[The prevalence of autoimmune endocrine diseases in vitiligo patients]

Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.

[Representation of the results when testing for syphilis.]

In medical organizations special forms (approved by orders of the Ministry of health and the Central statistical office) are used to present the results of laboratory examination of the population for syphilis. Currently, these forms include laboratory technologies that do not meet modern standards. In 2018-2019 the normative documents, regulating the use of accounting forms of medical documentation in the public health system, and the practice of using forms with the results of laboratory examination for syphilis were studied in 35 branches of 3 medical organizations of the Lyubertsy district of the Moscow region and in 18 branches of Moscow city was conducted. It is established that in the medical organizations of Moscow and the Moscow region are used the different forms of the registration forms approved by orders of the Ministry of health of the USSR which have now become invalid. The structure of the forms with the results of the population survey for syphilis does not correspond to the applied modern technologies and standards of the survey. On the basis of requirements of modern regulatory documents two new forms of registration forms for the presentation of results of laboratory researches have been developed, within 1,5 years tested and offered for application: one form at screening of the population for syphilis and another - for performing verification examinations for diagnostics and the subsequent clinical and serological supervision.

[The role of some individual amino acid substitutions in penicillin-binding protein (PBP2) of Neisseria gonorrhoeae in the emergence of resistance to ceftriaxone]

The goal of the study was to identify amino acid replacements in the structure of penicillin-binding protein PBP2, which may influence on the development of resistance N. gonorhoeae to the III cephalosporins generation. The gene penA of 50 strains of N. gonorrhoeae was sequenced: 20 strains with high sensitivity to ceftriaxone (MIC, Minimum Inhibitory Concentration, = 0.002 mg/L) and 30 strains with decreased sensitivity to ceftriaxone (MIC = 0.03-0.25 mg/L). The difference of MIC sensitivity between these strains was 30-250 times. Then nucleotide sequence was transformed into the amino acid sequence of PBP2 protein. Mutations in the gene penA and amino acid replacements in the protein PBP2 were found in 16 of 20 strains (80%) with high sensitivity to ceftriaxone and in all strains with decreased sensitivity to ceftriaxone. Amino acid replacements in the PBP2 protein were compared with amino acid replacements in groups, which characterize the PBP2 structure in accordance with the international classification Ito M. The amino acid replacement of PBP2 at positions 346, 505, 511, 517, 543, 567, 575, 576 are associated with V group by Ito M and have features of resistance of N. gonorrhoeae to ceftriaxone authentically (OR = 3.9 ± 2.5; χ2 = 4.9; p < 0.05). It was shown that the replacement of glycine to serine at position 543 of PBP2 in the analyzed strains induced the multiple increase of resistance to ceftriaxone. These data may be significant as showing strong influence of amino acid replacements at positions 346, 505, 511, 517, 567, 575 and, in particular, 543 for development of resistance N. gonorrhoeae strains to ceftriaxone.

Development of a complex of preventive measures and their assessment to prevent the propagation of gonococcal infection in the arkhangelsk region

Goal of the study. To assess the efficacy of a complex of preventive measures developed in 2011-2012 for preventing the propagation of gonococcal infection in the Arkhangelsk region based on a study of the gonococcal infection morbidity dynamics in the territory of the region in 2011-2013. Study materials and methods: the authors analyzed statistics on the gonococcal infection morbidity in the territory of the Arkhangelsk region. To assess the efficacy of the complex of measures developed to prevent the propagation of gonococcal infection and other STDs in the Arkhangelsk region, the morbidity dynamics rate was calculated. Results. A complex of preventive measures for preventing the propagation of gonococcal infection in the Arkhangelsk region was developed in 2011 and was put to practical use in 2012. In 2012, the gonococcal infection morbidity rate grew in the Arkhangelsk region by 49.1% vs. 2011. Such a growth can be explained by the improved procedures for recording cases of gonococcal infection used in departmental and private medical organizations as well as optimization of the infection diagnostics methods including cultural tests and PCR, in particular, in women. In 2013, the incidence of gonococcal infection fell down as compared to 2012 (85.3 cases per 100,000 people in 2012 and 68.6 cases in 2013) including among teenagers (76.9 cases per 100,000 people in 2012 and 52.9 cases in 2013) in most municipal districts of the Arkhangelsk region (in 20 districts and towns, or 76.9% of the territory). Conclusions. Practical implementation of the complex of preventive measures developed to prevent the propagation of gonococcal infection and other STDs in the Arkhangelsk region substantially reduced the morbidity of gonococcal infection in the territory of the region. The collected data are sufficient to give a positive assessment of the developed measures and emphasize their contribution to the reduction of the morbidity of gonococcal infection.

