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Purulent hydradenitis is a chronic relapsing disease that affects 4% of the population, caused by uncontrolled growth of hair follicle and apocrine gland cells, which leads to the development of autoimmune and then septic inflammation. The provoking factors are obesity, smoking, formation of apocrine glands in the body. The variety of subordinates of Suppurative hydradenitis, differences in the prognosis and course of the disease, as well as the need to manage patients with this pathology in the surgical department, determine the standardization of the therapeutic algorithm and the objectification of the degree of clinical response to the therapy using scoring scales.

Urgency. Juvenile idiopathic arthritis (JIA) remains one of the most urgent issues of pediatric rheumatology due to incapacitation at early stages of the disease. It has been established that the first years of arthritis are key in the aspect of progression of the pathological process. Despite significant progress in treating JIA with genetically engineered biopharmaceuticals, some patients do not respond to such a therapy and thus aggravate the disease course. The study was aimed at improving diagnosis and treatment of children with JIA by means of analyzing the main immunological factors Th17, suggesting methods of differentiating lymphocytes and developing recommendations on assessing prognosis of the disease's course and outcomes. Methods. The study included 108 2–18-yearsold children with various forms of JIA. The control group was comprised of 18 conventionally healthy 6–17-years-old children with unburdened heredity regarding autoimmune diseases and without any clinical symptoms of diseases. The total T helper population and subpopulations thereof (naive Th cells and Th memory cells, double-positive Th cells), subpopulations of Th17 cells and anti-inflammatory cytokines (IL 1β, IL 6, IL 17A and TNF α) in the peripheral blood were analyzed in all the patients, including the control group. Results. The levels of Th17 memory cells and anti-inflammatory cytokines (IL 1β, IL 6 and IL 17A) were significantly higher in children with enthesitis-associated arthritis (HLA B27+ juvenile ankylosing spondyloarthritis) and systemic JIA. The level of Th17 cells and high blood level of IL 17A affect development of an active disease; simultaneous increase in IL 6 results in higher risk of osteochondral destruction in children with JIA. Conclusion. According to the immunological data, there are at least 2 JIA phenotypes: Th17-dependent and Th17-independent. Th17-dependent JIA is characterized by the most adverse course of the disease and high risk of osteoarticular destruction, which is why children require earlier prescription of genetically engineered biopharmaceuticals. By contrast, Th17-independent phenotype features a more favorable disease outcome and low risk of osteoarticular destruction.

Objective: To investigate the direct effect of D 1 -like dopaminergic receptors antagonist on Th17-cells function in multiple sclerosis (MS) in vitro ., Material and Methods: Forty-one relapsing-remitting MS patients and twenty-five healthy subjects were examined. The functional activity of Th17-cells was assessed by the ability to produce IL-17 and IFN-γ by peripheral blood mononuclear cells (PBMCs) and CD4 + T cells, stimulated with microbeads coated with anti-CD3/anti-CD28-antibodies. To study the involvement of D 1 -like dopaminergic receptors in modulation of Th17-cell function, the samples of PBMCs or CD4 + T-cells were cultured in the presence of dopamine and/or specific D 1 -like dopaminergic receptors antagonist (SCH23390). Cytokine levels in cell culture supernatants were measured by ELISA., Results: The production of IL-17 and IFN-γ by stimulated PBMCs were higher in MS patients during relapse than in MS patients during clinical remission or in healthy subjects. The production of cytokines by stimulated PBMCs or CD4 + T-cells in MS patients during clinical remission and healthy subjects was comparable. Dopamine reduced the production of cytokines by PBMCs and CD4 + T-cells in all groups. Blockade of D 1 -like dopaminergic receptors did not affect the dopamine-mediated cytokine suppression in MS patients and healthy subjects. Blockade of D 1 -like dopaminergic receptors directly suppressed cytokine production by PBMCs and CD4 + T-cells in MS patients and healthy subjects., Conclusions: Dopamine and blockade of D 1 -like dopaminergic receptors have an inhibitory effect on Th17-cell function in MS. The activation of D 2 -like dopaminergic receptors could mediate the inhibitory effect of dopamine on Th17-cells.

Dopamine is a direct mediator of neuroimmune interactions. Recent studies show that by acting on the dopaminergic receptors, it is possible to modulate Th17-immune response, which play a crucial role in the pathogenesis of multiple sclerosis. Dopamine can modulate Th17 cells function as well as dendritic cell-mediated Th17-immune response that allows considering dopaminergic receptors as a new therapeutic target in multiple sclerosis. In this short communication, the prospects of using dopaminergic therapy as a pathogenetic treatment for multiple sclerosis are discussed.

