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The literature review presents the results of optical coherence tomography and optical coherence tomography — angiography used for Graves’ orbitopathy. The data on the thickness of the inner layers of the retina, microcirculation in the peripapillary and macular regions, parameters of the choroid, lamina cribrosa and extraocular muscles were analyzed as possible diagnostic criteria of the condition.

Currently, there is a wide range of antiglaucoma drugs. Ophthalmologists are faced with the task of choosing certain drugs and their combinations for specific patients. In this regard, studies aimed at studying the effectiveness of treatment, not only in terms of IOP indicators and instrumental research methods, but also in terms of the choice of a particular type of therapy by ophthalmologists, are of great interest. Purpose: to analyze the data obtained in the course of the study of the Russian multicenter scientific program: “Analysis of the assortability of ophthalmologists when choosing therapy within the framework of routine medical care in patients with primary open-angle glaucoma (POAG)”. The large-scale statistical study carried out was based on the study of 197 medical questionnaires from 61 cities of Russia, containing information on 6851 clinical cases. Doctors were asked to fill out a questionnaire based on the results of treatment (at least 2 months), taking into account the following criteria: satisfaction with treatment, adherence to treatment, accessibility, tolerability and ease of use of drugs. Evaluated the use of 5 antiglaucoma drugs of the company Sentiss Russ, belonging to different pharmacological groups: Prolatan (latanoprost), Bimatan (bimatoprost), Brinex-M (brinzolamide); Tisoptan (bimatoprost / timolol maleate), Brinarga (brinzolamide / timolol maleate). During the study, patients were divided into 6 groups depending on the drug used, and also into 3 groups depending on the stage of primary POAG. The data obtained indicate a statically high level of average values when using the point system of all the above criteria when using these drugs. When analyzing the degree of convenience and the level of tolerance of drugs, a tendency towards a decrease in the average scores of these indicators in patients with advanced stage of glaucoma was noted, which may be due to the long-term use of antiglaucoma therapy in this category of patients with changes in the ocular surface. 98.25% of doctors expressed their intention to continue prescribing antiglaucoma drugs from Sentiss Russ.

Streptococcus pneumoniae infection is the most common cause of high morbidity and mortality among children under 5 years of age, immunocompromised people, and the elderly. Despite significant success, the approved pneumococcal conjugate and polysaccharide vaccines are of limited efficacy, providing protection against a small fraction of the known pneumococcal serotypes. The rapid spread of multidrug-resistant strains exacerbates the global challenge of treating infection caused by S. pneumoniae. At the same time, the emerging new strains dictate the need to include new serotypes into vaccines. In view of this, further improvement of vaccines for the prevention of pneumococcal infections is an urgent task. The aim of this study was to review advances in the development of polysaccharide, conjugate, whole-cell pneumococcal vaccines, as well as vaccines based on protein antigens and vaccines with an antigen delivery system. Genomics and proteomics data have helped to improve approaches to the creation of polysaccharide and protein-based vaccines, as well as whole-cell vaccines with the potential for population prophylactic coverage against various pneumococcal serotypes that are not included in the licensed pneumococcal vaccines. The method of antigen delivery to the cell is of great importance in the development of vaccines. The most promising strategy for improving pneumococcal vaccines is the creation of vaccines based on bacterium-like or synthetic particles carrying several antigens, including pneumococcal surface proteins. In conclusion, it should be noted that top-priority vaccines are those that provide a wide range of protection against circulating pneumococcal serotypes and, in addition to eliciting a systemic immune response, also induce local immunity.

