Sergey Yu. Tereshchenko

Bronchial asthma is among the most common chronic respiratory diseases in pediatrics, with about half of children with asthma experiencing uncontrolled disease progression. Markers of eosinophilic endotype in asthma are well studied, but the neutrophilic endotype, especially in children, has not been sufficiently researched, and reliable serum/plasma markers of the neutrophilic pattern of inflammation in asthma are unknown. Our objective was to determine diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL) levels in blood plasma, and its dependence on clinical asthma control in children. 132 children with asthma aged 6-17 years (mean age 12.5±3.5 years; 81 boys/51 girls) were examined. The degree of asthma control was assessed using the Asthma Control Test questionnaire. The following groups were determined: controlled asthma cases (n = 21); partially controlled asthma (n = 47), and uncontrolled asthma patients (n = 64). NGAL concentration in blood plasma was determined using an automated immunoassay. Statistical analysis included the Kruskal-Wallis test, Mann-Whitney U test, Spearman's correlation analysis, and ordinal logistic regression. The NGAL levels In children with uncontrolled asthma were significantly higher than in controlled and partially controlled asthma groups (p = 0.043). NGAL levels showed a positive correlation with absolute number of peripheral blood neutrophils (r = 0.272; p < 0.001), and showed no association with markers of eosinophilic asthma endotype (total IgE, eosinophils). At the same time, we did not find any differences in NGAL concentration depending on the asthma severity (Kruskal–Wallis test p = 0.420), or clinical phases of the disease, i.e., 103 (63-185) ng/mL in remission stage (n = 46); 105 (66.8-156) ng/mL in exacerbation in presence of viral infection (n = 14); in exacerbation free of viral infection (n = 72), 138 (90.5-207) ng/mL. This difference was insignificant (p = 0.310 by Kruskal-Wallis test). Ordinal logistic regression showed that an increase in NGAL levels by every 10 ng/mL was associated with the likelihood of failed asthma control by 5% (OR = 1.05; 95% CI: 1.01-1.09; p = 0.022). regardless of gender, age, and disease severity. Plasma NGAL concentration is an independent biomarker of uncontrolled asthma in children, reflecting a predominantly neutrophilic inflammation pattern. NGAL may be used as a screening tool for early diagnostics of children at risk of losing asthma control and requiring further treatment adjustment.

Objective. To analyze the association between polymorphic variants of genes within the serotonergic system to elucidate their potential candidate role in the development of recurrent dorsalgia among adolescents. Material and methods. The study population consisted of Caucasian adolescents aged 12 to 18 years (n=817; mean age 14.38±1.92 years, boy/girl ratio — 45.4%/54.6%). The characteristics of recurrent dorsalgia were assessed in these adolescents, and saliva samples were collected for subsequent DNA isolation and genotyping of gene polymorphisms. Results. The findings indicate that the G allele of HTR1A rs6295 is protective against the severe pain in adolescents with recurrent dorsalgia. Conversely, the T rs6311 allele of the HTR2A gene and the A rs1799913 allele of the TPH1 gene were associated with an elevated risk of severe pain in this population. Conclusions. The results align with contemporary models of the role of the serotonergic system in mechanisms underlying the perception and tolerance of pain stimuli.

