Ivan Evgenievich Smirnov

Introduction. Despite the dominance of mild traumatic brain injury (mTBI) in the structure of TBI, the biochemical parameters of mild brain damage in brain concussions have not been sufficiently studied. This fact makes it difficult to predict the outcomes of concussions that are part of the mild form of TBI. Aim of the work: identify changes in markers of brain damage in children’s blood who underwent mTBI with an emphasis on brain concussions, and compare the indicators with a group of children with moderate TBI (mdTBI). Materials and methods. One hundred thirty six children were examined, including 35 children with concussion (15 points on the Glasgow Coma Scale (GCS)), 65 children with mTBI (13–14 points on the GCS) and 36 children with mdTBI (9–12 points on the GCS). In the first 1–2 days after TBI, the content of such markers of brain damage as glial protein S100b, acidic fibrillary protein GFAP, αII-spectrin (spectrin breakdown product — SBDP-145), 2 types of autoantibodies (aAT) to glutamate receptors (GluRc) — NMDA (NR2) and AMPA (GluR1) subtypes, degradation products of these receptors — peptides corresponding to the N-terminal regions of NMDA and AMPA GluRc (NR2 and AMPA1 peptides), as well as the content of nitric oxides (NOx) (NO ₂ – + NO ₃ –) and 3-nitrotyrosine (NT). The concentrations of these compounds in blood serum/plasma were determined by enzyme immunoassays. Results. In the first days after TBI, a significant proportion of children with mTBI showed an increase in the content of oxidative stress markers (NOx, NT) and a significant increase in the level of aAb to NMDA GluRc in the blood. In children with mdTBI, indicators of brain damage (S100b, GFAP, αII-spectrin, NOx, and NMDA GluRc degradation products — NR2 peptides) exceeded those in children with mTBI. On the contrary, the level of aAb to NMDA GluRc and the degradation products of AMPA GluRc — AMPA 1 peptides had maximum values in the group of mTBI in children with brain concussions. Conclusion. It has been shown that in many children with mTBI (GCS = 14–15), most of the indicators are at the upper limit or exceed the upper limit of the normal values, which indicates a different degree of brain response to mild traumatic stress. In children with concussion, a high level of aAb to NMDA GluRc against the background of a low content of their degradation products, NR2 peptides, in the first days after TBI may indicate more pronounced compensatory mechanisms aimed at reducing NMDA GluRc hyperstimulation in mTBI. At the same time, a higher content of AMPA 1 peptides in children with concussions may be the initial signs of diffuse axonal damage. Contribution: Sorokina E.G., Reutov V.P., Semenova Zh.B. — concept, design and writing the text; Semenova Zh.B., Sorokina E.G., Karaseva O.V. — collection and processing of the material; Smirnov I.E. — editing the text. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article. Acknowledgments. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: January 18, 2026Accepted: February 10, 2026Published: February 27, 2026

Introduction. Multifunctional glutamic acid (glutamate, Glu) is the main excitatory neurotransmitter in the central nervous system (CNS). By providing excitatory neurotransmission, Glu activates glutamate receptors (GluRc) associated with the intake of calcium (Ca2+). Acute and chronic Glu excitotoxicity and nitric oxide (NO) play a leading role in the mechanisms of neuron death during brain hypoxia, which accompanies cerebral circulatory disorders (CCD), strokes, epilepsy, traumatic brain injury (TBI), and neurodegenerative diseases. The aim of the study was to determine changes in the content of glutamic acid in the blood and cerebrospinal fluid (CSF) and the functional activity of GluRc receptors in children with various forms of hypoxic brain damage. Materials and methods. Seventy nine CCD newborns, 36 children with congenital hydrocephalus, 58 children with acute lymphoblastic leukemia complicated by neuroleukemia, 42 children with epilepsy and paroxysmal conditions, and 159 children with TBI were examined. The content of Glu, glutamine (Gln), ammonia and biochemical markers of hypoxia (glucose, lactate) were determined in CSF and blood in CCD newborns using enzyme methods. The content of autoantibodies to NMDA and AMP GluRc was determined by enzyme immunoassay methods. The content of NO and its transformation products was estimated by the total content of nitrites and nitrates using the Griss method. Results. As the severity of hypoxic brain damage increased, glucose levels decreased in the CSF of newborns, the content of lactate, protein, ammonia, and Glu increased, and the permeability of the brain-blood barrier increased. At the same time, the more pronounced brain damage was observed in children with various hypoxic CNS injuries, the higher the levels of Glu, total protein, and CA were observed in CSF. Conclusion. The established patterns allowed determining the importance of NO and its conversion products in the functional activity of GluRc and showing the involvement of NO in protective and damaging processes in brain tissue.