Application of Confocal Laser Scanning Microscopy in Biology and Medicine

Fluorescence confocal laser scanning microscopy and reflectance confocal laser scanning microscopy are up-to-date highend study methods. Confocal microscopy is used in cell biology and medicine. By using confocal microscopy, it is possible to study bioplasts and localization of protein molecules and other compounds relative to cell or tissue structures, and to monitor dynamic cell processes. Confocal microscopes enable layer-by-layer scanning of test items to create demonstrable 3D models. As compared to usual fluorescent microscopes, confocal microscopes are characterized by a higher contrast ratio and image definition.

Molecular monitoring and determination of N. gonorrhoeae sensitivity to antimicrobial drugs as tools to control the propagation of gonococcal infection in the Arkhangelsk Region

As a result of studying the sensitivity indices concerning antimicrobial drugs (AMD) for 203 strains of N. gonorrhoeae obtained from patients suffering from the gonococcal infection in the Arkhangelsk region, it was established that the trends of N. gonorrhoeae strains propagation, which are resistant to AMD, match the trends in Russia in general. Ceftriaxone is the drug of choice to treat the gonococcal infection in the territory of the region. It was observed that N. gonorrhoeae strains started developing resistance to the AMD in the territory of the region. The authors conducted a study of 51 N. Gonorrhoeae strains obtained from patients suffering from the gonococcal infection in 2011 using molecular epidemiology methods (sequence and phylogenetic analysis). Heterogeneity in the sample of the N. gonorrhoeae strains circulating in the territory of the Arkhangelsk region as well as high rate of their genetic variability were revealed. It was noted that N. gonorrhoeae strains, which are unique for this geographic region (dominating sequence types No. 343, 5042, 1523, 1152, 387, 6238, 5825 and 6234 as well as single sequence types), are registered in the territory of the Arkhangelsk region. The authors demonstrated the possibility to use molecular methods (PCR and sequence analysis) for individual identification of infection sources and sexual partners of patients suffering from the gonococcal infection and for the purposes of epidemiological monitoring. The authors established associations between the fact that the N. gonorrhoeae strains obtained from patients suffering from the gonococcal infection in the Arkhangelsk region belong to sequence types No. 343, 285, 2625 and 6237, and their multi-resistance, which demands a thorough examination to determine the treatment tactics for such patients. Taking into consideration the results of these studies, the authors prepared recommendations on how to control the propagation of the gonococcal infection in the territory of the Arkhangelsk region.