Sleep disorders are common among adolescents and are associated with an increased risk of academic failure, affective disorders, and behavioral problems. Individual differences in sleep parameters are partly due to genetic factors, polymorphisms of genes of neurotransmitter systems involved in the regulation of the sleep-wake cycle. Objective. To analyze the associations of nighttime sleep parameters and daytime sleepiness with polymorphic regions of nine candidate genes of serotonin-, dopamine-, and noradrenergic neurotransmitter systems ( MAOA, HTR1A, HTR1A2, COMT, DRD2, DRD4, DBH, SLC6A4, SLC6A2 ) in Russian adolescents. Materials and methods.896 Caucasian adolescents aged 12-18 years (mean age 14.38±1.92 years, boys/girls 45.4%/54.6%) were examined. Nighttime sleep parameters were assessed using selected questions from the Pittsburgh Sleep Quality Index, and daytime sleepiness was assessed using the Pediatric Daytime Sleepiness Scale. Genotyping was performed by real-time polymerase chain reaction using TaqMan probes. Statistical analysis was performed using the SNPStats program with evaluation of various inheritance Results. models and calculation of odds ratios with 95% confidence intervals. A significant association was found between the T allele of the rs1137070 polymorphism of the monoamine oxidase A gene and extremely short nighttime sleep duration (less than 6 hours; odds ratio (OR)1.41; 95% confidence interval (CI) 1.091.81; p=0.008) and increased daytime sleepiness (OR 1.29; 95% CI 1.05-1.60; p=0.018). The T allele of the rs1800497 (TaqIA) polymorphism of the dopamine receptor D2/ANKK1gene demonstrated a protective effect against frequent nighttime awakenings (OR 0.69; 95% CI 0.52-0.92; p=0.0098). Conclusion. The established genetic associations indicate a significant contribution of heritable individual differences in the functioning of monoaminergic neurotransmitter systems to sleep regulation in adolescents.

Objective. To establish an association between different primary headaches (PH) and sleep disorders taking into account psychosocial problems in Siberian adolescents. Material and methods. The study included 5.606 adolescents (2.605 boys, 3.001 girls) aged 11—18 years in three large Siberian cities: Krasnoyarsk, Abakan, and Kyzyl. The diagnosis of PH was based on migraine and tension-type headache (TTH) identification questionnaire and international headache criteria. Nighttime sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness — using the Pediatric Daytime Sleepiness Scale (PDSS), psychosocial problems — using the Strengths and Difficulties Questionnaire (SDQ). Multinomial logistic regression with inclusion of gender, age, and overall psychosocial problems was used to identify the association of headache with sleep disorders. Results. Associations were established between PH (adjusted for gender, age, and psychosocial problems) and going to bed after 11:00 p.m., sleep latency > 15 min, falling asleep after 12:00 p.m., getting up before 7:00 a.m., reduced sleep duration (<8 hours for those younger 14 years and <7 hours for those older 14 years), difficulty getting up, feeling of insufficient sleep, dyssomnia, daytime sleepiness, asthenic syndrome, feeling of pain during sleep and bad dreams. TTH is more associated with sleep disorders (going to bed after 23:00 (OR 1.4, 95% CI 1.02—2.0), sleep duration <7 hours for those younger 14 years and 1 hour (OR 7.2, 95% CI 2.6—20.1), daytime sleepiness (OR 3.0, 95% CI 2.1—4.2) and asthenic syndrome (OR 5.7, 95% CI 3.6—9.2)). At the same time, children with PH showed a higher level of psychosocial problems, as determined by the SDQ scale. Inclusion of psychosocial problems in multinomial logistic regression model to determine the associations between PH and sleep parameters noticeable decreased statistical significance of OR. This indicates an important role of psychosocial problems in associations between PH and sleep disorders. Conclusion. Associations of primary headache with sleep disorders and psychosocial problems should be taken into account in complex treatment and prevention of primary headache.

Context and relevance. The widespread use of social media among adolescents has led to a significant increase in problematic internet use; however, the psychological mechanisms underlying this relationship remain poorly understood. In particular, the question remains open as to what role social comparison plays in the development of problematic Internet behavior among adolescents who are in the process of identity formation and are highly sensitive to external evaluations. Objective. The aim of this review is to systematize and critically analyze current scientific data on the role of social comparison as a psychological mechanism in the development of problematic Internet use among adolescents, including an evaluation of existing psychometric instruments, the identification of key areas of empirical research, the determination of the role of the educational environment in the prevention of destructive patterns, and the identification of prospects for further research. Methods. A systematic search of scientific publications was conducted in international databases including PubMed, Web of Science, Scopus, PsycINFO, and Russian databases eLIBRARY.ru and CyberLeninka.ru for the period 2013-2025. Original empirical studies, systematic reviews, meta-analyses, and methodological works devoted to the validation of psychometric instruments for assessing social comparison were included in the analysis. Retrospective analysis of reference lists of selected publications was performed to identify relevant sources. Results. It was established that upward online comparisons are directly associated with decreased subjective well-being, increased depressive and anxiety symptoms, development of eating disorders, and formation of problematic Internet use among adolescents. The role of the educational environment in preventing destructive patterns of social comparison is demonstrated. Conclusions. Social comparison is a systemic predictor of problematic Internet use among adolescents in the digital age. Further longitudinal studies of causal relationships, development of integrative models and new psychometric instruments both adapted to the digital environment are needed, as well as implementation of educational programs aimed at developing critical thinking, media literacy, and stable self-esteem in adolescents.