Relevance. Human albumin (HA) accounts for 60% of all plasma proteins and is an important component of extracellular fluids, including lymph, interstitial and cerebrospinal fluid. This protein has multifunctional properties — it supports oncotic blood pressure, regulates the immune system, stabilizes the endothelium and affects key pathophysiological mechanisms. The aim of the review is to determine the features of the structure, properties and use of HA in acute medicine with a primary focus on brain damage of hypoxic-traumatic origin. Literature was searched in the databases PubMed, Google Academic, Web of Science, RSCI by keywords: human albumin, critical conditions, brain hypoxia, reactive oxygen species and nitrogen, search depth of 10 years. An analysis of data on the structure and modifications of HA in hypoxia/ischemia under conditions of increased formation of reactive oxygen species (ROS) and nitrogen (RNS) is presented. The informative value of HA modifications (“ischemia–modified albumin” — IMA and albumin oxidized by RNS from tyrosine — 3-nitrotyrosine — 3-HT residues) in the diagnosis and prognosis of various diseases is considered. One of the limitations of the use of HA in critical condition medicine is the lack of knowledge of the mechanisms of action of HA and modifications of endogenous and exogenous (injected) HA during infusion therapy. In the reduced state, HA has antioxidant activity and can neutralize the action of ROS and RNS formed during hypoxia. However, under conditions of hypoxia/ischemia and oxidative/nitrosative stress, HA is susceptible to oxidation and modification, which leads to the loss of its protective properties.

Introduction. The microbial biodiversity of the respiratory tract in children with cystic fibrosis (CF) in various subjects of the North Caucasus Federal District (NCFD) has not yet been sufficiently described. In the NCFD children with CF were previously shown to have specific clinical manifestations of the disease and changes in the frequencies of pathogenic variants of the CFTR gene. In this regard, the topic of the work is relevant. The aim of the study. To detect changes in the microbiota composition of the respiratory tract in CF children in various subjects of the NCFD. Materials and methods. There were examined one hundred 48 CF children, who underwent a study of the microbiota of the respiratory tract. The patients were divided into 2 groups: by subject (children of the Chechen, Karachay-Cherkess, Ingush, Kabardino-Balkarian, North Ossetia — Alania and Dagestan Republics) and by age (1 — infants under 12 months, 2 — 1–3 years, 3 — 3–7 years, 4 — 7–17 years). Results. For the first time, changes in the quantitative and qualitative composition of the respiratory tract microbiota in CF children in various subjects of the NCFD are presented. The quantitative composition of the microbiota of the respiratory tract of CF patients is represented by 45 species of bacteria and mold from the department of ascomycetes. Gram-negative microorganisms (86.3%) occupied a significant place in the composition of the microbiota of the respiratory tract in CF patients. The proportion of Gram-positive bacteria was 13.6%. The leading microbiota in the respiratory tract in CF patients in various subjects of the NCFD were: P. aeruginosa (68.9%), S. aureus (66.8%), of which 37.1% are MRSA, H. influenzae (51.3%), Moraxella catarrhalis and K. pneumoniae (30.4%), respectively. The biodiversity of the microbiota of the respiratory tract in CF children in various subjects of the NCFD differs from other regions of the Russian Federation in the high content of P. aeruginosa and H. influenzae, they are not characterized by the isolation of Achromobacter xylosoxidans. For the first time, a unique frequency distribution of the CFTR gene alleles was revealed in children with CF in various subjects of the NCFD. The most common pathogenic variants of the CFTR gene among all subjects of the NCFD were p.Y515 (150 alleles/51.9%), p.W1282 (48 alleles/16.6%), and p.E92K (26 alleles/8.9%). While the share of these pathogenic variants in the Russian Federation was 2.48%, 1.73%, and 3.67%, respectively. Conclusion. The established patterns of biodiversity of the microbiota of the respiratory tract in CF children are necessary to optimize their treatment and prevent exacerbations of the disease. Given the high content of hemophilic bacillus in the microbiota in CF children, special attention should be paid to vaccination of children against hemophilic infection type B

Introduction. Inflammation and activation of the immune system are the main cause of secondary injuries in traumatic brain injury (TBI). Given the central role of nitric oxide (NO) in the neuronal Glu cascade with significant changes in the content of ATP in neurons, as well as the presence of GluRc NMDA-type in lymphocytes, it is relevant to determine the effect of NO on the lymphocytes’ adenosine triphosphate (ATP) content. The aim of the work was to determine the effect of different concentrations of NO-generating compounds (NaNO2 and S-nitrosocysteine) on the content of intra- (hcATP) and extracellular ATP (ecATP) in human lymphocytes and to establish links between NO formed during TBI and the initiation of autoimmune processes in children with TBI of varying severity. Materials and methods. Blood samples from 36 TBI children were used for analysis. Lymphocytes were isolated in a ficol gradient according to a standard procedure. The ATP concentration in the tris-acetate buffer (pH 7.76) was determined on a Lucy-1 luminometer using luciferin luciferase (Promega). The ATP concentration was expressed in nmol/mg of protein, which was determined by the Bradford method using Fluka kits. Results. An increase in the level of ATP in lymphocytes immediately after TBI was found to be a positive factor reflecting the activation of lymphocytes. At the same time, a higher level of autontibodies (aAT) to GluRc immediately after severe TBI is a favourable sign for the TBI outcome and coincides with an increase in CGAP in lymphocytes. Prolonged negative trend in ATP content in lymphocytes with similar changes in serum ATP concentrations in severe TBI is an indicator of an unfavourable outcome of severe TBI in children. Conclusion. A moderate increase in NO in the blood immediately after TBI contributes to an increase in CGAP in lymphocytes and aAT to GluRc, which activates the immune response and protects the brain from hypoxic damage.

