[New clinical guidelines for COPD - a paradigm shift: A review].

Chronic obstructive pulmonary disease is now one of the most common noncommunicable diseases and the main causes of morbidity, disability and mortality in the world. In recent years, new approaches to epidemiology, diagnosis, classification (categorization), evaluation of phenotypes, as well as characterization and assessment of the severity of сhronic obstructive pulmonary disease exacerbations have emerged. Modern approaches to starting and subsequent drug therapy have changed significantly. This is largely due to the results of recently conducted major clinical trials, demonstrated high efficacy of triple fixed combinations, including inhaled glucocorticosteroids, long-acting beta-agonists and long-acting anticholinergic drugs. The use of non-medication methods (smoking cessation, physical activity and respiratory rehabilitation) and modern approaches to the treatment of respiratory failure and antibiotic therapy remain important. In terms of their significance, all these updates have a significant impact on real clinical practice and can be considered as a novel paradigm of the approaches to the diagnosis and management of this disease.

The Role of NMDA Receptor Subunits in the Effect of Memantine on the Brain of Healthy Animals.

The non-competitive NMDA glutamate receptor antagonist memantine has neuroprotective properties and is the first non-cholinergic drug approved for the treatment of Alzheimer's disease. The purpose of this work was to test the hypothesis that injections of memantine to healthy animals can affect the subunit composition of NMDA receptors in the brain, which may explain the effects of its chronic administration. For this, the expression of subunits GluN1, GluN2A, GluN2B, and GluN2C was studied in the hippocampus and prefrontal cortex of rats after single or five subchronic injections of memantine. The results showed that the GluN2C subunit (GRIN2C) plays an important role in the effects of memantine; against the background of memantine treatment, the expression of this subunit markedly decreased in the prefrontal cortex, but not in the hippocampus, which significantly affected the excitation/inhibition balance in cortical structures.

[Results of clinical studies of the efficacy and safety of the use of ethylmethylhydroxypyridine succinate in patients with chronic cerebral ischemia]. / Rezul'taty klinicheskikh issledovanii effektivnosti i bezopasnosti primeneniya preparatov etilmetilgidroksipiridina suktsinata u patsientov s khronicheskoi ishemiei golovnogo mozga.

Chronic cerebral ischemia (CCI) is a common syndrome that, in the absence of adequate therapy, is characterized by a progressive course, an increase in cognitive, emotional, motor and other disorders, eventually leading to persistent disability of the patient. In the treatment of patients with CCI, the use of drugs with a multimodal neuroprotective effect is indicated. The results of the analysis of a series of clinical trials of the drugs Mexidol and Mexidol FORTE in patients with CCI are presented. The effects in relation to cognitive, emotional, asthenic, vegetative and other manifestations of CCI are considered. It is concluded that it is advisable to consistently use the drugs Mexidol and Mexidol FORTE in such patients.

Autophagy in Neurons of the Prefrontal Cortex and Hippocampus of Rats after Trimethyltin Chloride Intoxication.

Ultrastructural studies of the hippocampus and the prefrontal cortex of rats were performed 7, 30, and 50 days after their damage by neurotoxicant trimethyltin chloride (TMT). Significant damage to neurons was observed in both brain structures. In the hippocampus, a large number of autophagosomes (0.9±0.1 per µm2) appeared in the soma of neurons, dendrites, and axons in 7 days after intoxication. In addition, we observed the appearance of hyperchromic neurons with abnormal structure of mitochondria. In the prefrontal cortex, damaged neurons also contained autophagosomes, but their number was significantly lower (0.3±0.1 per µm2). The number of autophagosomes decreased with increasing the time after TMT administration: 30 days after injection, the content of autophagosomes in the hippocampus was 0.10±0.01 per µm2, while in the prefrontal cortex, autophagosomes were no longer found. We hypothesized that autophagy in the hippocampus was not effective enough to prevent neuronal death caused by the neurotoxicant.

[The organization of pre-clinical studies of bactericidal and wound healing effects of the impulse photoherapy device "Zarya"].