Epidemiological aspects of gonococcal infection in the arkhangelsk region

The authors studied the incidence of gonococcal infection in the Arkhangelsk region in 2001—2011. They also analyzed gender and age distribution, social set-up, education level and marital status of patients. In areas with the low to moderate (Group I) and high (Group II) incidence, the authors analyzed such indices as density of the population, number of dermatovenerologists, territorial profile (agricultural or industrial depending on the branch) and transportation quality. In 2001—2011, the incidence of gonococcal infection in the Arkhangelsk region was falling down — from 187.4 per 100,000 people in 2001 to 78.9 per 100,000 people in 2011 (by 2.4 times). Substantial difference in the incidence rate was observed in different districts of the region. The authors revealed that young men aged 20—29 with secondary education, not engaged in public production, clerks or workers from industrial enterprises, not married, practicing often and sometimes unsafe sexual contacts with women belong to the risk group in terms of incidence of gonococcal infection in the Arkhangelsk region. The authors also revealed that living in big towns with well-developed heavy (machine building, shipbuilding), oil extraction and oil processing industry as well as transportation (in particular, marine and river transport) where young men are employed, and high migration of the population is observed (tourism, business travels, labor migration) may be a risk factor in terms of incidence and propagation of gonococcal infection in the Arkhangelsk region.

First experience of molecular typing and determining the antibiotic resistance of syphilis pathogen Treponema pallidum in the Russian Federation

The authors present the results of molecular typing and determining the antibiotic resistance of 190 T. pallidum strains sampled from primary and secondary syphilitic patients in the russian Federation in 2011—2012. molecular typing of T. pallidum strains was based on two variable gens: arp, tpr, and was supplemented with an analysis of gene tp0548 reading frame. Antibiotic resistance of syphilis strains was determined by means of sequencing the gene encoding 23S rRNA T. pallidum in such loci as A2058G and A2059G/C (resistance to macrolides), gene encoding 16S rRNA T. pallidum in locus G1058C, and determinant tetB (resistance to tetracyclines) as well as full-scale sequencing the genes encoding target proteins of β-lactams Tp47 and Tromp. As a result of molecular typing in the territory of the Russian Federation, ten subtypes of T. pallidum were revealed. Type 14 (98.4%) predominates; the share of subtype 14d/f is 91.03%; the share of subtypes 14d/Tand 14b/f, Type 14, was 2.10 and 3.16%, respectively; the share of all other subtypes (11d/f, 13d/f, 14a/a, 14a/f, 14d/g, 14d/c, 20d/f) was 0.53%. molecular markers of T. pallidum antibiotic resistance were revealed among the strains coming from the Central, Siberian and Volga federal regions of Russia: macrolides - three strains sampled in 2011; tetracyclines - two strains sampled in 2011 and one strain sampled in 2012.

Correlation of polymorphisms in genes coding cytokines TNF-α, IL-10, MBL2, IFN-γ and IL-6 with complicated course of urogenital chlamydial infection in men

Goal. To develop a personified approach to the management of men with the urogenital chlamydia infection based on studying the molecular and genetic risk factors of the development of complications. Materials and methods. Patients with the urogenital chlamydia infection (20 men with the urogenital chlamydia infection of the lower urogenital tract and 20 men with complicated forms of the urogenital chlamydia infection) and men without any clinical or laboratory signs of STDs and inflammatory diseases of the urogenital tract. The following methods were used in the study: anamnestic, clinical, instrumental (transrectal ultrasonography) and laboratory (microscopic, bacteriological, molecular and biological (PCR, SNaPshot)). Results. According to the study results, the share of cases of ureteritis caused by C. trachomatis amounted to 10.5% of the total share of cases of ureteritis and 13.0% of cases of non-gonococcal ureteritis. The percentage of complicated urogenital diseases caused by C. trachomatis amounted to 34.5% of the total share of complicated forms and 35.7% of noncomplicated forms of the non-gonococcal origin. Subjective clinical signs of complicated forms of the chlamydia infection did not have any reliable distinctions from those observed in case of non-complicated forms of the disease; the infectious process caused by C. trachomatis was characterized by the absence of leukocytosis in the urethra in 30.0% of men with both non-complicated and complicated forms of the disease. The study of the polymorphism of cytokine genes revealed that the CC genotype of IL-6 gene at the -174 locus can serve as a molecular predictor of the complicated course of urogenital chlamydiosis in men while the GC genotype of IL-6 gene at the -174 locus can serve as a molecular predictor of the non-complicated course of urogenital chlamydiosis in men. Based on these results, the authors developed an algorithm for a differential approach to the management of patients suffering from chlamydia infection. Conclusion. A differential approach to the management of men with the urogenital chlamydia infection depending on the molecular predictor of the complicated course of the disease was developed.