Vaccines by different manufacturers are available for most of the vaccine-preventable infections covered by the National Immunisation Schedule of the Russian Federation. Determination of the possibility of replacing a vaccine in the case of routine or emergency vaccination still remains a challenging issue. The aim of the study was to substantiate the problem of vaccine interchangeability, outline specific challenges and ways of solving them, analyse criteria underlying evaluation of vaccine interchangeability in Russia, and international experience in this area. The procedure for determining the interchangeability of biological products, including vaccines, was established in the Decree of the Government of the Russian Federation of 5 September 2020, No. 1360 “On the procedure for determination of interchangeability of medicinal products for human use”. The paper analyses the applicability of the official criteria for interchangeability of biological products, including vaccines. It outlines the main problems of performing evaluation of vaccine interchangeability in accordance with the established criteria. It is concluded that the vaccine interchangeability criteria need to be clarified in order to allow for assessment of comparability of active substances, and comparison of efficacy, safety, and immunogenicity of vaccines, taking into account vaccination schedules for different age groups. The possibility of evaluating interchangeability based on the results of post-authorisation studies also needs clarification. It is also necessary to align patient information leaflets for interchangeable vaccines.

Optical coherence tomography (OCT) is widely used in ophthalmological practice. The review presents the results of OCT in patients with somatotropin-producing pituitary adenoma, or somatotropinoma, which is a hormone-active tumor of the adenohypophysis, characterized by excessive production of somatotropic hormone (STH). It stimulates the secretion of type I insulin-like growth factor (IGF-I). The mechanisms of STH action (pro-angiogenic action, stimulation endothelial cell proliferation and migration, development of endothelial dysfunction and retinal edema) requires much attention to the results of examination of patients with somatotropinomas using modern diagnostic methods, such as OCT.

The emergence of fundamentally novel technological solutions in the field of gene therapy today, the formation of the priority and the development of genetic technologies create serious prerequisites for the beginning of a new Fusion era in ophthalmology in the near future. This review, in its second part, presents the results of fundamental and clinical studies on the use of genetic therapeutic strategies – gene replacement, gene suppression, genomic editing using CRISPR / Cas9 technology which have been used in ophthalmology over the past several years.

The emergence of fundamentally novel technological solutions in the field of gene therapy today, the formation of the priority and the development of genetic technologies create serious prerequisites for the beginning of a new Fusion era in ophthalmology in the near future. This review, in its first part, presents the results of fundamental and clinical studies on the use of viral and non-viral systems for the delivery of genetic material in ophthalmology. The second part of the review will focus on genetic therapeutic strategies (gene replacement, gene suppression, genomic editing using CRISPR / Cas9 technology, priming and transposon editing) that have been used in ophthalmology over the past several years.

In recent years, the range of combined narcotic drugs has widened. New chemical modifications have emerged, including so-called designer drugs, whose action on the body and in particular on the state of vision is increasingly difficult to determine. While the problem of drug abuse is growing drastically, timely detection of a possible toxic damage to the eye induced by drugs and reliable diagnosis differentiating such damage from other etiologies becomes a topical practical issue. The paper presents a clinical case of poppers maculopathy (poppers being a slang name of aromatic volatile alkyl nitrite compounds). Ophthalmological manifestations and differential diagnostic criteria of the damage are described. The mechanisms of action and possible treatment methods are discussed.

According to the recent WHO data, 39 million people in the world are blind. In developing countries cornea diseases are the second most common cause of blindness. Cornea transplantation remains the only radical method to regain lost vision for many blind people around the world. However, according to literature reports, cadaveric donor corneas pose a potential risk of herpes virus transmission to the recipient during penetrating keratoplasty. It is known that herpes simplex virus-1 persisting in the donor cornea can adversely affect graft survival up to causing the graft failure reaction. The latent herpes simplex virus may be reactivated by a number of factors, most of them occurring with penetrating keratoplasty. One of these factors is immunosuppressive therapy, an essential element of the pharmacological graft protection. Antiviral agents are strongly recommended in order to inhibit the replicating herpes simplex virus in the cornea graft. The most common antiviral agents are interferons with their inducers and acyclic nucleosides. Viral decontamination during cornea storage would prevent the donor-to-recipient transmission of herpes simplex virus in relation to keratoplasty.

