140 research outputs found
Fluorescence of Supported Phospholipid Bilayers Recorded in a Conventional Horizontal-Beam Spectrofluorometer
Supported phospholipid bilayers are a convenient model of cellular membranes in studies of membrane biophysics and protein-lipid interactions. Traditionally, supported lipid bilayers are formed on a flat surface of a glass slide to be observed through fluorescence microscopes. This paper describes a method to enable fluorescence detection from the supported lipid bilayers using standard horizontal-beam spectrofluorometers instead of the microscopes. In the proposed approach, the supported lipid bilayers are formed on the inner optical surfaces of the standard fluorescence microcell. To enable observation of the bilayer absorbed on the cell wall, the microcell is placed in a standard fluorometer cell holder and specifically oriented to expose the inner cell walls to both excitation and emission channels with a help of the custom cell adaptor. The signal intensity from supported bilayers doped with 1 % (mol) of rhodamine-labeled lipid in the standard 3-mm optical microcell was equivalent to fluorescence of the 70β80 nM reference solution of rhodamine recorded in a commercial microcell adaptor. Because no modifications to the instruments are required in this method, a variety of steady-state and time-domain fluorescence measurements of the supported phospholipid bilayers may be performed with the spectral resolution using standard horizontal-beam spectrofluorometers
The Ras G Domain Lacks the Intrinsic Propensity to Form Dimers
Ras GTPase is a molecular switch controlling a number of cellular pathways including growth, proliferation, differentiation, and apoptosis. Recent reports indicated that Ras undergoes dimerization at the membrane surface through protein-protein interactions. If firmly established this property of Ras would require profound reassessment of a large amount of published data and modification of the Ras signaling paradigm. One proposed mechanism of dimerization involves formation of salt bridges between the two GTPase domains (G domains) leading to formation of a compact dimer as observed in Ras crystal structures. In this work, we interrogated the intrinsic ability of Ras to self-associate in solution by creating conditions of high local concentration through irreversibly tethering the two G domains together at their unstructured C-terminal tails. We evaluated possible self-association in this inverted tandem conjugate via analysis of the time-domain fluorescence anisotropy and NMR chemical shift perturbations. We did not observe the increased rotational correlation time expected for the G domain dimer. Variation of the ionic strength (to modulate stability of the salt bridges) did not affect the rotational correlation time in the tandem further supporting independent rotational diffusion of two G domains. In a parallel line of experiments to detect and map weak self-association of the G domains, we analyzed NMR chemical shifts perturbations at a number of sites near the crystallographic dimer interface. The nearly complete lack of chemical shift perturbations in the tandem construct supported a simple model with the independent G domains repelled from each other by their overall negative charge. These results lead us to the conclusion that self-association of the G domains cannot be responsible for homodimerization of Ras reported in the literature
The experience of multiformat classes
The article describes the experience of forming a Β«multi-formatΒ» system of teaching the subject. The use of various forms of employment in combination with modern technologies of training gives a positive result.Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΎΠΏΡΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ Β«ΠΌΡΠ»ΡΡΠΈΡΠΎΡΠΌΠ°ΡΠ½ΠΎΠΉΒ» ΡΠΈΡΡΠ΅ΠΌΡ ΠΏΡΠ΅ΠΏΠΎΠ΄Π°Π²Π°Π½ΠΈΡ ΡΡΠ΅Π±Π½ΠΎΠΉ Π΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Ρ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½ΡΡ
ΡΠΎΡΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π·Π°Π½ΡΡΠΈΠΉ Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠΌΠΈ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠΌΠΈ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ Π΄Π°Π΅Ρ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΡΠ΅Π·ΡΠ»ΡΡΠ°Ρ
ΠΡΠΎΠ΅ΠΊΡΠ½ΠΎ-Π΄ΠΈΠΏΠ»ΠΎΠΌΠ½ΡΠ΅ ΠΊΠΎΠ»Π»Π΅ΠΊΡΠΈΠ²Ρ ΠΊΠ°ΠΊ ΠΎΡΠ½ΠΎΠ²Π° ΠΈΠ½ΡΠ΅Π³ΡΠ°ΡΠΈΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΈ Π½Π°ΡΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠΈΡΠΊΠ°
Integration of educational process and scientific inquiry, development of creative abilities of graduates by creating graduate thesis project writing teams. Cooperative work of students and teachers of higher educational institution is presented in the article.ΠΠ½ΡΠ΅Π³ΡΠ°ΡΠΈΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΈ Π½Π°ΡΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠΈΡΠΊΠ°, ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΡΠ²ΠΎΡΡΠ΅ΡΠΊΠΈΡ
ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠ΅ΠΉ Π²ΡΠΏΡΡΠΊΠ½ΠΈΠΊΠΎΠ² Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ ΠΏΡΡΠ΅ΠΌ ΡΠΎΠ·Π΄Π°Π½ΠΈΡ Π΄ΠΈΠΏΠ»ΠΎΠΌΠ½ΠΎ-ΠΏΡΠΎΠ΅ΠΊΡΠ½ΡΡ
ΡΠ²ΠΎΡΡΠ΅ΡΠΊΠΈΡ
ΠΊΠΎΠ»Π»Π΅ΠΊΡΠΈΠ²ΠΎΠ². ΠΠΏΡΡ ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΠΎΠΉ ΡΠ°Π±ΠΎΡΡ ΡΡΡΠ΄Π΅Π½ΡΠΎΠ² ΠΈ ΠΏΡΠ΅ΠΏΠΎΠ΄Π°Π²Π°ΡΠ΅Π»Π΅ΠΉ Π²ΡΠ·Π° Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΡΠ°ΠΊΠΎΠ³ΠΎ ΠΊΠΎΠ»Π»Π΅ΠΊΡΠΈΠ²Π° ΠΈΠ·Π»Π°Π³Π°Π΅ΡΡΡ Π² ΡΡΠ°ΡΡΠ΅
Abbreviations of the modern medical language used in the written press
El objetivo del presente artΓculo es estudiar el potencial lingΓΌΓstico y creativo de unidades lΓ©xicas creadas a base de palabras o sintagmas abreviados mediante el anΓ‘lisis del lenguaje de la prensa escrita. El estatus lingΓΌΓstico de las abreviaciones no es fijo, van acomodando su configuraciΓ³n externa, pronunciaciΓ³n y propiedades morfosintΓ‘cticas a las palabras naturales del idioma. Los rasgos que testimonian la adaptaciΓ³n de las abreviaciones son su lexicalizaciΓ³n y acomodaciΓ³n grΓ‘fica y fΓ³nica, pΓ©rdida de motivaciΓ³n semΓ‘ntica, participaciΓ³n activa en los procesos derivativos. La variedad en el aspecto grafemΓ‘tico y morfolΓ³gico (oscilaciones con respecto al gΓ©nero, formaciΓ³n del plural, dificultad para distinguir las categorΓas gramaticales de sustantivo y adjetivo, uso de guion, mayΓΊsculas o minΓΊsculas) tiene relaciΓ³n, por un lado, con el creciente y continuado uso de las unidades abreviadas en el lenguaje y con ausencia de normas de uso convencionales, por otro. La frecuencia y amplitud de uso de las abreviaciones por razones de comodidad y economΓa lingΓΌΓstica concurre con la bΓΊsqueda de efectos estilΓsticos, por lo que su presencia es amplia en los llamados gΓ©neros de opiniΓ³n
EBV-Positive Lymphoproliferative Diseases: A New Concept and Differential Diagnosis (Literature Review and Case Reports)
In recent years increasing attention focuses on the concept of EBV-positive lymphoproliferative diseases related to primary or secondary immunodeficiency resulting from immunosuppressive therapy and persistent infections. Due to the progress of treatment methods in oncohematology and oncology this pathology also occurs as a delayed event when new surgical and therapeutic approaches are applied. The paper presents proof for the pathogenetic significance of Epstein-Barr virus (EBV) in the pathology under consideration with its various clinical manifestations and describes the evolution of knowledge on posttransplant lymphoproliferative disorders with their morphological classification underlying EBV+ lymphoproliferative diseases. The WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues revised in 2017 includes new forms of EBV+ lymphoproliferative diseases (mucocutaneous ulcer, T- and NK-cell childhood lymphoproliferative disorders including cutaneous and systemic forms of chronic active EBV infection) and EBV+ large B-cell lymphomas (unspecified and fibrin-associated diffuse large B-cell lymphomas). The paper summarizes major characteristics of these diseases and exemplifies them by the authorβs own experience
Conformational States of Cytochrome P450 Oxidoreductase Evaluated by FΓΆrster Resonance Energy Transfer Using Ultrafast Transient Absorption Spectroscopy