The purpose of the study is to determine therapeutic effectiveness of the pulsed high intensity optical irradiation device "Zarya" exemplified by treatment of model wounds in laboratory animals and to compare with traditional methods of wound treatment. The prototype of "Zarya" device was used whose operating principle was based on pulsed irradiation of affected areas with high intensity optical radiation in continuous spectrum generated by pulsed xenon lamp. The therapeutic effect of the "Zarya" device was compared with effectiveness of the certified medical ultraviolet irradiator based on low-pressure mercury lamp and also with known wound-healing and antibacterial medication Levomekol ointment. The mature male rats of Wistar line were used in the study. The animals were distributed to 4 groups: group 1 was irradiated by "Zarya" device, group 2 was irradiated by low-pressure mercury lamp, group 3 was treated with Levomekol ointment and group 4 was exposed to no exposure. The linear wound was modeled according to the standard method under ether anesthesia. The therapeutic procedures were applied daily during 7 days. The bactericidal effect was studied on the basis of smears from wound onto flora on the 2nd, 5th and 7th day. On the 8th day the animals were subjected to euthanasia. It was established that "Zarya" device application permits to reduce considerably both duration of therapeutic procedures and therapy course in general and also to achieve more pronounced bactericidal effect. The obtained data is supposed to be used for development of program of clinical trials.

[Peculiarities of Mild Asthma in Russia: the Results of SYGMA2 Study].

AIM: Patients with mild asthma may experience severe exacerbations. This analysis was conducted to investigate regional peculiarities of mild asthma population in Russia. MATERIALS AND METHODS: The SYGMA2 is a double-blind multinational study involving adult patients with mild asthma (n=4176). We conducted an open-label descriptive analysis of the baseline characteristics of the Russian group (n=579) of SYGMA2 trial comparing to SYGMA2 population from other countries. The subanalysis was descriptive only, and no hypothesis were tested. RESULTS: The Russian population of patients with mild asthma was comparable to the rest of countries in terms of demographic characteristics, smoking status and duration of asthma. The spirometric parameters in the Russian group was slightly worse than in the other population. At the study entry 48% of Russian patients had symptom control on maintenance therapy, but 52% were uncontrolled on short-acting bronchodilators. While in other countries this ratio was inverse (55/45%). More patients with mild asthma in the Russian group had at least one severe exacerbation in the previous year (30.1% vs 20.7% in other countries). CONCLUSION: We revealed a delayed prescription of controller therapy and overuse of short-acting bronchodilators in the Russian group of mild asthma patients, that may increase risk of asthma non-control and severe exacerbation.

[Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with chronic cerebral ischemia]. / Effektivnost' i bezopasnost' primeneniya etilmetilgidroksipiridina suktsinata u patsientov s khronicheskoi ishemiei golovnogo mozga.

Chronic cerebral ischemia (CCI) is a common cerebrovascular syndrome, the development of which is associated with a high risk of increasing cognitive, behavioral, and motor disorders, and the formation of a patient's dependence on others. Timely start of treatment can slow down the course of the disease, make it more favorable. The review considers the possibility of using the domestic neuroprotector mexidol in patients with CCI. The results of a series of clinical studies on the use of ethylmethylhydroxypyridine succinate (mexidol) in patients with CCI are analyzed. The effectiveness of the drug in relieving cognitive, affective and motor disorders is noted. Information about the good tolerance of mexidol is presented.

[The efficacy of ethylmethylhydroxypyridine in the rehabilitation treatment of poststroke patients]. / Effektivnost' primeneniya etilmetilgidroksipiridina suktsinata v vosstanovitel'nom lechenii patsientov, perenesshikh ishemicheskii insul't.

The analysis of the clinical efficacy and safety of ethylmethylhydroxypyridine succinate (mexidol) in the complex of rehabilitation measures in patients after ischemic stroke (IS) shows that course treatment with mexidol improves the recovery of neurological functions, decreases neurological deficit, cognitive disorders, including memory impairment, and manifestations of asthenic syndrome, increases the level of social adaptation and improves the psycho-emotional state of patients, reduces spasticity, increases motor and speech activity, praxis, reliably eliminates the ignoring syndrome. There is a decrease in the level of total cholesterol and low-density b-lipoproteins in the blood, and decrease in the severity of hypercoagulation. The results of the studies have convincingly shown the efficacy of mexidol at all stages of rehabilitation treatment of patients with IS.