The literature review presents the results of a static perimetry for the study of the visual field in patients with compression in the chiasm-sellar region on the Humphrey Visual Field Analyzer (HFA) and Octopus. These models of perimeters are recognized as the “gold standard” and are most widely used in the global ophthalmic practice. The analysis of research results using traditional and function-specific perimetry with selective stimulation of the magnocellular and koniocellular (frequency-doubling technology perimetry, FDT; short-wavelength automated perimetry, SWAP) visual pathways was performed. The literature data analysis allows us to conclude that the static perimetry for the study of the visual field in patients with chiasmatic compression is carried out quite widely and is informative. But despite this, there are no generally accepted recommendations on the use of certain testing strategies and programs for the diagnosis and further dynamic observation of changes in the visual field in patients with this pathology. In this regard, it is advisable to conduct further studies that will allow the formation of standard perimetric protocols for diagnosing and monitoring visual field defects in patients with compression in the chiasm-sellar region based on a comparative analysis of the diagnostic informativity of various strategies and programs.

An increase in the growth of cardiovascular diseases has been observed in the last few years. Cardiac rhythm disturbances, especially atrial fibrillation, in absence of cardioversion and proper prophylaxis lead to thromboembolic complications. Drug therapy in rhythm disorders consists of the many antiarrhythmic drugs, prescribed for a long period of time. This fact can result to the ocular toxicy, which have insidious and slow progression. First and foremost, there is a risk of amiodarone-associated toxicity. Amiodarone affects as anterior segment structures (photosensitivity, corneal and conjunctiva deposits, anterior subcapsular cataract) as posterior segment structures (optic neuropathy). Fibers of the papillomacular bundle are the most vulnerable structures in optic nerve to the toxic effect of amiodarone due to the absence of myelination and salutatory conduction, their small size and high-energy requirements. The difficulties in diagnosis of amiodarone-associated optic neuropathy are related to slow progression (patients don’t notice symptoms until the late stages) and clinical similarity to ischemic optic neuropathy.

Recovery and preservation of visual functions during compression in the chiasm-sellar region is possible in the case of early diagnosis of pathology and timely surgical decompression. Today optical coherence tomography (OCT) of the retina is one of the most informative methods for diagnosing pathology of the retina and optic nerve. It can, due to the presence of early diagnostic criteria, promptly detect the compression in the chiasm-sellar region and expand the indications for surgical treatment. The literature review presents the results of optical coherent tomography (OCT) of the retina during compression in the chiasm-sellar region. An analysis of literature data revealed that in patients with chiasmatic compression, the thickness of the nerve fiber layer in the peripapillary and macular areas decreases, the thickness of the macular complex, consisting of the retinal ganglion cell layer and the inner plexiform layer, decreases. Also, there is a change in the value of asymmetry between the GCC thickness indices in the nasal and temporal halves of the macular region. It has been established that a decrease in the thickness index of a macular complex may precede changes in the visual field. According to the results of single studies, a correlation was found between the parameters of the peripapillary RNFL thickness and the the internal capillary retinal plexus density in the same areas. The results of literature sources’s analysis are summarized in the table by the parameters studied, the OCT model; etiology, treating methods and the results of the OCT study. Despite the results obtained, the early specific and sensitive OCT diagnostic criteria for chiasmatic compression have not yet been developed. In addition, a change in the thickness of GCC and RNFL can also be observed in the absence of chiasmatic compression in certain types of tumors and in the presence of comorbidities (arterial hypertension). In this regard, it is necessary to conduct further studies that will reveal the informative OСT-diagnostic criteria for compression in the chiasm-sellar region, develop diagnostic algorithms taking into account the type of tumor, the presence of concomitant pathology. Early diagnostic criteria for chiasmatic compression will expand the indications and improve the result of surgical treatment of patients.