Program for the evaluation of the quality of medical products for syphilis diagnostics

The article presents quality monitoring data for over 300 batches of medical products for syphilis diagnostics performed by GNTsDK in 2003—2011. It was demonstrated that the result made it possible to ensure the necessary level of the diagnostic efficacy of medical products to be used in medical institutions in the Russian Federation for the purposes of syphilis diagnostics (clinical sensitivity and specificity: min. 95%, reproducibility of results: 100%). To ensure the quality of medical products for diagnosing sexually transmitted diseases including syphilis, FGBU GNTsDK (Ministry of Health Care of the Russian Federation) developed and implemented the Voluntary Quality Control Program for Medical Products for Diagnosing STDs in the Russian Federation in 2006. The Program provides for quality control for batches of medical products, centralized control and information about its results to heads of specialized dermatovenerological medical institutions engaged in syphilis diagnostics, and will also improve the quality of studies for the purposes of syphilis diagnostics using a controlled set of chemicals.

Immune predictors of complications of the urogenital chlamydial infection leading to infertility

Goal: determination of immune predictors of the development of complications of the urogenital chlamydial infection (UGCI) in women and further disorder of the reproductive function (infertility) due to the past infection. Маterials and methods. 80 women have been examined: 40 patients with uGCI (20 — with UGCI of lower sections of the urogenital tract and 20 — with pelvic UGCI), 20 patients with secondary (tubal) infertility with the previous UGCI in the anamnesis and 20 clinically healthy women. The qualitative and quantitative study of the spectrum of cytokines (IL-2, -4, -6, -8, -10, INF-γ, TNF α and GM-CSF) with the use of the хМАР multiplex technology in blood and the cervical secretion. Results. The research has determined the spectrum of cytokines with a change in their concentration having an effect on the outcome of UGCI and the development of complications causing disorders of the reproductive function in women: these are TNF-α, IFN-γ, IL-2 inflammatory cytokines аs well as the IL-10 inflammatory cytokine.

Control materials used for diagnostics of syphilis: types and methods for ensuring stability

The authors present data about the types of control materials used for diagnostics of serological syphilis, examine problems related to the development of control materials with or without anti-syphilis pathogen antibodies on the basis of the human blood serum. The authors substantiate the advantages of using liquid native control materials as compared to their lyophilic analogs. The article evaluates the effect of a body of physical and chemical factors on the preservation of the specific activity of protein structures in human blood serum samples stored in the native and lyophilic forms. The possibility to use different stabilizers for long-term preservation of the specific activity of antibodies forming a part of control materials is discussed.

Experience of molecular typing and phylogenetic analysis of N. gonorrhoeae strains in the Russian Federation

The article presents results of the molecular typing and phylogenetic analysis of N. Gonorrhoeae strains in the Russian Federation conducted based on a large sample of N. Gonorrhoeae strains. A considerable genetic variety of N. Gonorrhoeae strains circulating in the territory of the Russian Federation was revealed, which can serve as an evidence of a high rate of accumulation of por and tbp gene mutations among the Russian population of N. Gonorrhoeae strains. The authors established the genetic relationship between individual sequence types of N. Gonorrhoeae strains, and revealed total and dominating sequence types of N. Gonorrhoeae strains found both in different territories of the Russian Federation and abroad, which confirms that such strains can be transferred between different territories of the Russian Federation and from abroad due to active migration of population.