NADPH-cytochrome P450 oxidoreductase (CYPOR) was shown to undergo large conformational rearrangements in its functional cycle. Using a new FΓΆrster resonance energy transfer (FRET) approach based on femtosecond transient absorption spectroscopy (TA), we determined the donorβacceptor distance distribution in the reduced and oxidized states of CYPOR. The unmatched time resolution of TA allowed the quantitative assessment of the donorβacceptor FRET, indicating that CYPOR assumes a closed conformation in both reduced and oxidized states in the absence of the redox partner. The described ultrafast TA measurements of FRET with readily available redβinfrared fluorescent labels open new opportunities for structural studies in chromophore-rich proteins and their complexes
COGNITIVE PROBLEM IN THE MODERN STUDIES OF SOCIO-INTEGRAL PROCESSES (TO A FIRST APPROXIMATION)
Π¦Π΅Π»Ρ.Β ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΡΠΎΠ»Ρ, Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΠΌΠ°ΡΠΈΠΊΠΈ Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π½Π°ΡΠΊΠ°Ρ
ΠΎΠ± ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅ Ρ ΡΠΎΡΠΊΠΈ Π·ΡΠ΅Π½ΠΈΡ ΡΠ²ΡΠΈΡΡΠΈΡΠ½ΠΎΡΡΠΈ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅Π³ΡΠ°ΡΠΈΠΈ.ΠΠ΅ΡΠΎΠ΄ ΠΈΠ»ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΠ°Π±ΠΎΡΡ.Β ΠΡΠΈ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠ΅ ΡΡΠ°ΡΡΠΈ Π±ΡΠ»ΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Ρ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΈ ΠΎΠ±ΠΎΠ±ΡΠ΅Π½ΠΈΠ΅ Ρ ΡΠ΅ΡΠ΅ΡΠ΅Π½ΡΠΈΠ΅ΠΉ ΠΊ Π΄Π°Π½Π½ΡΠΌ ΠΊΠ°ΠΊ ΡΠ΅ΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
, ΡΠ°ΠΊ ΠΈ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ.Β Π ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ ΠΎΠ±ΡΠ΅ΡΡΠ²ΠΎΠ·Π½Π°Π½ΠΈΠΈ, Π²ΠΊΠ»ΡΡΠ°ΡΡΠ΅ΠΌ ΡΠΎΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡ, Π°Π½ΡΡΠΎΠΏΠΎΠ»ΠΎΠ³ΠΈΡ, ΡΠΊΠΎΠ½ΠΎΠΌΠΈΠΊΡ, ΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΡ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½Π°Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΡΠΈΠΊΠ° Π·Π°Π½ΠΈΠΌΠ°Π΅Ρ Π²ΡΠ΅ Π±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΌΠ΅ΡΡΠΎ, ΡΡΠΎ Π΄Π°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΡ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΡ Π½Π° Π½ΠΎΠ²ΠΎΠΌ ΡΠ΅ΠΎΡΠ΅ΡΠΈΠΊΠΎ-ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΡΠΎΠ²Π½Π΅ ΠΈ Π² ΡΠ°ΠΌΠΊΠ°Ρ
Π΄Π΅ΠΉΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΈΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΠΎΡΡΠΈ. Π‘Π΅ΡΡΠ΅Π·Π½ΡΠΌ ΡΠ²ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΠΎΠΌ ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄, ΡΡΠΈΡΡΠ²Π°ΡΡΠΈΠΉ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ, ΠΈ Π΄Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ² ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅Π³ΡΠ°ΡΠΈΠΈ ΠΈΠ»ΠΈ ΠΊΠΎΠ½ΡΡΠ½ΠΊΡΠΈΠΈ, Π½Π°ΠΏΡΡΠΌΡΡ ΡΠ²ΡΠ·Π°Π½Π½ΡΠΌ Ρ Π΄ΠΎΠΌΠΈΠ½ΠΈΡΡΡΡΠ΅ΠΉ Π² ΠΌΠ°ΡΡΠΎΠ²ΠΎΠΌ ΡΠΎΠ·Π½Π°Π½ΠΈΠΈ Π² ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΡΠΉ ΠΈΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ Β«ΡΡ
Π΅ΠΌΠΎΠΉΒ».ΠΠ±Π»Π°ΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ².Β ΠΡΠ²ΠΎΠ΄Ρ ΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½Ρ Π΄Π»Ρ ΡΠ΅ΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ½Π°ΡΠ΅Π½ΠΈΡ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ², Π²ΠΊΠ»ΡΡΠ°Ρ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΡ ΠΈΠ½ΡΠ΅Π³ΡΠ°ΡΠΈΡ. ΠΠ°ΠΊΠΎΠ½ΠΎΠΌΠ΅ΡΠ½ΡΠΌ Π±ΡΠ΄Π΅Ρ ΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π°Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π² ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-Π³ΡΠΌΠ°Π½ΠΈΡΠ°ΡΠ½ΡΡ
Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΉ.Purpose.Β To analyze the role, significance and directions of realizing of cognitive themes in modern social sciences from the point of view of the applicability of this approach in studies of the problem of social integration.Methodology.Β During the preparation of the article, comparative analysis and generalization used with reference to the data of both theoretical and practical studies.Results.Β In modern social science, including sociology, anthropology, economics, social psychology, cognitive problems occupy an increasingly important place, which makes it possible to investigate social processes on a new theoretical and methodological level and within the framework of actual polydisciplinarity. A cognitive-based approach has an important heuristic potential for the study of processes of social integration, for those are directly related to a certain behavioral βschemeβ dominant in the mass consciousness in a given historical period.Practical implications.Β Conclusions and results could be applied to the theoretical substantiation and methodological equipment of further studies of various social processes, including social integration. It will be natural to use these results in the educational practice of social and humanitarian areas
Analysis of Binding Site Hot Spots on the Surface of Ras GTPase
We have recently discovered an allosteric switch in Ras, bringing an additional level of complexity to this GTPase whose mutants are involved in nearly 30% of cancers. Upon activation of the allosteric switch, there is a shift in helix 3/loop 7 associated with a disorder to order transition in the active site. Here, we use a combination of multiple solvent crystal structures and computational solvent mapping (FTMap) to determine binding site hot spots in the βoffβ and βonβ allosteric states of the GTP-bound form of H-Ras. Thirteen sites are revealed, expanding possible target sites for ligand binding well beyond the active site. Comparison of FTMaps for the H and K isoforms reveals essentially identical hot spots. Furthermore, using NMR measurements of spin relaxation, we determined that K-Ras exhibits global conformational dynamics very similar to those we previously reported for H-Ras. We thus hypothesize that the global conformational rearrangement serves as a mechanism for allosteric coupling between the effector interface and remote hot spots in all Ras isoforms. At least with respect to the binding sites involving the G domain, H-Ras is an excellent model for K-Ras and probably N-Ras as well. Ras has so far been elusive as a target for drug design. The present work identifies various unexplored hot spots throughout the entire surface of Ras, extending the focus from the disordered active site to well-ordered locations that should be easier to target
Π£ΡΠΏΠ΅ΡΠ½Π°Ρ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½Π°Ρ ΠΈΠΌΠΌΡΠ½ΠΎΡΠΏΠΈΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΡΡΠΈΡΡΠΎΠ΄Π΅ΡΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΌΡ Π³ΡΠΈΠ±ΠΎΠ²ΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΌΠΈΠΊΠΎΠ·Π°
Mucosis fungoidea (ΠF) belongs to the class of epidermotropic T-cell lymphomas. MF is represented by over 10 sub-types only in terms of its clinical manifestations, with one of them being erythrodermic MF (EMF). This disease is characterized by diverse symptomatology in the form of erythroderma and intense skin itch, aggressive Ρlinical course and unfavorable prognosis. The disease prognosis also correlates with age, previous history of long-term systemic gluco-corticosteroid treatment (GCS), increased activity of lactate dehydrogenase (LDH) and hypereosinophilia. The choice of MF treatment is determined by the disease stage and somatic status of the patient. In EMF, a therapy combining various effective preparations and taking into account the specifics of the given case is required. Extracorporeal photopheresis (ECP) is frequently an approach of choice; however, it has demonstrated the highest efficacy in Sezary disease or in EFM associated with leucemization. Application of new pharmaceuticals (monoclonal antibodies, epigenetic agents) in combination or in sequence with immune therapy is a promising direction, particularly for treating patients older than 75 years. In this paper, we describe the clinical case of an elderly patient suffering from EMF without peripheral blood leukemia with multimodal factors of unfavorable prognosis, such as age, increased lactate dehy drogenase activity, history of prolonged inefficient treatment with gluco-cortecosteroid preparations and eosinophilia. A long-term positive response to the treatment using sequential immune epigenetic therapy has not been achieved, although the treatment tolerability and the patient's life quality were satisfactory.