Purpose. To carry out a comparative analysis of results in the treatment of the circumscribed choroidal hemangioma (CCH) by methods of diode-laser transpupillary thermotherapy and brachytherapy.Material and methods. The data of treatment of 185 patients (185 eyes) with circumscribed choroidal hemangioma were analyzed, previously the patients were divided into groups by type of treatment. For the comparative analysis, the groups were standardized by tumor thickness, length of the base, tumor localization, follow-up period, initial visual acuity, frequency of detectable retinal detachment. As a result, the group of diode-laser thermotherapy consisted of 54, and the group of brachytherapy – 33 individuals.Results. After the treatment, the average visual acuity after treatment in the group of transpupillary thermotherapy was significantly higher (0.47) than in the group of brachytherapy (0.2) (p=0.0004). It was noted that the improvement of visual acuity after transpupillary thermotherapy was achieved in 27 (53%) cases more often than after brachytherapy – in 5 cases (15%) (p=0.01 χ2 criterion). Each of the treatment types led to the resorption of the subretinal transudate and the reposition of the detached retina in all cases. In the evaluation of changes in average visual acuity before and after the treatment in each group, there were noted statistically significant differences in the group of transpupillary thermotherapy (0.33 before the treatment, 0.47 after the treatment; p=0.046) and their absence in the group of brachytherapy (0.22 before treatment, 0.2 after treatment; p=0.7).Conclusion. Diode laser transpupillary thermotherapy leads to better functional results compared with brachytherapy. Taking into consideration the absence of surgical trauma in transpupillary thermotherapy and an increased risk of complications in brachytherapy, the priority in the choice of a treatment method for CCH should be given to transpupillary thermotherapy.

Mass vaccination is an essential element of immunoprophylaxis of infectious diseases, and the global community has agreed that it is crucial for preserving the lives and health of children and adults. The objective of this study was to analyse the current state of vaccination of infants under one year old against bacterial infections, given that the National Immunisation Schedule is overladen with various vaccines, and there are apparent inconsistencies between the types of marketed vaccines and recommendations on their use. The article summarises the types of antibacterial vaccines marketed in the Russian Federation, analyses some aspects of combination of different antigens and interchangeability of vaccines. The authors justify the need to amend recommendations on antibacterial vaccination and to develop common rules for the use and combination of vaccines, as well as for their interchangeability. Another important issue is adoption of requirements for the contents of patient information leaflets. The article summarises the main safety concerns regarding the use of polyvalent vaccines and simultaneous vaccination against several pathogens. It discusses safety issues of multiple immunisation and the strategy to reduce potential risks associated with an intensive vaccination schedule. The authors highlight the safety of current immunisations schedules and the need to update vaccination standards. They also demonstrate the need to harmonise national recommendations on the use of vaccines based on clinical data and the results of international clinical trials.

Background. Linden flowers (Tilia cordata Mill) in the form of various medicinal forms is used as a diaphoretic and expectorant. The pharmacological properties of Linden flower preparations are mainly due to the essential oil (farnesol) and polysaccharides. However, according to literature data, the raw materials of Linden contain flavonoids, which are represented by tilianin, quercetin, hyperoside, and rutin. One of the most important properties of flavonoids is the ability to increase the strength of capillary walls (P-vitamin activity) due to the antioxidant effect, which is important in the treatment of chronic venous insufficiency, hypertension and other cardiovascular diseases associated with increased permeability of blood capillaries [1, 2]. The most striking representative in this group of substances is rutin, which belongs to the group of vitamin R. In this case, Linden flowers are of great interest. The problem of chemical standardization of raw materials of this plant is not fully solved, it is important to develop methods of standardization for the quantitative content of the amount of flavonoids. In our opinion, despite the complex chemical composition of Linden flowers, represented by such groups of biologically active compounds as essential oil, polysaccharides, flavonoids, it is advisable to standardize this plant according to the content of flavonoids. Objective – research on the development of a method for quantifying the content of flavonoids in Linden raw materials. Materials and methods. The object of the study was used 3 samples of dried Linden flowers grown in the Penza, Samara and Moscow regions. Quantitative determination of flavonoids was performed by the method of differential spectrophotometry. Results. In methods of quantitative determination of flavonoids of plant raw materials, water-alcohol solutions of different concentrations are used for extraction. It was found that in comparison with 70 % alcohol extracts, the intensity of peaks in 40 and 95 % alcohol extracts is less. Therefore, for the extraction of flavonoids from Linden flowers, it is advisable to use 70 % ethanol. It is shown that the UV spectra of Linden flower extracts have one clear maximum absorption at 279 nm, regardless of the concentration of ethanol-extractant. In the development of quantitative determination of flavonoids in Linden flowers, UV spectra of their complex compounds with aluminum chloride were studied. It was found that in the presence of aluminum chloride, the maximum absorption of the complex compound of Linden flavonoids is in the region of 408 ± 2 nm. As a result of the study, it was revealed that the best concentration of alcohol is 70 %, the best ratio of raw materials and extractant is 1:100, the best time for extraction is 60 minutes. Conclusions. Samples of Linden grown in different regions of Russia were analyzed using the developed technique for determining flavonoids. It was found that the content of flavonoids in Linden flowers varies from 1,5–2,0 %.