Electronic Structure of Nitrogen- and Phosphorus-Doped Graphenes Grown by Chemical Vapor Deposition Method.

Heteroatom doping is a widely used method for the modification of the electronic and chemical properties of graphene. A low-pressure chemical vapor deposition technique (CVD) is used here to grow pure, nitrogen-doped and phosphorous-doped few-layer graphene films from methane, acetonitrile and methane-phosphine mixture, respectively. The electronic structure of the films transferred onto SiO2/Si wafers by wet etching of copper substrates is studied by X-ray photoelectron spectroscopy (XPS) and near-edge X-ray absorption fine structure (NEXAFS) spectroscopy using a synchrotron radiation source. Annealing in an ultra-high vacuum at ca. 773 K allows for the removal of impurities formed on the surface of films during the synthesis and transfer procedure and changes the chemical state of nitrogen in nitrogen-doped graphene. Core level XPS spectra detect a low n-type doping of graphene film when nitrogen or phosphorous atoms are incorporated in the lattice. The electrical sheet resistance increases in the order: graphene < P-graphene < N-graphene. This tendency is related to the density of defects evaluated from the ratio of intensities of Raman peaks, valence band XPS and NEXAFS spectroscopy data.

[Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with ischemic stroke]. / Effektivnost' i bezopasnost' primeneniya etilmetilgidroksipiridina suktsinata u patsientov s ostrym ishemicheskim insul'tom.

Stroke is still the most significant problem of the modern medicine and the leading cause of mortality and morbidity. There is the great experience of neuroprotection in patients with stroke in the Russian Federation. In clinical practice it's important to follow conditions, where neuroprotection will have maximum safety and effectiveness. The clinical trials of ethylmethylhydroxypyridine succinate (mexidol) in patients with acute ischemic stroke are described in the present review. Early management (in the first 6 hours) with mexidol significantly improve recovery dynamic and stroke outcome. Therapy with mexidol increases neurological recovery, improves vital activity and quality of life of patients with stroke. Furthermore, mexidol demonstrates high safety profile.

Effect of Interleukin-10 on Localization of AMPA Receptors in Synapses during Long-Term Posttetanic Potentiation in Cultured Hippocampal Slices.

The effect of the anti-inflammatory cytokine IL-10 on the ultrastructural distribution of AMPA receptor GluR1 subunit in CA1 field of cultured hippocampal slices was studied by using immunohistochemical technique. It was found that long-term posttetanic potentiation increased the content of GluR1 in the postsynaptic density of the axo-spinous synapse. Addition of IL-10 in concentrations of 1 and 10 ng/ml to the medium facilitated long-term posttetanic potentiation thereby changing the distribution of GluR1 in the spine: the number of receptors increased in the cytoplasm and decreased in the postsynaptic density. It is assumed that activation of neuronal IL-10 receptors affects the distribution of AMPA receptors in axo-spinous synapses of hippocampal field CA1 through interplay of intracellular signaling pathways, thereby participating in the mechanisms of synaptic plasticity under normal conditions.

Effect of TGF-beta1 on long-term synaptic plasticity and distribution of AMPA receptors in the CA1 field of the hippocampus.

Using the methods of electrophysiology and immunohistochemistry, the effect of the transforming factor beta-1(TGF-ß1), an anti-inflammatory cytokine, on the long-term post-tetanic potentiation (LTP) in CA1 field hippocampal slices and the distribution of the GluR1 subunit of the AMPA receptor has been studied. It was shown that TGF-ß1 at a concentration of 10 ng/ml did not significantly affect the initial stage of LTP and substantially changed the distribution of synaptic AMPA receptors in response to tetanic stimulation. Twenty five minutes after the tetanization, the main pool of AMPA receptors (90%) was due to the postsynaptic density (PSD). By contrast, LTP in the presence of TGF-ß1 was accompanied by less pronounced changes in the distribution of AMPA receptors. Their localization in both pre- and postsynaptic regions remained nearly the same as that in the control. It may be suggested that the normal distribution of AMPA receptors in spinous synapses promotes the stabilization of potentiated synapses, thereby retaining LTP for longer terms.

