia areata have led to the creation of two algorithms: a diagnostic algorithm and a therapeutic algorithm. These algorithms provide a differentiated approach to patient management, with age, disease severity, clinical form, disease activity stage, comorbid pathology, prognostic factors, and patient quality of life taken into account. Agents with immunosuppressive action belong to the main group of drugs in the treatment of alopecia areata, according to the antigenic concept of the pathogenesis of the disease. Ongoing work is being done to update treatment protocols to include JAK inhibitors and other preparations, taking into based on new developments and the expanding pharmaceutical market.

ABSTRACT. Much attention is paid to the problem of secondary osteoarthritis caused by various microorganisms and fungi of the genus S. albicans, associated with their significant growth and prevalence throughout the world among the population of various age groups, high temporary and permanent disability. At the same time, the problem of immunopathology in the pathogenesis of secondary osteoarthritis is being actively studied. The developed immunopathological process induced by pathogenic and opportunistic microflora in articular cartilage and synovial membrane is the main factor in the degenerative destruction of articular cartilage. Goal. to determine the role of pathogenic and opportunistic microflora localized in the oropharynx in the etiopathogenesis of secondary osteoarthritis. Research materials and methods. 65 patients aged from 19 to 45 years, who were undergoing inpatient treatment at Artz Klinic, Kharkiv, were examined for secondary osteoarthritis of the knee joint. The diagnosis was established according to the International Classification of Diseases of the 10th revision (ICD-10) - M18.1. Patients with a history of a high frequency of accompanying pathologies of the oropharynx were selected for the study: chronic tonsillitis - 48 (73.8%), tonsillitis - 32 (49.2%), pharyngitis - 34 (52.3%), sinusitis - 13 (20) %), otitis – 9 (13.8%) the etiology of which is determined by gram-positive and gram-negative microorganisms. All patients underwent microbiological examination of throat swabs, and 24 patients underwent microbiological examination of synovial fluid, which was taken for examination before intra-articular therapy. The obtained data were statistically processed by calculating the arithmetic mean and its error. The results. Presented modern ideas about secondary osteoarthritis caused by etiologically significant macroflora persisting in the oropharynx and as a result of organotropy due to the inclusion in its structure of mimicking antigens of articular cartilage play a leading role in the degradation of articular cartilage and articular bag, transferring the pathological process to an autoimmune basis. This approach makes it possible to develop early immunodiagnostics, prognosis of the disease, and immunocorrective therapy. Conclusions. Pathogenic and conditionally pathogenic microflora persisting in the oropharynx is characterized by organotropy (community of lipopolysaccharides and glycoproids), is identical to the cell-tissue structures of articular cartilage and synovial membrane in the causative agent and modulates the immune response through mimicking antigens.

ABSTRACT. A large number of studies have been devoted to the study of the problem of genital endometriosis, however, the etiology and mechanisms of the disease remain unresolved. Adenomyosis affects about 10% of women of reproductive age, occurs in 30% of women with pelvic pain syndrome and up to 50% of patients with female infertility. Numerous theories of the origin of endometriosis cannot explain the key points in the development of the disease, namely the penetration of the basal layer of the endometrium into the adjacent myometrium. This makes it difficult to choose an adequate treatment strategy for patients with adenomyosis. Treatment of adenomyosis is one of the most difficult issues in modern gynecology, one of the promising approaches in increasing the effectiveness of treatment of patients with adenomyosis is immunocorrective therapy. The aim of the work was to increase the effectiveness of treatment of adenomyosis patients by improving the diagnostic and prognostic tactics of patient management based on the study of pathogenetic aspects. Materials and methods. 115 patients of reproductive age were included in the study. The effectiveness of complex compared to traditional treatment was evaluated. Clinical and laboratory, instrumental and immunological indicators were evaluated in dynamics. Research results and their discussion. Taking into account the peculiarities of pathogenetic mechanisms, which indicate a violation of the cellular and macrophage links of immunity, cytokine imbalance, which contribute to the development of the disease and its persistence, we have developed a comprehensive approach to increasing the effectiveness of the treatment of patients with adenomyosis, which aims to reduce the pro-inflammatory immunological potential. Against the background of the comprehensive treatment, the activity of autoimmune reactions is reduced, the indicators of phagocytic and oxygen activity of neutrophils and monocytes are normalized, cytokine imbalance is reduced - the level of production of pro-inflammatory cytokines and VEGF is normalized. Conclusions. Based on the results of the work, the approaches to the treatment of adenomyosis patients were optimized, the feasibility of using corrective drugs in complex therapy was substantiated.