Background. Flax seed – Linum usitatissimum L. family. Flax – Linaceae, widely used in traditional medicine. The main group of biologically active compounds (BAS) are fatty acids, including linoleic, linolenic and oleic. Due to the presence of polyunsaturated fatty acids (omega acids), it has a wide range of pharmacological effects: hypocholesterolemic, anti-inflammatory, and antioxidant. Currently, a large number of new flax varieties have been obtained, the seeds of which have significant differences. In modern medicine, flax seeds are used as sources of polysaccharides, while not taking into account the fatty acid composition and the ratio of ω-6 and ω-3 polyunsaturated fatty acids. In the last decade, a large number of new varieties with different amino acid and fatty acid composition have been developed, and the content of these biologically active compounds has not been sufficiently studied. In this regard, it seems relevant to study the fatty acid composition of flax seeds. Objective – to study the component and fatty-acid composition of seeds of modern varieties of flax seed. Materials and methods. As a material for the study, samples of powdered raw flax of six varieties were used: Istok, linola +, Severny, Brestsky, Karabalyksky, Belochka. Fat content was determined in the Soxhlet apparatus method (skim balance); protein – titration in the Kjeldahl apparatus; fiber – to Henneberg and Shimano in the modification of TIN; phosphorus content – by combustion at Pinevich modification Kurchaeva spectrophotometrically at a wavelength of 670 nm. The study of the fatty acid composition of flax seed oil was performed by gas-liquid chromatography after preliminary conversion of fatty acids to methyl esters according to GOST 31665–2012. Results. As a result of the analysis, it was found that flax seeds differ in oil content and protein content, the total number of which varies on average from 55 to 75 % of the total weight. The maximum amount of protein was found in the raw materials of Linol + (25,97 %), Belochka (25,10 %) and fatty oil – Istok (46,52 %), Severny (45,17 %), and Brest (44,25 %) varieties. Sixteen fatty acids were identified and their quantitative composition was established. Under the same growing condipolyunsaturated fatty acids. The oil is characterized by a high content of unsaturated fatty acids (75–90 %), including polyunsaturated (60–80 %). From unsaturated fatty acids, linolenic, linoleic, and oleic acids predominate; from marginal ones, palmitic. Conclusions. Flax seeds have a high nutritional value due to the high content of protein and fatty oil, the total amount of which is 60–75 %. The seeds of the following varieties have the highest oil content: Istok (46,52 %), Severny (45,17 %), and Brestsky (44,25 %). The largest amount of fiber contains raw oilseed flax varieties: Brest (10,91 %), Karabalyk (11,60 %), Belochka (11,70 %). In terms of palmitic acid content, the leading fatty oil is Linola + (6,682 %), stearic – Brest (5,862 %), oleic – Belochka (27,987 %), linoleic – Istok (69,161 %), linolenic – Brest (55,637 %).