The World Health Organization has recently highlighted a sharp rise in problematic digital device use among adolescents (1). Alongside well-documented mental health consequences, growing evidence links excessive smartphone and internet use to somatic symptoms, including headache and musculoskeletal pain (2). These associations warrant closer methodological scrutiny to distinguish correlation from causation and inform targeted prevention.Parra-Fernandez et al. address a clinically meaningful and increasingly visible issue: the cooccurrence of adolescent musculoskeletal pain and mobile phone dependence (MPD) (3). In their school-based cross-sectional sample of 622 adolescents (10-18 years), more than half reported pain in at least one body region during the preceding six months, with upper back and neck pain being most prevalent. The authors also report higher MPD scores among adolescents reporting pain and identify the mobile phone "abuse and difficulty regulating use" dimension as significantly associated with general pain and neck pain in logistic regression models. These findings are valuable for pain researchers because they move beyond screen time as a single exposure and instead examine dependence-related dimensions of device use. This commentary has three objectives: (1) to examine whether psychosocial factors may confound or mediate the reported MPD-pain associations; (2) to consider whether disaggregating device dependence by activity type could sharpen exposure assessment; and (3) to discuss how pain phenotyping and temporal alignment of measures could strengthen inference. These suggestions are offered to build on the contribution of the original study and to support comparability in future work.

Aim. To analyze the key quality-of-life parameters of adolescents with uncontrolled bronchial asthma (BA) and to evaluate their significance as risk factors and/or markers of poor disease control. Design. Comparative clinical study. Materials and methods. A total of 182 adolescents aged 12–18 years with bronchial asthma (BA) were examined: the main group consisted of 105 (57.7%) patients with uncontrolled asthma, while the comparison groups comprised 40 (22%) patients with partially controlled BA and 37 (20.3%) with controlled asthma. The study population included 122 (67%) boys and 60 (33%) girls; the median age was 14 [13; 15] years. Adolescents' quality of life was assessed using the Pediatric Quality of Life Inventory version 4.0-rus (PedsQL 4.0-rus). Four key domains were evaluated, with particular attention paid to their specific characteristics in adolescents with uncontrolled asthma: Physical Functioning, Emotional Functioning, Social Functioning, and School Functioning. Patient age and sex were taken into account when evaluating the scores. Results. According to the PedsQL 4.0-rus questionnaire, adolescents with uncontrolled asthma demonstrated statistically significantly lower scores across all four key domains of quality of life. The most significant predictors of uncontrolled asthma were below-average scores on the Physical Functioning, Emotional Functioning, and Social Functioning subscales (odds ratio (OR) = 2.494, 95% confidence interval (CI): 1.312–4.738; OR = 2.160, 95% CI: 1.177–3.963; and OR = 2.167, 95% CI: 1.021–4.598). Conclusions. Quality-of-life parameters of adolescents with bronchial asthma, assessed using the PedsQL 4.0-rus questionnaire, can be used not only to evaluate treatment efficacy but also to predict the course of the disease. Keywords: adolescents, bronchial asthma, level of asthma control, quality of life, predictive value, predictors/markers.