ΠΡΠΈΠ±ΠΎΠ²ΠΈΠ΄Π½ΡΠΉ ΠΌΠΈΠΊΠΎΠ· (ΠΠ) ΠΎΡΠ½ΠΎΡΠΈΡΡΡ ΠΊ ΡΠΏΠΈΠ΄Π΅ΡΠΌΠΎΡΡΠΎΠΏΠ½ΡΠΌ Π’-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ Π»ΠΈΠΌΡΠΎΠΌΠ°ΠΌ ΠΈ ΠΏΠΎ ΡΠ²ΠΎΠ΅ΠΌΡ ΡΠΎΠ»ΡΠΊΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ ΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ 10 ΠΏΠΎΠ΄ΡΠΈΠΏΠ°ΠΌΠΈ, ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΠΈΡΡΠΎΠ΄Π΅ΡΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠΎΡΠΌΠ° ΠΠ (ΡΠΠ). ΠΠ°Π½Π½ΡΠΉ Π²Π°ΡΠΈΠ°Π½Ρ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈΠΌΠ΅Π΅Ρ ΡΠ°Π·Π²Π΅ΡΠ½ΡΡΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΡ Π² Π²ΠΈΠ΄Π΅ ΡΡΠΈΡΡΠΎΠ΄Π΅ΡΠΌΠΈΠΈ ΠΈ Π½Π°Π»ΠΈΡΠΈΡ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΊΠΎΠΆΠ½ΠΎΠ³ΠΎ Π·ΡΠ΄Π°, Π°Π³ΡΠ΅ΡΡΠΈΠ²Π½ΡΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ·. ΠΡΠΎΠ³Π½ΠΎΠ· ΡΠ°ΠΊΠΆΠ΅ ΠΊΠΎΡΡΠ΅Π»ΠΈΡΡΠ΅Ρ Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ, ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΠΈΠΌ Π°Π½Π°ΠΌΠ½Π΅Π·ΠΎΠΌ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΈΠ΅ΠΌΠ° ΡΠΈΡΡΠ΅ΠΌΠ½ΡΡ
Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² (ΠΠΠ‘), ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ Π»Π°ΠΊΡΠ°ΡΠ΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (ΠΠΠ) ΠΈ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΈΠ΅ΠΉ. ΠΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΠ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ ΡΡΠ°Π΄ΠΈΠ΅ΠΉ, ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΡΠ°ΡΡΡΠΎΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΠΈ, ΠΊΠ°ΠΊ ΠΏΡΠ°Π²ΠΈΠ»ΠΎ, ΠΏΡΠΈ ΡΠΠ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², ΠΎΡΠ½ΠΎΠ²ΡΠ²Π°ΡΡΡ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½Ρ-ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π΅. ΠΠΊΡΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΡΠΉ ΡΠΎΡΠΎΡΠ΅ΡΠ΅Π· (ΠΠΠ€) ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΡΠ΅ΠΌΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ, ΠΎΠ΄Π½Π°ΠΊΠΎ Π½Π°ΠΈΠ»ΡΡΡΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΡΠ΅Ρ ΠΏΡΠΈ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ΅ Π‘Π΅Π·Π°ΡΠΈ ΠΈΠ»ΠΈ ΡΠΠ Ρ Π»Π΅ΠΉΠΊΠ΅ΠΌΠΈΠ·Π°ΡΠΈΠ΅ΠΉ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½ΠΎΠ²ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² (ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ Π°Π½ΡΠΈΡΠ΅Π»Π°, ΡΠΏΠΈΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π°Π³Π΅Π½ΡΡ) Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ ΠΈΠ»ΠΈ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎ Ρ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΠΈΠ·ΡΡΠ°Π΅ΠΌΡΠΌ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ, ΠΎΡΠΊΡΡΠ²Π°ΡΡΠΈΠΌ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ°ΡΡΠ΅ 75 Π»Π΅Ρ. Π ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ Ρ ΠΏΠΎΠΆΠΈΠ»ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΡΡΠΈΡΡΠΎΠ΄Π΅ΡΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ Π²Π°ΡΠΈΠ°Π½ΡΠΎΠΌ Π³ΡΠΈΠ±ΠΎΠ²ΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΌΠΈΠΊΠΎΠ·Π° Π±Π΅Π· Π»Π΅ΠΉΠΊΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΎΡΡΠ°Π²Π° ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ Ρ ΠΌΡΠ»ΡΡΠΈΠΌΠΎΠ΄Π°Π»ΡΠ½ΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π°, ΡΠ°ΠΊΠΈΠΌΠΈ ΠΊΠ°ΠΊ Π²ΠΎΠ·ΡΠ°ΡΡ, ΠΏΠΎΠ²ΡΡΠ΅Π½Π½Π°Ρ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΠΠ, Π°Π½Π°ΠΌΠ½Π΅Π· Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΏΡΠΈΠ΅ΠΌΠ° ΠΠΠ‘ ΠΈ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΈΡ, ΠΏΠΎΠ»Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΡΠ΄Π°Π»ΠΎΡΡ Π΄ΠΎΡΡΠΈΡΡ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΡΠΏΠΈΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΈ ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠΈΠΌΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Ρ
ΠΎΡΠΎΡΠ΅Π³ΠΎ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ
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