ABSTRACT. Among residents of Chernivtsi region, the main characteristics, frequency and peculiarities of the occurrence of long-term symptomatic and post-COVID-19 syndrome have not been sufficiently elucidated. The goal of the study was set: to evaluate the options for the course of the post-covid syndrome depending on age, gender, comorbidity and severity of the course of COVID-19. Material and methods. The following research methods were used: electronic questionnaire, epidemiological, clinical and anamnestic, analytical and statistical methods. The study included 214 adult patients who were infected with the SARS-CoV-2 virus (the diagnosis was confirmed by PCR) and who suffered from COVID- 19 of varying degrees of severity and were randomized into two groups: the 1st group (main) included – 112 people (ratio of men/women - 56.4 % (n = 63): 47.5 % (n = 49)), comparative (102 people) – patients with a mild and moderate course of COVID-19 who were consulted and were treated on an outpatient basis (male/female ratio – 45.5 % (n = 46): 54.5 % (n = 56)). Statistical processing of the data obtained during the research was carried out using the IBM SPSS Statistics v26.0 program. Results. It was found that among inpatients there was a significantly significant number of patients older than 60 years old (p < 0.001), whereas among outpatients there were significantly more patients aged 18-29, which indicates a connection between the age of the respondents and the need for inpatient treatment presence of COVID-19. In the main group, the following symptoms occurred more frequently (p < 0.05): cough OR = 2.023 [CI 1.105-3.703], fever OR = 6.916 [CI 2.061-23.204], difficulty breathing (dyspnea) OR = 4.421 [2.230 -8.764]. In the comparison group, the following prevailed: loss of smell OR = 0.147 [CI 0.077-0.281], fatigue OR = 0.456 [CI 0.226-0.920], increased temperature OR=2.023 [2.061- 23.204]. With a higher frequency, such diseases as: coronary heart disease (OR = 33.088 [CI 9.444-115.930]), arterial hypertension (OR = 13.641 [CI 6.547-28.422]), diabetes (OR = 4.755 [CI 1.915-11.803]), heart failure (OR = 18.504 [CI 8.200-41.752]), obesity (OR = 4.828 [CI 2.433-9.581]). Conclusions. 1. Among the patients who received inpatient treatment, the vast majority were people over 40 years old, younger men (from 40 years old) were more likely than women (over 60). 2. In persons with a severe course of COVID-19, the frequency of symptoms of shortness of breath, cough, difficulty breathing, chest pain is more likely to be registered, and in outpatients - loss of smell and fatigue. 3. With a greater frequency, such diseases as: coronary heart disease (37.5 %), arterial hypertension (57.4 %), diabetes (21.3 %), heart failure (54,1 %), obesity (41.1 %). Smoking and alcohol abuse did not show significant reliable differences. 4. The combination of 3 pathologies (hypertension, heart failure, obesity) was most common - in 11 people (10 %).

ABSTRACT. At the current stage of solving the problem in the pathogenesis of atopic BA in moderate-severe and severe course of the disease, the leading role is played by pro-inflammatory cytokines of T-lymphocytes and factors of the late phase of allergic inflammation. Goal. To determine the effect of the drugs of the therapy protocol recommended by GINA (2021) and the Ministry of Health of Ukraine No. 2856 on the production of pro-inflammatory cytokines in children with AD. Materials and methods. The study was conducted in 106 patients with BA and 20 healthy children aged 5 to 14 years in the period of disease remission before and after therapy. The impact of the protocol therapy scheme on the production of pro-inflammatory cytokines and their antibody control in children with different degrees of severity of the course of the disease was evaluated. The results. In asthma in children with a mild persistent course, protocol therapy reduces the release of mediators of the early phase of the allergic disease and the partial production of pro-inflammatory cytokines, which leads to clinical remission of the disease. With a moderately severe persistent course of AD, the influence of protocol therapy drugs reduce the level of production of pro-inflammatory cytokines to weakly positive values, which indicates incomplete control of therapy and unstable clinical remission. In severe persistent AD, protocol therapy partially reduces the production of pro-inflammatory cytokines, but does not affect the late phase of allergic inflammation and the autoimmune component of the pathogenesis of the disease. Conclusions. The recommended GINA protocol therapy (2021) eliminates the early phase and does not affect the late phase of allergic inflammation and the autoimmune component. This requires the development of additional therapy for moderate and severe asthma in children.

