Патогенетичні фактори розвитку аутоімунних захворювань. Сучасні підходи до їх лікування

In experimental models of pathologies of autoimmune genesis there was grounded the possibility and confirmed the efficiency of using the products of fetoplacental complex. There was tested their ability to activate T-regulatory immunity link and normalize cell indices in experimental animals. More pronounced immune correcting potential of cryopreserved material has been shown at cell and molecular levels. На экспериментальных моделях патологий аутоиммунного генеза обоснована возможность и доказана эффективность применения продуктов фетоплацентарного комплекса. Продемонстрирована их способность к  активации Т-регуляторного звена иммунитета и нормализации клинических показателей экспериментальных животных. Показан более выраженный  иммунокорригирующий потенциал криоконсервированного материала на клеточном и молекулярном уровнях.На експериментальних моделях патологій аутоімунного генезу обгрунтована можливість і доведена ефективність застосування продуктів фетоплацентарного комплексу. Продемонстровано їхню здатність до активації Т-регуляторної ланки імунітету і нормалізації клінічних показників експериментальних тварин. Показано більш виражений імунокоригуючий потенціал кріоконсервованого матеріалу на клітинному і молекулярному рівнях

2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy

Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate

Aortic atherosclerosis as an embolic source

Stroke is the third leading cause of death in several industrial countries and cardiogenic embolism accounts for 15\u201330 % of ischaemic strokes [1\u20135]. The diagnosis of a cardioembolic source of stroke is frequently uncertain and relies on the identification of a potential cardiac source of embolism in the absence of significant autochthonous cerebrovascular occlusive disease. In this regard, echocardiography (either transthoracic \u2013 TTE or Transoesophageal \u2013 TEE) serves as a cornerstone in the evaluation and diagnosis of these patients [6, 7]

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

BACKGROUN

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at high cardiovascular risk. METHODS In two parallel, multinational trials with different entry criteria for LDL cholesterol levels, we randomly assigned the 27,438 patients in the combined trials to receive bococizumab (at a dose of 150 mg) subcutaneously every 2 weeks or placebo. The primary end point was nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or cardiovascular death; 93% of the patients were receiving statin therapy at baseline. The trials were stopped early after the sponsor elected to discontinue the development of bococizumab owing in part to the development of high rates of antidrug antibodies, as seen in data from other studies in the program. The median follow-up was 10 months. RESULTS At 14 weeks, patients in the combined trials had a mean change from baseline in LDL cholesterol levels of -56.0% in the bococizumab group and +2.9% in the placebo group, for a between-group difference of -59.0 percentage points (P<0.001) and a median reduction from baseline of 64.2% (P<0.001). In the lower-risk, shorter-duration trial (in which the patients had a baseline LDL cholesterol level of ≥70 mg per deciliter [1.8 mmol per liter] and the median follow-up was 7 months), major cardiovascular events occurred in 173 patients each in the bococizumab group and the placebo group (hazard ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the higher-risk, longer-duration trial (in which the patients had a baseline LDL cholesterol level of ≥100 mg per deciliter [2.6 mmol per liter] and the median follow-up was 12 months), major cardiovascular events occurred in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to 0.97; P = 0.02). The hazard ratio for the primary end point in the combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site reactions were more common in the bococizumab group than in the placebo group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no benefit with respect to major adverse cardiovascular events in the trial involving lower-risk patients but did have a significant benefit in the trial involving higher-risk patients