Adema Samadin

Mucins are highly glycosylated proteins that form the structural basis of mucus and represent a key component of innate immunity at mucosal surfaces, particularly in the respiratory tract. Beyond their mechanical barrier function, mucins actively participate in pathogen trapping, regulation of mucociliary clearance, modulation of inflammatory responses, and maintenance of epithelial homeostasis. Dysregulation of mucin synthesis, composition, or transport contributes to mucus hypersecretion, impaired airway clearance, and chronic inflammation in respiratory diseases such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis. This review summarizes current insights into mucin biology, including their biosynthesis, structure, classification, and regulation, with emphasis on the gel-forming mucins MUC5AC and MUC5B. The role of mucins in mechanical protection, host–pathogen interactions, control of inflammation, and coordination of innate immune responses is reviewed. Attention is given to the interplay between mucins, immune cells, and microbial communities in maintaining airway barrier integrity. The article further examines mucoactive therapeutic strategies aimed at restoring mucus barrier function. Expectorants, mucolytics, mucoregulators, and mucokinetic agents are reviewed with respect to their mechanisms of action and clinical relevance. Established drugs, including N-acetylcysteine, carbocysteine, dornase alfa, ambroxol, and hypertonic solutions, are considered alongside emerging molecular targets such as NF-κB-dependent regulation of mucin expression, calcium-activated chloride channels, MARCKS-mediated mucin exocytosis, purinergic signaling pathways, and NO/cGMP signaling. Non-pharmacological approaches, including airway clearance techniques and respiratory rehabilitation, are covered concisely. Conclusions: Overall, this review highlights mucins as dynamic regulators of innate immunity and underscores the need for mechanism-based, personalized mucoactive therapies to improve outcomes in chronic inflammatory airway diseases.

Brucellosis is one of the most significant zoonotic infectious diseases, having a substantial impact on public health and the economy. Purpose. To conduct a retrospective analysis of brucellosis incidence in the Republic of Kazakhstan and the city of Almaty during 2019-2024, and to assess the organization of medical care for patients, including hospitalization structure and patient routing. Methods. The study utilized official statistical data from the branch of the «National Scientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring» under the Republican State Enterprise «National Center of Public Health» of the Ministry of Health of the Republic of Kazakhstan, as well as the branch of the «Salidat Kairbekova National Scientific Center for Health Development» of the Ministry of Health. A descriptive retrospective epidemiological research method was applied, including calculation of incidence rates, transmission routes, sources of infection, age distribution of cases, and characteristics of inpatient care organization. Descriptive statistical data are presented using diagrams. Results. In the Republic of Kazakhstan, brucellosis incidence ranged from 842 cases in 2019 to 693 in 2023. The majority of cases were reported among rural populations (up to 80.6%) and working-age individuals. Contact transmission was predominant (up to 72%), with small ruminants identified as the main source of infection. In Almaty, the incidence varied from 123 to 197 per 100,000 population in 2022-2024. The main hospitalization burden fell on the I. Zhekenov City Clinical Infectious Diseases Hospital, with 90% of patients admitted on an emergency basis. A high proportion of unspecified disease forms was noted, indicating insufficient laboratory diagnostics. Conclusions. Brucellosis remains a significant epidemiological concern in Kazakhstan. The high rate of emergency hospitalizations and unspecified forms of the disease reflects a lack of early detection and inadequate outpatient follow-up. To enhance the effectiveness of brucellosis control, a multidisciplinary approach is required, along with strengthening of primary care services and improved interagency coordination.