Asthma remains the most common chronic non-infectious respiratory disease in children, affecting about 14 – 15% of the global pediatric population. Current research shows that asthma is not a single disease, but a spectrum of different endotypes and phenotypes. Phenotypes describe the observed demographic and clinical characteristics of asthma, while endotypes reflect the underlying pathogenetic mechanisms of the disease. The aim. The review systematizes current data on clinical phenotypes (allergic and non-allergic asthma, preschool-age asthma, severe asthma) and inflammatory endotypes (T2-high and T2-low) of asthma in children. Results. Biomarkers used to identify endotypes and their clinical significance are analyzed. The main problems in determining phenotypes and endotypes of asthma in children are highlighted, including the possibility of combining several phenotypes in one patient, temporal instability of biomarkers, and the influence of comorbid conditions. Particular attention is paid to insufficient study of non-allergic asthma and T2-low endotype in children. Conclusion. It is shown that the determination of phenotypes and endotypes of asthma is critical for personalizing therapy and improving the prognosis of the disease. However, further studies of their stability over time and validation in prospective studies are needed for more effective use in clinical practice.

   The relevance of the study is due to the role of IL-4 and IL-13 cytokines in the pathogenesis of diseases of the respiratory system, including bronchial asthma. Changes in the IL4 and IL13 genes can affect their expression levels and, consequently, predisposition to asthma.   The aim of the work was to analyze the prevalence of polymorphic variants of the IL4 rs2243250, rs2070874 and IL13 rs1800925 genes in populations of Russians, Khakas and Tuvans.   Materials and methods. School students from Krasnoyarsk, Abakan, Kyzyl at the age of 12–18 years were studied, their nationality was verified by the nationality of both parents and was determined as Russians (n = 293), Khakas (n = 73), Tuvans (n = 158). Polymorphisms rs2243250 IL4, rs2070874 IL4, and rs1800925 IL13 were determined using real-time PCR.   Results and discussion. It was shown that the CC genotype of the rs2243250 IL4 is more common in Russians (57.7 %) compared with Khakas (34.3 %) and Tuvans (17.1 %) (p < 0.05), allele T – in Tuvans (56.6 %) compared to European (16.8 %) and South Asian populations (18.4 %) (p < 0.05). The Russian population has a predominance of the CC rs2070874 IL4 (54.3 %) compared with other studied groups. The frequency of the allele T is higher among Tuvans (54.7 %) than in Russians (26.8 %), Khakas (41.1 %), European (16.8 %) and South Asian populations (18.6 %), but less than in East Asian populations (77.9 %) (p < 0.05). The CC rs1800925 IL13 is significantly more common in Tuvan (81.6 %) compared with Russians (55.0 %) and Khakas (67.1 %) (p < 0.05). Among Tuvans (81.6 %), this genotype also prevails over East Asian (66.3 %) and South Asian (63.8 %) populations, p < 0,05. Allele T is significantly less common in Tuvans (10.1 %) than in European (17.8 %), East Asian (17.8 %) and South Asian (20.0 %) populations (p < 0.05).   Conclusions. Rare alleles of the polymorphisms rs2243250 and rs2070874 IL4, associated with the development of bronchial asthma, are more common among Khakas and Tuvans compared with Russians. Genotype TT of the rs1800925 IL13, associated with bronchial hypersensitivity and increased total IgE level, is more common among Russians compared with Tuvans.

The purpose of the research is to assess the main indicators of sleep patterns, taking into account gender, age and ethnicity in adolescents aged 12-18 in three large cities of Central Siberia: Krasnoyarsk (the studied ethnic group is Caucasians), Abakan (the studied ethnic groups is Khakass) and Kyzyl (the studied ethnic groups is Tuvans).The findings show Siberia adolescents have disturbance in sleep patterns: staying up late and an insufficient duration of sleep compared to age norms, which requires preventive measures. Moreover, these sleep disturbances are more pronounced in Krasnoyarsk (among Caucasians), than in Abakan (among Khakassians) and Kyzyl (among Tuvinians). Gender and age differences were identified as well: established sleep disorders are more pronounced among girls compared to boys, and in the older age group (15-18 years) compared to the younger group (11-14 years). All this requires preventive measures to regulate sleep patterns in schoolchildren.