The paper presents the data on the assessment of the demand for heterologous drugs and highlights the need for their use in practical healthcare. Currently, 15 heterologous immunoglobulins and sera are registered in the Russian Federation. Nine of them are against bacterial and viral infections (anthrax, diphtheria, tetanus, botulism, rabies, anti-gangrenous), one – against snake venom, five other – anti-thymocyte immunoglobulins produced by domestic and foreign manufacturers. Analysis of the data has demonstrated that anti-rabies immunoglobulin, anti-diphtheria and anti-botulinic sera, A, B and E type are the most in-demand. Production of other therapeutic drugs from this group, for instance, anti-gangrenous serum, tends to decline. Adequate provision of medical curative and preventive institutions with these preparations is a significant element in timely treatment of infectious diseases such as anthrax, diphtheria, tetanus, botulism, rabies, as well as snake bites. In prophylaxis and treatment of certain diseases (emergency aid in case of anthrax, rabies, venomous snake bites) heterologous preparations still oftentimes do not have an alternative. The key problem in regulation of heterologous preparation circulation is absence of quality, efficacy and safety criteria applicable to other immunobiological preparations. Development of unified requirements to standardization of heterologous sera and immunoglobulins of various specificity, principles of efficacy and safety evaluation is necessary for harmonization of current guidelines on medical use. Earlier elaborated by WHO approaches to heterologous sera to venoms of snakes can be used for monitoring and harmonization of normative legal documents on the improvement, evaluation of quality, efficacy and safety of alternative drugs being in circulation in the pharmaceutical market of the Russian Federation.

Keratoplasty in patients with recurrent destructive processes in the cornea nowadays remains one of the most serious problems in ophthalmic surgery.Purpose. The analysis of results of penetrating keratoplasty (PK) in patients with destructive processes of the cornea or the corneal graft depending on the initial level of GDNF and the activity of the MAP kinase cascade of the signaling pathways.Material and methods. The analysis of the results of PK was performed in 23 patients (34 eyes) with acute destructive processes of cornea or the corneal graft in different etiologies. The follow-up period was from 6 months to 2 years. The analysis of the results of treatment was carried out depending on the condition of the corneal graft at various times after PK.The immunohistochemical examination of the biological material (corneal disks of the recipient) was performed using antibodies to GDNF, phospho-ERK1 / 2, phospho-JNK1 / 2, Ki67, GAP43, Bcl2 and Bax.Results. The time of epithelialization of the graft after PK in destructive processes of the cornea was increased in 79% of cases. When the epithelialization of the corneal graft was completed more than 6 and 10 days after PK in the postoperative period persistent erosions of the graft (PEG) with ulceration were formed in 22% and 89% of cases, respectively.The intensity of immunohistochemical reactions with antibodies to GDNF, phospho-ERK1 / 2, phospho-JNK1 / 2 in corneal disks at the epithelialization time of up to 5, 10 days and more eythan 10 days after PK was reduced from moderately positive to weakly positive and negative, respectively.When the time of epithelialization was completed in 6-10 days and there was not PECG, the intensity of reactions with antibodies to GDNF remains moderately positive, phospho-ERK1 / 2, phospho-JNK1 / 2 was lightly positive; when there was PEG the intensity of all reactions was weakly positive.Conclusion. The severity of the destructive pathological process in the cornea and postoperative complications after PK in patients with destructive corneal processes depend on the degree of GDNF deficiency, the decrease in the activity of the MAP kinase cascade of signaling pathways; the density of nerve plexuses in the own corneal tissue or corneal graft, and the activity of apoptosis processes.

