The use of Tofacitinib in the treatment of inflammatory bowel disease.

Major advances in pharmacology of the 21st century include the development of a new class of drugs, which are low-molecular, chemically synthesized molecules (the so-called "small molecules"), the point of application of which is Janus kinase (Janus kinase, JAK) involved in intracellular cytokine signaling. The review examines the molecular aspects of the JAK-STAT signaling pathway, justifying the use of the JAK-kinase inhibitor (tofacitinib) in the treatment of inflammatory bowel disease.

[The history of the Kazan School of Therapists (on the occasion of the 200th anniversary of the Kazan State Medical University)].

The history of the Kazan School of Therapists numbers two centuries of scientific achievements and discoveries. German Professors F.H. Erdman and K.F. Fuks laid the groundwork for clinical teaching continued by Russian therapists N.A. Skandovsky, N.A. Vinogradov, A.P. Kazem-Bek, N.K. Goryaev, and other distinguished scientists. The prominent scientists of the 20th century made great contributions to the development of modern therapy; the names of M.N. Cheboksarov, Z.I. Malkin, A.G. Teregulov, and I.G. Salikhov are known and they are respected by the world medical public.

[Fecal neutrophil gelatinase-associated lipocalin is a surrogate marker of inflammation in inflammatory bowel disease].

AIM: To evaluate the fecal level of neutrophil gelatinase-associated lipocalin (NGAL) in different behavior of inflammatory bowel disease (IBD). MATERIALS AND METHODS: We prospectively included 41 people into the study--30 patients with active IBD and 11 healthy volunteers. The concentration of NGAL in faeces was determined by enzyme immunoassay method. RESULTS: Fecal NGAL level was increased in both UC and CD: in CD--5924.27 ± 2067.6 ng/ml (p < 0.05), in UC--5826.09 ± 891.8 ng/ml (p < 0.05) NGAL levels were higher than in the control group (658.8 ± 237.7 ng/ml). Maximal changes were seen in colonic involvement. NGAL levels increased with the increasing extension of lesion in UC (p < 0.05), while in CD concentration was higher in colitis than in ileitis and ileocolitis (p > 0.05) . NGAL level increased with severity of CD (p < 0.05), in patients with UC difference was not significant. In UC NGAL level was increased with increasing extension of lesions (p < 0.05), in CD this pattern was not marked. Correlation NGAL level with some clinical and laboratory indicators in CD was established. Sensitivity of test in evaluation of exacerbation of IBD was 80%, specificity--90.9%, area under the ROC curve (AUC)--0.9, positive predictive value--96%, negative predictive value--62.5%; positive likelihood ratio--8.8 and negative likelihood ratio--0.22. CONCLUSIONS: The fecal concentration of NGAL significantly increased during IBD. With increasing severity and activity of disease level ofNGAL was increased in CD (p < 0.05). Lipocalin-2 values was higher with the increasing extension of lesions in UC (p < 0.05). There has been established the high diagnostic value of the detection of fecal NGAL as a marker of the active phase of IBD.