Analysis of the results of clinical and laboratory examination of female patients withnon-complicated and complicated forms of the urogenital chlamydia infection

полиморфизмы, хламидийная инфекция, цитокины. The authors provide a detailed clinical and laboratory description of female patients with the Chlamydia infection of the lower urogenital tract and small pelvis organs as well as patients with secondary infertility (Chlamydia infection in the anamnesis). The authors also present the results of a pilot study aimed at determining the content of cellular metabolism mediators (cytokines IL-2, IL-4, IL-6, IL-8, IL-10 and IFN-alpha) in blood and cervical secret samples as well as a study of single-nucleotide polymorphisms of cytokine encoding genes.

Research methods for molecular markers of the individual genetic risk for development ofcomplications of the urogenital chlamydia infection

The authors present the results of the first four stages of research conducted under Government Contract No. 02.740.11.0774: Development of a Technology for Molecular Diagnostics of the Individual Genetic Risk of Development of Reproductive Function Disorders Associated with Human Urogenital Chlamydial Infection.

Development of the molecular typing protocol for C. Trachomatis based on the sequencing of ompa,pbpb, ct046, ct058, ct144, ct172 genes

The article is devoted to the development and validation of a standard operating procedure entitled «Molecular typing of С. trachomatis for assessment of the clonal structure and extent of genetic diversity of С. trachomatis strains circulating in the territory of the Russian Federation.» The studies that involved the typing of C. trachomatis strains obtained from regions of the Russian Federation with the use of six c. trachomatis genes (ompA, СТ046, cT058, cT144, cT172 and pbpB) revealed their significant heterogenicity with the prevalence of the E serotype. However, the typing of c. trachomatis for six genes at one time seems to be too time-consuming and long-lasting and is hard to be interpreted, which explains the need to develop other typing protocols using a smaller number of relevant genes (not more than two or three - by analogy with NG-MAST).

Markers of efficacy of Infliximab in psoriasis patients

The article presents the results of molecular and genetic studies aimed at determination of molecular markers for forecasting the clinical response of psoriasis patients to treatment with Infliximab. The authors revealed that it is possible to forecast high efficacy of treatment with Infliximab in case TT genotype is revealed at the 676 locus of exon 6 of the TNF-RII gene and IL-10 is present in the blood serum prior to the onset of treatment in the amount of more than 2.7 pg/ml.

Modern approaches and prospects of development of laboratory diagnostics for sexuallytransmitted infections

The authors provide a comparison of modern approaches to the use of well-known laboratory methods for diagnostics of syphilis, gonorrhea, trichomoniasis and urogenital clamidiosis, which are approved in the world science and practice. They also examine promising directions in the development of up-to-date laboratory technologies (biomicrochips, multiprimer PCR, mass spectrometry, PLEX-ID technology, immunoblotting, chemiluminescence immunoassay (CLIA), xMAP, pyrosequencing) for detecting STD pathogens, which is necessary to make an etiological diagnosis and determine efficient methods of treatment minimizing the period of time required for examination of patients.

Current methods to identify the gonococcal infection pathogen

The authors present the data on the current laboratory methods and recommendations for identifying the gonorrhea pathogen applied in Russia and abroad: microscopy method, cultural (bacteriological) study method, nucleic acid amplification techniques and DNA chip technology. The benefits and shortcomings of each of the techniques have been compared. The authors emphasize the cultural method is currently considered to be the key one for diagnosing gonorrhea due to its high specificity and sensitivity making it possible to define the N.gonorrhoeae sensitivity to antimicrobial drugs, which is very important taking into consideration the N. gonorrhoeae resistance to antibiotics. The nucleic acid amplification techniques and, first of all, polymerase chain reaction, can be used in Russia as screening methods. The results obtained by using the techniques need confirmation by the cultural method.

Cephalosporins of the third generation for the treatment of gonorrhea

The article presents the data on antibiotic resistance and N. gonorrhoeae mechanisms for developing resistance to antimicrobial drugs belonging to different pharmacologic groups and applied for causal treatment of gonorrhea. The article proves the key problem related to the treatment of gonococcal infection in Russia lies in the prevalence of strains being resistant to most of the antibacterial drugs that used to be applied in the clinical practice on a broad scale and efficiently. So, cephalosporins of the third generation are presently the only drug type that N. gonorrhoeae remains sensitive to. Their application ensures the maximum efficacy against the gonococcal infection. According to the presentday international recommendations complying with the WHO criteria as well as accumulated experience, cefixime, a drug belonging to cephalosporins of the third generation, can be a drug of choice for the antibacterial therapy of gonorrhea along with ceftriaxon.