The method for the assessment of biological activity of erythropoietin preparations in vitro on TF-1 sensitive cells culture has been developed. The special characteristics of measurements and calculations of the biological activity of erythropoietin with different levels of glycosylation in vivo and in vitro. Linear response ranges for cell lines to erythropoietin and its hyperglycosylated analogue differ and make (0.39-0.56 ng/ml) and (3.1-12.5 ng/ml), respectively. The results have shown the possibility of using cellular test for comparing and assaying the activity of erythropoietin analogues in standard international units of biological activity (IU) set for erythropoietin.

Purpose. To study experimentally in vitro secretion of the nerve growth factor (NGF) and the brain-derived neurotrophic factor (BDNF) using intact and induced multi-potent mesenchymal limbal stem cells (MSCs) in three-dimensional culture (3D).Material and methods. MSCs were obtained by culturing of limbal fragments, isolated from the cadaveric human donor eyes, according to the medical technology of the S. Fyodorov Eye Microsurgery Federal State Institution. The phenotype of obtained cell culture was studied by the flow cytometry method.Stimulation of secretion of neurotrophic factors was performed via a two-step technique using non-specific activation factors: EGF, hbFGF, N2 additive, dibutyryl cAMP, NRG1-beta 1, PDGF, 3-isobutyl-1- methylxanthine. The 3D-cell spheroids were generated using agarose plates (3D Petri dishes, Microtissue, USA) for three comparative groups where: Group I – control, Group II – with the induction of spheroids at 1 day of cultivation; Group III – with induction of spheroids at 7 days of cultivation. The concentration of NGF and BDNF in the culture medium was studied using the enzyme linked immunosorbent assay (ELISA).Results. The induction of the 3D spheroids of limbal MSCs, that carried out on the 1st and 7th days of incubation, contributes to a significant increase in the production of NGF and BDNF, but subsequently a pronounced reduction in the secretion of these factors is observed. The conducting of an induction leads to a change in the morphology of spheroids: loss of compactness, the emergence of «fringed» (debris). Such changes indicate a non-viability of the obtained 3D-cell spheroids.Conclusion. The cellular spheroids, created from 2D-culture of intact limbal MSCs by the three-dimensional culture method, are capable in sufficient therapeutic concentrations spontaneously to synthesize NGF and BDNF, have the most optimal design for transplantation in extrabulbar and intraocular tissue niches of the eyeball, are a potential source of prolonged secretion of neural basis function in cell treatment of optic neuropathy.

Aim. To develop technology to create 3D-spheroid multipotent mesenchymal stem cells (MMSC) of limbal cadaveric human eyes, capable of safe and long-term secretion of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF).Materials and methods. MMSC were obtained by cultivation of limbal fragments, released from cadaveric donor human eye. Cultivation was carried out in DMEM/F12 medium, supplemented with L-glutamine, penicillin, streptomycin, amphotericin B, HEPES, insulin, dexamethasone and 10 vol.% FBS under standard conditions (5% СО2, 37 °C), medium change was performed every 3 days. To determine the phenotype of the received cell culture the method of immunophenotyping by marker proteins to MMSC (CD73, CD105, CD19, CD90, CD133) was used. Stimulation of neurotrophic factor secretion was performed via a twostep procedure. 3D-cell spheroids were created with the help of agarous plates for three groups of comparison, where group I was control group, spheroids of intact 2D-culture MMSK; group II – spheroids of previously induced 2D-culture MMSC; group III – spheroids of 2D-MMSC induced on the 1st day of cultivation. Cell cultures supernatants were selected in different periods for NGF and BDNF follow-up study by ELISA procedure.Results. Induction of 3D-spheroids of limbal MMSC promotes short-term increase of the level of BDNF and NGF, but further, the secretion of these factors significantly decreases. Induction leads to a change in the morphology of spheroids: loss of compactness and emergence of «fringed» (debris). Such changes indicate of frailty of received constructions. Spheroids from previously induced MMSC are capable of stable NTF secretion, but the level of secretion is much less as compared to the control group.Conclusion. 3D-cell culture of intact 2Dculture of limbal MMSC can be considered as cellular medication for a safe and long-term neuroprotection in optic neuropathy treatment.