ABSTRACT. Acute rhinosinusitis is one of the most common diseases that affects up to 15% of the world's population every year and can occur at any age. The provisions of EPOS 2020 do not provide for the appointment of antibiotics in acute viral and acute post-viral rhinosinusitis. Thus, there is a need to find medicines to improve the well-being of patients, speed up recovery and prevent complications. One of such promising means of combating viral and bacterial infection of the ENT organs is the use of drugs with silver nanoparticles. Purposes. The purpose of this work was to study the effectiveness of using Deflu Silver Nose in the treatment of patients with acute rhinosinusitis. There was a study of its influence on the clinical course of the disease and parameters of local immunity.Materials and methods. Two groups of patients with acute rhinosinusitis were under our observation. The first group (main) consisted of 32 patients who, together with traditional symptomatic therapy (saline solution intranasally for 2 injections 3 times a day, multivitamins) received the aid Deflu Silver Nose (intranasally for 2 injections 3 times a day for 7 days). The drug was used from the 3rd day after the onset of the disease. The second group (comparison group) consisted of 30 patients who received similar therapy, except for Deflu Silver Nose.Clinical examinations and studies of local immunity were carried out before and after the start of therapy (on the 3rd and 7th day, on the 6th and 10th day of the disease). The results of the examination of 10 healthy people were used as an indicator of the norm. Rhinocytograms (cytological studies of scrapings from the nasal mucosa) were studied.Immunoglobulins, lysozyme, and cationic proteins were carried out in oropharyngeal secretions. Results. Clinical observations showed that under the influence of Deflu Silver Nose, patients with acute rhinosinusitis on the 3rd day from the start of treatment had a noticeable reduction or complete disappearance of the clinical symptoms of the disease. On the 3rd day of treatment, in the rhinocytograms, in the patients of the main group, there was a decrease in the nasal mucosa of destroyed cells and the percentage of lymphocytes in the scraping of cells of the flat and prismatic epithelium. On the 7th day of using Deflu Silver Nose, the level of all antimicrobial factors in nasal secretions in patients of group 1 decreases to normal levels.During this period, the inflammatory process was stopped and excessive swelling of the nasal mucosa was not observed in the vast majority of patients in the main group. No such positive changes were observed in the 2nd group of patients. Conclusion. Intranasal use of Deflu Silver Nose has a positive effect on the clinical course of acute rhinosinusitis, contributes to the prevention of bacterial complications, and increases the local immunoreactivity of the body. Under the influence of the nasal spray, the duration of the disease is reduced and the quality of life of patients improves.

ABSTRACT. Studying biological markers of oxidative stress is crucial and relevant, as this process can trigger the transition from an organ's "normal state" to a "malignant lesion". The use of metal nanoparticles to correct oxidative stress manifestations in oncology is one of the most popular subjects of modern science and is actively being introduced into modern medicine. Practically all possible types of nanoparticles have found their use in solving different problems in oncology. Therefore, our study aimed to investigate the possibility of Au/Ag/Fe nanoparticles use for the correction of redox balance disorders of the antioxidant system under the conditions of induced colon adenocarcinoma. Materials and methods. The study was performed on 150 white male rats. Animals were kept in standard vivarium conditions. Division of experimental rats into groups: I - control intact group (40 individuals); II - experimental group (70 individuals) with N,N-dimethylhydrazine hydrochloride administration once a week for 30 weeks; ІІІ – an experimental group (40 animals) with daily intragastric administration of Au/Ag/Fe nanoparticles. Oxidative stress was assessed in colon tissue homogenate by changes in the concentrations of 8-iso-prostaglandin F2α (8-iso-PGF2α), TBC-active products, diene and triene conjugates, Schiff bases, as well as by the activities of catalase, superoxide dismutase, glutathione peroxidase, glutathione reductase, and reduced glutathione. Results. Due to this research, we established that Au/Ag/Fe nanoparticles use leads to a decrease in the concentration of 8-iso-prostaglandin F2α (8-iso-PGF2α), TBC-active substances, diene, triene conjugates, Schiff bases. As a result of the above, we observed a reduction of manifestations of oxidative stress and restoration of enzymes of the antioxidant system and its biological mediators of a non-enzymatic nature. The activity of catalase, superoxide dismutase, glutathione peroxidase, and the concentration of reduced glutathione was restored to control indicators. Conclusions. Therefore, the use of Au/Ag/Fe nanoparticles leads to the restoration of the balance of redox equilibrium, improving the antioxidant system with induced adenocarcinoma of the large intestine.

ABSTRACT. It is known that under the influence of specific mitogens, sensitized T-lymphocytes produce № 199 cytokines in the culture medium, which are divided into two fractions: F1 and F2. The first (F1) of them determines the pathogenesis of AD in children and the cytokines of this fraction are produced during immunopathological reactions, and the second (F2) is responsible for the immunological parameters of activation of the T-system of immunity and their regulation. Goal. To investigate the functional activity of T-lymphocytes activated by bronchopulmonary antigens and its differential immunodiagnostic value in children with BA. Materials and methods. To determine the cytokines of sensitized T-lymphocytes, the qualitative composition of cytokines of T-lymphocytes in the culture fluid, discphoresis in polyacrylamide gel was used in 105 children with asthma and 20 healthy children aged 5 to 14 years with specific antigens of bronchi and lung tissue, as well as with non-specific myogen FHA from the company «Reanal». Results. In BA in children, the more quantitative presence of bands and discforograms is detected depending on the severity of the course of the disease and is characterized by high production of F1-fraction cytokines by sensitized T-lymphocytes. The structural analysis of cytokine disc-phorograms of T-lymphocytes in AD under the conditions of mitogenic activity of sensitized T-lymphocytes switched with lipopolysaccharide antigens of the bronchi and lung tissue showed discrepancies in the form of the presence of two bands that have qualitative differences determined by the thickness, with the total numbering from the start having the serial number 8 and 9. Conclusions. It has been established that the severity of BA correlates with the expression of the spectrum of cytokine production of sensitized T-lymphocytes in the blood serum of children with BA, and allows diagnosing the severity of the disease with high accuracy.