Using the Line Blot Syphilis test system for diagnosingsyphilis by the linear immunoblotting method

ZAO ECOlab (Russia) developed Line Blot Syphilis, a new test system on the basis of the linear immunoblotting method using Treponema рallidum recombinant antigens. The article assessed the diagnostic value of the Line Blot Syphilis test system in the form of a confirmatory test. As a part of the conducted study, the test system demonstrated its absolute sensitivity and specificity to serum-positive (n = 237) and serum-negative (n = 114) samples, in which the presence or absence of Т.pallidum antibodies was confirmed by two treponemal tests. As a result of examining 14 samples attributed to doubtful analytes based on two test results (passive hemagglutination test and immunofluorescence test with absorption), the data compliance between the Line Blot Syphilis test system and data from INNO-LIA Syphilis Score amounted to 100% (14/14) or 93% (13/14) for the immune-enzyme assay and 57% (8/14) for the immunofluorescence test with absorption. It is recommended to use the Line Blot Syphilis test system (ZAO ECOlab) as a confirmatory syphilis test.

Analysis of the neurosyphilis incidence rate and quality oflaboratory diagnostics in the russian federation

According to the analysis of the state statistical reporting, the rate of new neurosyphilis cases was growing in the Russian Federation in 1999-2009. Substantial differences in the number of detected neurosyphilis cases by different federal districts were established. Low-quality laboratory diagnostics was proved to be one of the factors promoting the neurosyphilis incidence rate. The quality of the neurosyphilis laboratory diagnostics was studied by means of questionnaires distributed among dedicated dermatovenerological medical institutions. Substantial shortcomings in the neurosyphilis laboratory diagnostics were established including absence of spinal fluid diagnostics in 17%-33% of the institutions and inadequate compliance with the regulatory study methods (immunofluorescence test with whole spinal fluid, microprecipitation test, cytosis and protein determination in the spinal fluid). For the purposes of optimizing the neurosyphilis diagnostics in the Russian Federation, we suggest to provide for all-round and complex examination of patients with suspected neurosyphilis based on the regulatory laboratory and functional diagnostics methods; it is also required to make the spinal fluid examination based on the passive hemagglutination test being highly sensitive and specific as well as having a high diagnostic efficacy for neurosyphilis a part of the standards aimed at rendering medical aid to neurosyphilis patients.

Immune and genetic mechanisms of infertility andreproductive function disorders associated with humanurogenital chlamydial infection

This review covers current concepts of immune and genetic mechanisms of infertility associated with human urogenital chlamydial infection. It describes studies of individual polymorphisms of genes coding cytokines and other immune system mediators. It also presents the results of studies aimed at searching for genetic predisposition to the development of complications resulting in human reproductive function disorders caused by past urogenital chlamydial infections.

Personalized approach to the selection of therapy for patients with psoriasisbased on the results of molecular and genetic tests

The article presents the results of tests aimed at revealing biomarkers of patients clinical response to treatment with Infliximab and phototherapy with the use of molecular and genetic technologies. The authors revealed that the predictor of evident clinical response to treatment of psoriasis patients with Infliximab is the homozygous TT genotype at the 676 locus of exon 6 of the TNFR- II gene; predictors of high efficacy and safety of treatment of psoriasis patients with Infliximab with the use of ultraviolet therapy (PUVA and mid-wavelength ultraviolet therapy (311 nm)) are: heterozygous GA genotype at the 19007 locus of the ERCC gene and homozygous CC genotype at the 27945 locus of the XPF gene.