Expression of mGlu Receptor Genes in the Hippocampus After Intoxication with Trimethyltin.

A variety of localization and signaling properties of eight subtypes of metabotropic glutamate receptors (mGluRs) in the brain provide glutamate an important regulatory role in many processes, including neurodegeneration and repair of neuronal damage. To identify specific subtypes of mGluRs, which are involved in neurodegeneration process, we assessed expression levels of their genes under pathophysiological conditions. Using quantitative real-time RT-PCR analysis, we studied transcription levels of mGlu2-5 and mGlu7 genes in the hippocampus after its damage by neurotoxicant trimethyltin chloride (TMT) in Wistar rats. This organotin compound is known to cause neurodegeneration in the brain, especially in the hippocampus. Morphological studies confirmed neuronal damage in CA3-CA4 subfields of the hippocampus 6 weeks after the treatment with TMT. Step-through passive avoidance test revealed memory deterioration in rat-treated TMT. Interestingly, 3 and 6 weeks after the treatment with TMT, expression levels of the mGlu2 and mGlu7 genes were not changed in comparison to the control values while expression level of mGlu4 genes was upregulated throughout the whole studied period of TMT action. The dynamics of mGlu3 gene expression revealed the existence of neuroinflammation 3 weeks after the treatment with TMT, which was further confirmed by the upregulation of cyclooxygenase-2 gene expression. The expression level of mGlu5 receptors was downregulated 6 weeks after the treatment with TMT. Our results revealed a significant role of mGlu4, mGlu5, and mGlu3 receptors in the neurodegenerative/reparative processes in the hippocampus after the treatment with TMT. Ligands of these receptor subtypes can be, therefore, considered potential therapeutic targets for prevention or reduction of neurodegeneration.

Iron-filled multi-walled carbon nanotubes for terahertz applications: effects of interfacial polarization, screening and anisotropy.

Interface interactions in multicomponent nanoparticles can affect electromagnetic properties of an absorbing system. In this work, we investigate the electromagnetic response of multi-walled carbon nanotubes (MWCNTs) filled with iron-containing nanoparticles (ICNs) in the terahertz frequency range. MWCNTs with different iron content have been synthesized by aerosol-assisted catalytic chemical vapour deposition method from toluene containing a certain quantity of ferrocene used as a catalyst. According to the x-ray diffraction analysis, encapsulated ICNs were mainly in the form of iron carbide. Thin composite films were prepared from the iron-filled MWCNTs and polymethylmethacrylate (PMMA) by casting and stretching methods. The composites showed an enhanced permittivity and anisotropy in the transmittance spectra when iron content increased. This behaviour was related to the mechanism based on electrical conductivity and polarization of ICNs and ICN/MWCNT interfaces. Since terahertz field penetrates inside MWCNTs, the filling of their cavities can be a way of varying the electromagnetic properties of MWCNT-containing composites.

Effect of Pharmacological Modulation of Activity of Metabotropic Glutamate Receptors on Their Gene Expression after Excitotoxic Damage in Hippocampal Neurons.

Microinjection of kainic acid into rat hippocampus causes excitotoxic neuronal damage predominantly in the CA3 and CA1 fields. These lesions can be significantly reduced by simultaneous administration of MPEP, a negative allosteric modulator of type 5 metabotropic glutamate receptors, and LY354740, an agonist of type 2 metabotropic glutamate receptors. The decrease in neuronal death in the hippocampus during pharmacological modulation was paralleled by adaptive changes in gene expression. In the hippocampus, gene expression of type 5 postsynaptic metabotropic glutamate receptor was close to the control level, and in the frontal cortex expression of the gene of α1-subunit of the GABAA receptor returned to normal. In the frontal cortex, a reciprocal relationship was observed for type 2 metabotropic glutamate receptor: expression of the corresponding gene decreased in response to pharmacological activation.