Chronic glomerulonephritis (CGN) is a disease with a steadily progressing course, which is based on inflammation with the activation of immune cells. The severity of the inflammatory reaction in the kidney tissue is determined by the balance of locally pro-inflammatory factors and protective mechanisms, which include anti-inflammatory cytokines and T-regulatory lymphocytes (Treg). The study of processes that can modulate the severity of inflammation in the kidney is of particular interest for understanding the basic patterns of CGN progression., Aim: To determine the clinical significance of the Th17, Th1, and Treg cytokines in urine to assess the activity and progression of chronic glomerulonephritis with nephrotic syndrome (NS)., Materials and Methods: The study included 98 patients with CGN 37 women and 61 men. Patients were divided into two groups according to the degree of CGN activity. Group I consisted of 51 patients with NS. In 21 subjects, a decrease in GFR60 ml/min was revealed. Group II included 47 patients with proteinuria from 1 to 3 g/day without NS. GFR60 ml/min/1.73 m2 was observed in 26 patients. A kidney biopsy was performed in 65 patients and the hystological diagnosis was verified: 20 had mesangioproliferative GN, 16 had membranous nephropathy, 18 had focal segmental glomerulosclerosis, and 11 had membranoproliferative GN. The control group consisted of 15 healthy people. The levels of IL-6, IL-10, IL-17, tumor necrosis factor a (TNF-a) in the urine were determined using enzyme-linked immunosorbent assay. The number of FoxP3-positive cells in the inflammatory interstitial infiltrate of the cortical layer was determined in 39 patients (in a biopsy sample in a 1.5 mm2 area)., Results: In group of patients with CGN, there was an increase in the levels of Th17, Th1, and Treg cytokines in urine TNF-a and IL-10 compared with healthy individuals. An increase in the levels of IL-6 in the urine of patients with high clinical activity of CGN (with NS and renal dysfunction) was more pronounced than in patients with NS and normal renal function. There was a decrease in the number of Treg cells in the interstitium of the kidney and a decrease in the production of anti-inflammatory IL-10 in CGN patients with NS, compared with patients without NS. The most pronounced changes in the cytokine profile were observed in patients with FSGS with an increase in pro-inflammatory cytokines and a decrease in Treg in the kidney tissue/anti-inflammatory IL-10 in the urine., Conclusion: An imbalance of cytokines characterized by an increased levels of pro-inflammatory IL-17, IL-6, TNF-a, and a reduced levels of anti-inflammatory IL-10 and T-regulatory cells in the kidney tissue is noted in patients with NS, especially with FSGS. Imbalance of cytokines reflects the high activity of CGN and the risk of the progression of the disease.

Aim: To assess the possibility of using serum levels of chemokine CXCL13, B-cell activating factor (BAFF), interleukin 1 and 17 (IL-10, IL-17) as markers of the development/progression of multiple sclerosis (MS)., Material and Methods: Sixty-seven patients with MS in remission and 14 healthy volunteers were examined. The levels of BAFF, CXCL13 and the main products of Th17 and Treg - interleukin 17 (IL-17) and IL-10 in the serum were determined, their relationship with clinical characteristics of MS during remission was assessed., Results and Conclusion: The content of IL-17 and BAFF in the serum of patients with MS did not differ significantly from the control group, and the levels of IL-10 and CXCL13 were lower than the corresponding indicators of healthy donors. In patients with MS, no correlation was found between IL-17, IL-10, BAFF and clinical characteristics of MS. The level of CXCL13 correlated with quality of life, fatigue, clinical and functional status of patients. According to the results of this study, BAFF and CXCL13 cannot be proposed as diagnostic biomarkers of MS.

Aim: to assess prognostic significance of blood content of regulatory and effector T-lymphocytes for progression of atherosclerosis (AS) of carotid arteries., Material and Methods: We enrolled in this study 33 men with various severity of carotid AS. Carotid artery duplex scan was done at admission and in 1 year after enrollment. AS progression was defined as appearance of novel stenosis in common or internal carotid artery or more or equal 5% increase of preexisting stenosis. Peripheral blood lymphocyte phenotyping was performed by direct immunofluorescence and flow cytometry at the enrollment. T-helpers (Th) 1 were identified as CD4+IFNgamma+ cells, Th2 - CD4+IL4+, activated T-cells (T-act) - D4+CD25lowCD127high, regulatory T-cells (T-reg) - D4+CD25highCD127 low and CD4+FoxP3+, Th17 - CD4+IL17a+ cells., Results: Progression of carotid AS was observed in 18 patients. Basal values of Th17 were higher while ratio T-reg/Th17 was lower in patients with compared with those without AS progression. ROC-analysis showed high sensitivity and specificity of blood levels of Th17, T-act and T-reg/Th17 ratio for carotid AS progression during one year in patients with low density lipoprotein cholesterol (LDLCH) level below 3.5 mmol/l., Conclusion: The imbalance between circulating levels of regulatory T-cells and T-helpers 17 with the prevalence of proinflammatory T-helpers 17 may reflect a predisposition for carotid AS progression, what also refers to patients with relatively low LDLCH.

Aim: Тo investigate the possible association between clinical characteristics of multiple sclerosis (MS), quantitative and qualitative characteristics of Th17, dopamine and norepinephrine concentrations in the serum in patients with multiple sclerosis (MS)., Material and Methods: A comprehensive neurological and immunological examination of 43 patients with relapsing-remitting-MS (RR-MS) was performed. All patients were subjected to a standard neurological examination with assessment of the EDSS score. Dopamine and norepinephrine concentrations in serum were measured by enzyme-linked immunosorbent assay (ELISA). Percentage of Th17-cells was determined by flow cytometry. The functional activity of Th17- and Th1-cells was assessed by the production of interleukin-17 (IL-17) and interferon-gamma (IFN-γ), respectively, by peripheral blood mononuclear cells (PBMC) stimulated with microbeads coated with anti-CD3 and anti-CD28-antibodies., Results: The percent Th17-cells and cytokine production was significantly higher in MS patients with the exacerbation of disease than in the control group or remission, while the dopamine level was lower. Norepinephrine levels in MS patients in the acute stage and remission were comparable, but nevertheless, reliably lower than in the control group., Conclusion: The results suggest the inhibitory effect of catecholamines on Th17 cells.