Major directions in the development of diagnostics technologies indermatovenerology

This review describes major directions in the development of laboratory diagnostics of STDs and dermatoses in the Russian Federation. It also discusses strategic directions in the development of diagnostics departments in dermatovenerological institutions (three-level structure of laboratory aid, centralization, automation, standardization of tests, external and internal laboratory quality control, introduction of laboratory information technologies and laboratory information exchange systems). It also substantiates the priority directions in the diagnostics of STDs (etiological diagnostics, acceleration of the cycle of laboratory tests for patients, determination of the resistance of causative agents to antimicrobial drugs, molecular monitoring of the spreading of STDs) and dermatoses (diagnosis verification, diagnosing an organ pathology, marker diagnostics, prevention and prediction of the efficacy and safety of dermatosis treatment).

On quality of serological diagnostics of syphilis in dermatovenerologicalinstitutions of the russian federation

The article presents the results of a cycle of external quality control of serological tests for diagnostics of the syphilitic infection conducted by FGU GNTsD Rosmedtekhnologiy (State Research Center for Dermatology and Venereology of the Federal Agency for High-Technology Medical Aid) in 2009 in 125 serology laboratories of dermatovenerological institutions in different subjects of the Russian Federation. The authors evaluated the quality of serological tests (microprecipitation test, RPR, passive hemagglutination test, immunofluorescence test and immune-enzyme assay) of four reference serum samples based on formal and essential characteristics. The percentage of non-satisfactory results of studies for a set of reference serum samples in nontreponemal tests (microprecipitation test and RPR) was 10.9%; in treponemal tests: in immune-enzyme assay - 1.4%, in passive hemagglutination test - 1.2%, in immunofluorescence test - 0.9%. The most significant differences in the results were revealed in studies of reference serum samples with the low content of antibodies (weakly positive) as well as those that contained no antibodies to the syphilis causative agent.

Selection of drugs for treatment of gonococcal infection based on the results ofthe monitoring of N. gonorrhoeae antibiotic resistance

The article presents recommendations for selecting drugs for treatment of gonococcal infection based on the results of the monitoring of N. gonorrhoeae antibiotic resistance in 2009 and 2005-2009. It was shown that it is not recommended to use penicillin, tetracycline and ciprofloxacin in the territory of the Russian Federation because of the high level of N. gonorrhoeae resistance to these drugs. The drug of choice for gonorrhea treatment in the Russian Federation is Ceftriaxon because of the high level of N. gonorrhoeae sensitivity (100%). It is recommended to use spectinomycin for gonorrhea treatment only in the Ural and Far Eastern Districts; azithromycin - only in the Ural and Central Districts characterized by the high level of N. gonorrhoeae sensitivity to these antimicrobial drugs, and it is necessary to use spectinomycin and azithromycin in other federal districts of Russia only under control of determination of N. gonorrhoeae sensitivity.

Prospects of using proteome technologies in the diagnostics of sexually transmitted infections and skin diseases

The article presents data from the literature describing up-to-date syphilis diagnostics methods used in the Russian Federation. It also describes main proteome techniques and gives the results of applying proteome technologies in the diagnostics of diseases including infectious ones, and prospects and opportunities for using direct proteome profiling to develop a new method for syphilis diagnostics are analyzed.

Clinical, molecular and genetic studies of efficacy and safety of using UV irradiation for psoriasis patients

The authors give the results of clinical, molecular and genetic studies of efficacy and safety of treatment of 87 patients suffering from extensive psoriasis with the use of UV irradiation of different spectral ranges. They showed that the administration of a course of treatment with the use of the PUVA therapy or narrowband medium-wave UV therapy with the wavelength of 311 nm does not result in the development of any clinically significant genetic mutations associated with the DNA excision repair system. They revealed that the GC genotype of the XPC gene in the 32828 site and CC genotype of the XPF gene in the 27945 site may be predictors of a pronounced therapeutic effect in treatment of patients with the use of phototherapy methods. The authors obtained data confirming a possible protective role of T>C polymorphism in the 27945 site of the XPF gene in the development of phototoxic reactions when psoriasis patients undergo an UV therapy.