Subacute activation of mGlu4 receptors causes the feedback inhibition of its gene expression in rat brain.

AIM: The present study aimed to understand the relationship between pharmacological activation of mGlu4 receptors and regulation of its gene in the hippocampus. MAIN METHODS: The expression level of the GRM4 gene, encoding mGluR4 receptors, was studied in the hippocampus and frontal cortex of rats after pharmacological activation of the receptor with positive allosteric modulator (E)-4-(2-Phenylethenyl)-2-pyrimidinamine (TCN 238). The drug was injected subcutaneously four times at a dose of 2mg/kg. The animals were previously trained with hippocampal-dependent task and after the treatment were tested for memory retrieval. The expression level of GRM4 was determined by qRT-PCR in control and experimental groups of animals one and five days post-treatment. KEY FINDINGS: We found that TCN 238 did not affect the performance of the learned task. However, the expression level of GRM4 in the hippocampus was reliable down-regulated five days after treatment with TCN 238. In addition, we showed that the expression level of GABRA1, encoding GABAA α-subunit was downregulated five days after the treatment in the frontal cortex. SIGNIFICANCE: Subacute pharmacological intervention in mGluR activity by the selective positive modulator TCN 238 has led to adaptive rearrangements of transcription processes in the hippocampus. Moreover, this regulation affected GABA system, confirming importance of the brain excitation-inhibition balance. Since the pharmacological influence on mGluR activity can be regarded as a promising tool aimed to correct brain dysfunction, the properties of mGluR modulators should be studied in more detail, including the level of gene transcription.

Correction of oxidative stress in patients with chronic cerebral ischemia.

A pilot study of the effect of the antioxidant drug ethylmethylhydroxypyridine malate on indicators of oxidative stress in patients with chronic cerebral ischemia. At 6 day course administration investigated the antioxidant in these patients significantly accelerates the process of generation of superoxide anion radical, established by lucigenin-depended chemiluminescence that probably regulate a feedback mechanism oxidase systems. This increases the activity of superoxide dismutase, and reduced the concentration of secondary peroxidation product - malondialdehyde, making reasonable use of antioxidants in the treatment of this pathology.

Expression of metabotropic glutamate receptors after hippocampal injury.

The expression of metabotropic glutamate receptors (mGluR2, mGluR3, mGluR4, and mGluR5) and dendritic cytoplasmic BC1 RNA in the hippocampus and frontal neocortex of Wistar rats was studied 1 and 4 weeks after intrahippocampal microinjection of kainic acid. The efficiency of glutamatergic transmission was shown to change not only in the injured hippocampus, but also in the neocortex. It was associated with variations in the expression of presynaptic (mGluR2, mGluR3, and mGluR4) and postsynaptic receptors (mGluR5).

Memory disorders in rats after impairment of the dorsal hippocampal CA3 field with kainic acid.

We studied the possibility of conditioning of food-procuring response in animals after impairment of the dorsal hippocampal region with kainic acid. Histological studies of brain sections showed that the greater part of dorsal hippocampal CA3 pyramidal neurons were lyzed in 2 weeks after kainic acid microinjection into the hippocampus. Morphological signs of necrosis were found in CA2 and CA4 neurons at the interface with CA3 field. Preinjection of anti-inflammatory cytokine IL-10 virtually did not prevent neuronal death. Damage to the hippocampus impaired learning of experimental animals and they required more attempts for reliable performance of the skill than the controls. Short-term memory of experimental rats was retained, which was proven by the results of single-day training. It was hypothesized that memory dysfunctions in animals after damage to the dorsal hippocampal CA3 field and to the hippocampus in general are determined by impaired transition of short-term into long-term memory.

[Metabotropic glutamate receptors as targets for new drug development].

The review is devoted to experimental investigations of metabotropic glutamate receptors and the properties of drugs (ligands) belonging to agonists, antagonists, and modulators of the activity of these receptors. Possibilities of the treatment of neurodegenerative disorders, cognitive disturbances in schizophrenia patients, and narcotic dependency by using drugs of this class are considered.