Дистальные тубулопатии. Синдром Гительмана

The clinical recommendations on management of children with Gitelman syndrome developed by the experts of the Union of pediatricians of Russia are presented in this article. Gitelman syndrome is a dysfunction of distal renal tubules with further development of hypomagnesemia, hypocalciuria and secondary aldosteronism which determine hypokalemia and metabolic alkalosis. Features of epidemiology, etiology and pathogenesis, disease progression, differential diagnostics and evidence-based treatment are presented.Представлены разработанные экспертами Союза педиатров России клинические рекомендации по оказанию медицинской помощи детям с синдромом Гительмана — нарушением функции дистальных почечных канальцев с развитием гипомагнеземии, гипокальциурии и вторичного альдостеронизма, который обусловливает гипокали-емию и метаболический алкалоз. Отмечены особенности эпидемиологии, этиологии и патогенеза, клинического течения, дифференциальной диагностики, а также лечения, основанного на принципах доказательности

Петлевые тубулопатии: синдром Барттера

The authors provide a review of current clinical guidelines regarding medical care provided to children with Bartter’s syndrome — impaired renal tubular function (loop of Henle) with the development of hypokalemia, hypochloremia, metabolic alkalosis and hyperreninemic hyperaldosteronism.  The specifics of disease epidemiology, etiology and pathogenesis  are described. The issues of differential diagnosis and treatment based on the principles of evidence are covered.Авторами  представлены   основные  положения   актуальных  клинических  рекомендаций  по  оказанию  медицинской помощи детям с синдромом Барттера  — нарушением функции  почечных канальцев  (петли  Генле)  с развитием гипокалиемии,  гипохлоремии,  метаболического  алкалоза  и гиперренинемического  гиперальдостеронизма. Рассматриваются  особенности  эпидемиологии,  этиологии  и патогенеза.  Освещены вопросы дифференциальной диагностики, лечения, основанного на принципах доказательности

Adaptation of Mycoplasmas to Antimicrobial Agents: Acholeplasma laidlawii Extracellular Vesicles Mediate the Export of Ciprofloxacin and a Mutant Gene Related to the Antibiotic Target

This study demonstrated that extracellular membrane vesicles are involved with the development of resistance to fluoroquinolones by mycoplasmas (class Mollicutes). This study assessed the differences in susceptibility to ciprofloxacin among strains of Acholeplasma laidlawii PG8. The mechanisms of mycoplasma resistance to antibiotics may be associated with a mutation in a gene related to the target of quinolones, which could modulate the vesiculation level. A. laidlawii extracellular vesicles mediated the export of the nucleotide sequences of the antibiotic target gene as well as the traffic of ciprofloxacin. These results may facilitate the development of effective approaches to control mycoplasma infections, as well as the contamination of cell cultures and vaccine preparations

Mitochondria as a Possible Place for Initial Stages of Steroid Biosynthesis in Plants

With the aim of thorough comparison of steroidogenic systems of plants and animals, transgenic plants of Solanaceae family expressing CYP11A1 cDNA encoding cytochrome P450SCC of mammalian mitochondria were further analysed. Positive effect of CYP11A1 on resistance of the transgenic tobacco plants to the infection by fungal phytopathogene Botrytis cinerea was for the first time detected. Subtle changes in mitochondria of the transgenic Nicotiana tabacum plants expressing mammalian CYP11A1 cDNA were demonstrated by transmissive electron microscopy. The main components of the electron transfer chain of plant mitochondria were for the first time cloned and characterized. It was established that plants from the Solanacea family (tomato, tobacco and potato) contain two different genes with similar exon-intron structures (all contain 8 exons) encoding mitochondrial type ferredoxins (MFDX), and one gene for mitochondrial ferredoxin reductase (MFDXR). The results obtained point out on profound relatedness of electron transfer chains of P450-dependent monooxygenases in mammalian and plant mitochondria and support our previous findings about functional compatability of steroidogenic systems of Plantae and Animalia

Loop tubulopathies: Bartter’s syndrome

The authors provide a review of current clinical guidelines regarding medical care provided to children with Bartter’s syndrome — impaired renal tubular function (loop of Henle) with the development of hypokalemia, hypochloremia, metabolic alkalosis and hyperreninemic hyperaldosteronism.  The specifics of disease epidemiology, etiology and pathogenesis  are described. The issues of differential diagnosis and treatment based on the principles of evidence are covered

Distal Tubulopathy. Liddle Syndrome

The clinical recommendations on management of children with Liddle syndrome which is characterized by severe hypertension along with low activity levels of renin and aldosterone in blood plasma, hypokalemia and metabolic alkalosis, were developed by the experts of the Union of pediatricians of Russia. Aspects of epidemiology, etiology and pathogenesis, disease progression, differential diagnostics and evidence-based treatment are presented

Current Approaches in Management of Patients with Hypophosphatasia

he authors present the latest data on the hypophosphatasia (HPP) management in children. Hypophosphatasia is a rare genetic disease caused by deficiency of tissue-specific alkaline phosphatase due to mutation in the ALPL gene. The article covers all the features of epidemiology, etiology and pathogenesis, detailed stages of differential diagnostics. Treatment guidelines for pediatric patients are provided, they are based on the principles of evidence-based medicine. Special attention was given to the only effective method of hypophosphatasia management —enzyme replacement therapy (ERT). This material is the clinical guideline draft for the management of patients with hypophosphatasia prepared by the Union of Pediatricians of Russia and the Association of Medical Geneticists