At present it is accepted that glaucoma is a multi-factorial neurodegenerative disease, in which process there occur a death of retinal ganglion cells (RGC), progressive optic neuropathy and a visual field loss.In recent years, a number of large multicenter studies have convincingly shown that the effective reduction of intraocular pressure by medication and surgical methods does not guarantee a long-term stabilization of the glaucomatous process, and therefore a number of patients have a progression of the neurodegenerative process.This fact determines the necessity to search new ways of glaucoma optic neuropathy therapy, one of these can be the neuroprotection based on the methods of cell therapy.It is shown that the apoptosis is the primary mechanism of RGS death in glaucoma as in other neurodegenerative diseases. Currently found a large number of triggers of RGS apoptosis. One of the most important is the factor blocking axoplasmatic transport of neurotrophins.Neurotrophins are a family of structurally and functionally similar polypeptides that plays an important role in the differentiation, survival and regeneration of neurons.Numerous studies have shown that the neurotrophic factors in general, especially brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) significantly improves the RGC survival in experimental models of glaucoma.It is revealed that multipotent mesenchymal stromal cells (MMSC) can release a large number of bioactive factors, including neurotrophins, both in vivo, as well as in experiments in vitro.MMSC of eye limbus phenotypic match the bone marrowderived mesenchymal stromal cells. During MMSC culturing they secrete a wide variety of cytokines, interleukins, growth-factors. Therefore we consider the transplantation of allogenic limbus fragments as a candidate for cell therapy in the treatment of glaucomatous optic neuropathy.

In the pathogenesis of uveitis the immune reactivity of the organism, which includes links of congenital and acquired (adaptive) immunity plays an important role. The congenital immune system forms a first line of defense towards pathogenic agents, penetrating into the human body. Implementation of specificity innate immune system falls into a family of evolutionarily conserved receptors, known as Toll-like receptors (TLR), which play a crucial role in the early protection of the organism against pathogens.Purpose. To study and carry out comparative characteristics of different types of expression of Toll-like receptors on peripheral blood cells in the control and uveitis of various etiologies.Material and methods. The study involved 15 patients (7 male and 8 female) aged 25-54 years, with a diagnosis of acute or exacerbation of chronic uveitis of various etiologies. The control group consisted of healthy persons aged 23-27 years – 12 individuals. The level of expression of Toll-like receptor was evaluated by the flow-cytometric analysis of leukocytes stained according to the standard protocols by fluorescentlylabeled antibodies (HyCult Biotech, The Netherlands) to the superficial (TLR2, TLR4, TLR6) or intracellular (TLR3, TLR9)receptors.Results. The obtained results were statistically significant in the reduction of the TLR2 expression on B lymphocytes and monocytes (p=0.02 and 0.014, respectively) more than two-times; TLR4 and TLR6 – on monocytes (p=0.01 and 0.047, respectively) in patients with infectious-toxic uveitis. In patients with severe autoimmune uveitis (6 individuals) the TLR expression differed by the polymorphism and tended to an increase compared to the control.Conclusion. In infectious uveitis the most toxic pathogenetic importance is a significant inhibition of the TLR2, TLR4 and TLR6 expression on peripheral blood monocytes, that is probably due to the excessive stimulation of Toll-like receptors by exogenous ligands prior to or at the onset of the disease, and the development of state of hyposensitivity of Toll-like receptors, as a defensive reaction of the uvea from the hyperinflammation. There are required further studies of character of Toll-like receptors expression in uveitis remission in order to assess the influence of inflammatory activity and drug therapy on the TLR expression.

The analysis of long-term morbidity of acute and chronic viral hepatitis B in the Republic of Buryatia is lead. The data of inspections of HBV infection among the population of republic are presented. The interrelation between morbidity and. immunization of the population against a virus of hepatitis B is revealed. The results of the realization priority national project of healthcare on additional immunization of the population against HBV infection in republic are given.