Научный рецензируемый журнал "Российский педиатрический журнал"

An overview of the basic data on the curriculum vitae and creative activity of an outstanding Russian pediatrician, Academician M.Ya. Studenikin is presented. On his initiative, for the first time in the country, specialized departments were established at the Institute of Pediatrics of the USSR Academy of Medical Sciences and there were formed scientific Schools, united by the main goal — to create effective systems of medical rehabilitation for children with various forms of pathology and develop of new prevention methods to ensure the fall in of morbidity and disability in children. In the 1960s, M.Ya. Studenikin contributed to the reform of clinical Pediatrics and the creation of promising scientific directions, thanks to which the Institute of Pediatrics became a multidisciplinary clinical institution. The range of academic interests of Academician M.Ya. Studenikin is very wide. He is the author of more than 300 scientific papers, including 14 monographs and more than 44 chapters in collective manuals. Personal contribution of academician M.Ya. Studenikin’s to pediatric science and practice is determined not only by his monographs, but also foundation of the inventive scientific school: 69 doctoral and 82 PhD theses were defended under his supervision. In 1996, the Institute of Pediatrics of the Russian Academy of Medical Sciences was named as the leading scientific school of the country by the Grant Council under the President of the Russian Federation, and Academician M.Ya. Studenikin was recognized as the Supervisor of the pediatric scientific school. Time only confirms the contribution to the future made by M.Ya. Studenikin to continue his creative work in various spheres of life of a large scientific team.

Introduction. Inflammatory bowel diseases (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases with an autoimmune attack on the gastrointestinal tract. Insufficient knowledge of the pathogenesis and the lack of reliable biomarkers of the severity of the condition in IBD dictates the need to search for new prognostic markers to assess the condition and effectiveness of therapy in IBD patients during remission and exacerbation of diseases. The aim of the work was to evaluate the protein profile, the amount of ischemia-modified albumin (IMA) and the content of 3-nitrotyrosine (3-NT) in the blood serum in IBD children. Materials and methods. In the blood serum of twenty two children in accordance with the pediatric indices of PCDAI/PUC disease activity in remission and exacerbation of IBD, electrophoretic separation of serum proteins was performed on the Hydrases 2 scan focusing device (Sebia). The content of IMA was determined by colorimetric method, 3-NT — by enzyme immunoassay (Hycult-Biotech, USA). Results. The article presents data on the content of fractions of albumin (A) and globulins, IMA, and 3-NT in the blood serum in children with different severity of IBD (CD and UC), corresponding to remission and exacerbation of diseases. It was shown that the more severe the condition, the more pronounced the decrease in A with an increase in the fraction of acute phase proteins and a decrease in the albumin/globulin index (A/G). Simultaneously with a decrease in the level of A, the content of IMA and 3-NT indicators of oxidative and nitrosative stress increases. Conclusion. The results obtained indicate modifications of serum proteins and the presence of oxidative and nitrosative stress in children with severe IBD. Due to the fact that such changes are typical for hypoxic brain damage and hyperstimulation of glutamate receptors (GluRc) of neurons, it is suggested that the indicators of oxidative and nitrosative stress in IBD children are associated with the possible development of disorders in the brain through GluRc activation.

The review discusses the content of the concept of health in scientific and philosophical discourse. Taking into account the correlation of the subjects of clinical, preventive and social medicine, the historical stages of studying the problem of the health of the person (individual) and public health are briefly described. The content of the concept of health is revealed in accordance with the concept of B.G. Yudin in three dimensions: as a fact, norm and value. A methodological analysis of the definition of health in the WHO Constitution is given. The issue of legal correctness of Part 1 of Art. 27 of the Federal Law “On the Fundamentals of Protecting the Health of Citizens”. The problems of the philosophy of health are covered in the context of bioethics, the relevance of ethical control and health care is emphasized. The review defines the guidelines for the coverage of some problems of the philosophy of health in teaching in the system of domestic medical education.

The review is devoted to the 100-year history of the Institute of Pediatrics, mainly there are analyzed the activities of scientific laboratories and departments, the peculiarities of their reorganization in various historical periods, the contribution of scientists to the development of domestic pediatric science and established patterns essential for the formation of the national system of child health care. The scientific achievements of the scientists of the Institute of Pediatrics were established to be noted by the Grants Committee under the President of the Russian Federation. On a competitive basis, the Institute of Pediatrics of the Russian Academy of Medical Sciences is recognized as a leading scientific school, and its director, Academician M.Ya. Studenikin, as a the leader of the pediatric scientific school. Currently, the Institute of Pediatrics is the largest pediatric institution of the National Medical Research Center for Children’s Health of the Ministry of Health of Russia, has significant scientific potential, is able to ensure the children’s health care and create new generations of pediatricians on a modern scientific basis.