Methods for typing std pathogens (N. Gonorrhoeae, C. Trachomatis, T. Pallidum)

Phenotypic methods were initially used for bacterial typing yet they have a number of drawbacks limiting their use. Methods of molecular and genetic typing have become wide-spread today. Among these methods, bacterial typing based on multilocus sequence typing (Multilocus Sequence Typing - MLST) has been developing at the fastest rate. However, schemes of molecular and genetic typing of STD pathogens as compared to other bacteria are insufficiently developed, which considerably complicates the planning of measures aimed at the reduction of their spread.

Automated assessment of spinal fluid examination results in passivehemagglutination reaction in neurosyphilis diagnostics

Spinal fluid samples collected from 50 patients suffering from neurosyphilis (key group) and 30 patients with a nervous system pathology and craniocerebral injuries without any signs of syphilis in the anamnesis (control group) were examined in the course of regulated serological tests to reveal anti-T. pallidum antibodies (complement-fixation test with a treponemal antigen, complementfixation test with a cardiolipin antigen, immunofluorescence test with whole spinal fluid, ELISA) as well as in the course of TPHA with the use of modified methods with the end-point dilution of spinal fluid as 1:4. Visual assessment was used to assess the TPHA results with the determination of the result positivity degree expressed in conditional units - «pluses», along with the automated assessment using the Criterion 2 hardware system. Comparative results of visual and instrumental assessments of the spinal fluid study results in TPHA revealed full compliance of the qualitative study results and 97.5% correspondence in the results expressed in conditional units («pluses»), which provides sufficient grounds for recommending the Criterion 2 automatic diagnostics complex for TPHA image assessment to be used in clinical and diagnostic laboratories in health care institutions for determining treponemal specific antibodies in spinal fluid for neurosyphilis diagnostics.

[Comparative study of immunochromatographic sets for rapid diagnosis of syphilis]

The paper presents the results of the comparative study of 9 commercial kits made in foreign countries for the rapid diagnosis of syphilis, performed at the Central Research Institute of Dermatovenereological Infections, Russian Agency for Health Care, within the framework of the International Sexual Transmitted Diseases Diagnostic Initiative Program under the aegis of the World Health Organization during 2002-2005. The above diagnostic kits were assessed in the context of the availability of and statement simplicity in the instruction for use; the technological complexity in performing a study procedure and the simplicity in interpreting the findings; the necessity of employing additional laboratory equipment. The parameters of the clinical efficiency (sensitivity and specificity) were studied; a passive sensitized red blood cell agglutination test was used as a reference method. The comprehensive study showed that the "Determine Syphilis TP test system ("Abbot Lab", USA) yielded the best results with a total of 10 scores at 100% sensitivity and 100% sensitivity) while the "Bioline Syphilis anti-TP Test Card" ("Pacific Biotech Co.", Thailand) provided a total of 9 scores at 96% sensitivity and 98% specificity.

[Results of study of the diagnostic efficiency of the new linear enzyme immunoassay test system "INNO-Lia Syphilis Score"]

A comparative study of 224 serum samples certified in different serological tests for syphilis has established the high diagnostic effectiveness of the new linear enzyme immunoassay test system (immune blotting assay "Improved INNO-Lia Syphilis ("IMMO-Lia Syphilis Score")) (Immunogenetics, Gent, Belgium). The assay showed a 100% sensitivity and 98% specificity; the reproducibility of positive and negative results was 100%. It is proposed to use the test system in the laboratories engaged in the expert diagnosis of syphilis as an additional or alternative Treponema pallidum immobilization test and immunofluorescence test supporting the assay of serum or plasma samples for this infection, which has yielded positive results on screening.