EFFECT OF SOMEUNFAVORABLE FACTORS OF ENVIRONMENT ON THE SURVIVAL OF CHILDREN WITH ACUTE LEUKEMIA IN A LONG6TERM PERIOD AFTER ACCIDENT ON THE CHORNOBYL NPP. / VPLYV DEIaKYKh NESPRYIaTLYVYKh ChYNNYKIV DOVKILLIa NA VYZhYVANIST' DITEI Z GOSTRYMY LEIKEMIIaMY U VIDDALENYI PERIOD PISLIa AVARIÏ NA ChORNOBYL'S'KII AES.

OBJECTIVE: Determine of the influence of adverse environmental factors, including irradiation, on the survival ofchildren with acute leukemia in the long-term period after the Chornobyl accident (2008-2017). MATERIALS AND METHODS: Examined 74 children with acute leukemia (АL): 64 with acute lymphoblastic leukemia(ALL); 10 - acute myeloblastic leukemia (AML). The influence of negative environmental factors was assessed bythe degree of integrated pollution of the atmospheric air, surface waters and soils with pesticides, heavy metals (Pb,Cu, Ni, Cr, Mn, Zn, Fe) and cesium isotope 137Cs. These regions were ranked on a moderately polluted (1), polluted (2),very (3) and extremely (4) polluted territories. Took into account the age of children, blood test, immunophenotyp-ic of variant the acute leukemia, survival of patients and place of residence (city / village), serum ferritin level (SF). RESULTS: Exposure doses of children were in the range from 0.4 mSv to 35.0 mSv (average values were (4.25 ± 0.63 mSv)and did not affect the prognosis and variants of AL. 52 children lived in moderately and polluted territories (30 wereresidents of cities, 22 - villages). 22 patients were lived in very and extremely polluted territories (4 were residentsof cities, 18 - villages). Of 74 patients with ALL and AML 24 children died (32.4 %). The smallest number ofchildren, who died, were patients with «general type¼ В-ALL (18.7 %), most of all children with pro-В-ALL (8 out of10) and Т-ALL (3 of 4). Of the 52 patients, the inhabitants of moderately and polluted regions, 13 patients died (25%), while out of 22 patients, who lived in very and extremely polluted areas, 11 children died (50 % share)(rs = 0.39; p < 0.05). Of the 10 patients with AML, 4 children died. Most often, children died, who were residents ofvillages. Moreover, the level of SF was significantly higher in children over 6 years, the inhabitants of villages -(406.8 ± 40.6) ng/ml, compared to younger patients - (211.2 ± 32.1) ng/ml) and residents of of cities: up to 6years - (297.4 ± 52.3) ng/ml; over 6 years - (275.6 ± 29.8) ng/ml. CONCLUSIONS: The obtained data testify to the negative influence of environmental factors, including iron, and canbe the basis for understanding the mechanisms of potentiating influence of metals and their compounds on thedevelopment of malignant diseases of the blood system in children.

Cortisol level as risk factor for malignant hematologic pathology in children exposed to ionizing radiation after Chornobyl accident. / STAN ERYTROÏDNOÏ, GRANULOTsYTARNOÏ TA TROMBOTsYTARNOÏ LANOK GEMOPOEZU NA ETAPAKh KhIMIOTERAPIÏ U DITEY̆ Z GOSTRYMY LIMFOBLASTNYMY LEY̆KEMIIaMY, IaKI ZAZNALY VPLYVU IONIZUIuChOGO VYPROMINIuVANNIa VNASLIDOK AVARIÏ NA ChAES.

OBJECTIVE: Determination of serum cortisol level in the initial period of acute leukemia in children, who exposed to ion izing radiation and other factors of Chornobyl accident, depending on their age and prognosis of disease. MATERIALS AND METHODS: The study involved 283 children residents of Kyiv, Zhytomyr and Chernihiv regions. There were 90 acute leukemia patients(AL) (ALL - 56, AML - 34), and 193 people of comparison group with anemia, leukemoid reactions and lymphadenopathy. We analyzed the type of comorbid somatic pathology, diseases in the genealogy, hematological parameters, cortisol levels in blood serum and irradiation doses in all children. In patients with AL expected median survival was calculated. RESULTS: In 28.9 % of AL children the initial cortisol content was below 200 nmol/l, in 7.8 % - higher than 500 nmol/l (in the comparison group 10.4 % and 17.1 % respectively). Among AL patients with cortisol levels below 200 nmol/l were significantly less amount of persons with chronic bacterial infections and persistent viral infections (CMV, EBV) and in the genealogy of these children allergic reactions, endocrine pathology diagnosed more often compared with patients, whose hormone levels was higher than 200 nmol/l (p < 0.05). Distribution of children from control group by gradations of cortisol, age groups, defined somatic pathology and diseases in genealogy had no difference. It is shown, that lower initial blood serum cortisol level in ALL children correlates to a greater probability of relapse (Rs = -0,67). In patients with AML a direct correlation between cortisol level and median survival was detected (Rs = 0,79). Children radiation doses were ranging from 0.08 mSv to 14.9 mSv, and there were slightly higher among residents of Zhytomyr region (8.4 ± 1.2 mSv) compared to other regions. However, these doses did not affect blood serum cortisol levels in children and the course of AL. CONCLUSIONS: These data suggest the need for correction and individualization of corticosteroid doses for optimization of AL patients treatment. Children, who have lower than normative serum cortisol levels are at increased risk of hema tologic pathology and they need for hematologic monitoring.

Modern state of problem of delivery of medicines with use of erythrocytes as cell-carriers.

Erythrocytes are prospective carriers of wide range of medicines and other biologically active agents. Main peculiarity and advantage of erythrocytes as carriers of medicines is their absolute bio-compatibility and ability for long circulation in an organism. While growing old these cells undergo natural process of biodegradation. Relatively inactive endocellular environment protects carried medicine from being inactivated by different endogenous factors. At the present time different methods of loading medicines in erythrocytes are used: electroporation, induced endocytosis, osmotic pulse hematolysis, hypotonic hematolysis. Most of these methods are based on the ability of these cells for reversible deformation of the surface without changing area of surface. Introduction of medicines in erythrocytes can be conducted in natural way as a result of their sorption on cell membrane. Different medicines can be used as the objects for targeted transport: antibiotics, antineoplastic drugs, corticosteroids, peptides, enzymes etc. extracorporeal pharmacotherapy with use of erythrocytes as carriers can be applied in the treatment of different diseases. Range of used medicines and provided possibilities is quite wide at a present time, but further development of this direction is very prospective. The aim of the authors was to outline a common concept of the potential of erythrocytes as universal transportation means of medicines for therapy of different pathological conditions.

[Structural and Functional Properties of Vascular Endothelium].

We have summarized in this paper main conceptions on structure and function of vascular endothelium with special attention to the role of caveolae both in regulation of function of endothelium itself and transvesicular transport of metabolic substrates. We have also described the role of shear stress in activation of vascular endothelium and putative mechanisms of its action.

[Structural and Functional Properties of Vascular Endothelium].

We have summarized in this paper main conceptions on structure and function of vascular endothelium with special attention to the role of caveolae both in regulation of function of endothelium itself and transvesicular transport of metabolic substrates. We have also described the role of shear stress in activation of vascular endothelium and putative mechanisms of its action.

Protective effect of transplantation of neonatal liver cell nuclei on the model of acute toxic hepatitis.

We present the results of comparative analysis of functional and morphological changes in the liver of animals with experimental CCl(4)-induced hepatitis under conditions of transplantation of neonatal liver cells and nuclei. It was found that transplantation of neonatal liver cell nuclei in acute toxic hepatitis provides better functional and structural state of the target organ.

[Candida albicans sensitization in patients with atopic bronchial asthma and atopic dermatitis]. / Sensibilizatsiia k Candida albicans u bol'nykh atopicheskoi bronkhial'noi astmoi i atopicheskim dermatitom.

Candida albicans, a component of normal human microflora, can induce synthesis of specific IgE-antibodies in patients with atopic bronchial asthma and atopic dermatitis. The study included 25 patients with atopic dermatitis sensitized to C.albicans and 23 patients with atopic dermatitis non-sensitized to C.albicans. The sensitization was determined by the skin test and enzyme immunoassay. The patients had the history of atopic dermatitis exacerbation after taking food containing baking yeasts. Atopic dermatitis with sensitization to C.albicans is characterized by severe course correlating with the following indices: high total IgE (r = 0.6), level of IgE antibodies to C.albicans (r = 0.6), level of serum IgG (r = 0.46) and IgA (r = 0.33). Contrary to adults, children with sensitization to C.albicans had decreased relative number of CD4+, CD8+ and CD72+ of lymphocyte subpopulations. Thus, sensitization to C.albicans manifests in severe atopic dermatitis which in children is often associated with immune deficiency.