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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mimmun</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинская иммунология</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Immunology (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1563-0625</issn><issn pub-type="epub">2313-741X</issn><publisher><publisher-name>SPb RAACI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15789/1563-0625-2018-1-85-98</article-id><article-id custom-type="elpub" pub-id-type="custom">mimmun-1435</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>ОПРЕДЕЛЕНИЕ НОРМАТИВНЫХ ЗНАЧЕНИЙ TREC И KREC В СУХИХ ПЯТНАХ КРОВИ НОВОРОЖДЕННЫХ РАЗНОГО СРОКА ГЕСТАЦИИ В СВЕРДЛОВСКОЙ ОБЛАСТИ</article-title><trans-title-group xml:lang="en"><trans-title>DETERMINATION OF REFERENCE VALUES FOR TREC AND KREC IN DRY BLOOD SPOTS OF NEWBORNS FROM DIFFERENT GESTATION AGES IN SVERDLOVSK REGION</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дерябина</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Deryabina</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>заведующая лабораторией молекулярной диагностики ГБУЗ СО «Клинико- диагностический центр „Охрана здоровья матери и ребенка“»; младший научный сотрудник лаборатории иммунологии воспаления ФГБУН «Институт иммунологии и физиологии» Уральского отделения Российской академии наук; младший научный сотрудник кафедры иммунохимии ГОАУ ВПО «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина</p></bio><bio xml:lang="en"><p>Head, Laboratory of Molecular Diagnostics, Medical Center “Health Care of Mother and Child”; Junior Research Associate, Laboratory of Inflammation Immunology, Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences; Junior Research Associate, Department of Immunochemistry, B.N. Yeltsin Ural Federal University</p></bio><email xlink:type="simple">ssderyabina@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тузанкина</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tuzankina</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, главный научный сотрудник лаборатории иммунологии воспаления ФГБУН «Институт иммунологии и физиологии» Уральского отделения Российской академии наук; ведущий научный сотрудник кафедры иммунохимии ГОАУ ВПО «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина; врач аллерголог-иммунолог научного отдела ГБУЗ СО «Областная детская клиническая больница № 1», г. Екатеринбург</p></bio><bio xml:lang="en"><p>PhD, MD (Medicine), Professor, Chief Research Associate, Laboratory of Inflammation Immunology, Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences; Leading Research Asociate, Department of Immunochemistry, B.N. Yeltsin Ural Federal University; Clinical Allergologist/Immunologist, Research Department, Regional Children Clinical Hospital No. 1</p></bio><email xlink:type="simple">ssderyabina@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шершнев</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Shershnev</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.ф.-м.н., доцент, ФГБУН «Институт промышленной экологии» Уральского отделения Российской академии наук; доцент кафедры вычислительной техники, ГОАУ ВПО «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина, г. Екатеринбург</p></bio><bio xml:lang="en"><p>PhD (Physics/Mathematics), Associate Professor, Institute of Industrial Ecology, Ural Branch, Russian Academy of Sciences; Assistant Professor, Department of Computer Science, B.N. Yeltsin Ural Federal Universit</p></bio><email xlink:type="simple">ssderyabina@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ СО «Клинико-диагностический центр „Охрана здоровья матери и ребенка“», г. Екатеринбург;&#13;
ФГБУН «Институт иммунологии и физиологии» Уральского отделения Российской академии наук, г. Екатеринбург;&#13;
ГОАУ ВПО «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Medical Center “Health Care of Mother and Child”, Ekaterinburg;&#13;
Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences, Ekaterinburg;&#13;
B.N. Yeltsin Ural Federal University, Ekaterinburg</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУН «Институт иммунологии и физиологии» Уральского отделения Российской академии наук, г. Екатеринбург;&#13;
ГОАУ ВПО «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина;&#13;
ГБУЗ СО «Областная детская клиническая больница № 1», г. Екатеринбург</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences, Ekaterinburg;&#13;
B.N. Yeltsin Ural Federal University, Ekaterinburg;&#13;
Regional Children Clinical Hospital No. 1, Ekaterinburg</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГОАУ ВПО «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина, г. Екатеринбург;&#13;
ФГБУН «Институт промышленной экологии» Уральского отделения Российской академии наук, г. Екатеринбург</institution><country>Россия</country></aff><aff xml:lang="en"><institution>B.N. Yeltsin Ural Federal University, Ekaterinburg;&#13;
Institute of Industrial Ecology, Ural Branch, Russian Academy of Sciences, Ekaterinburg</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>11</day><month>01</month><year>2018</year></pub-date><volume>20</volume><issue>1</issue><fpage>85</fpage><lpage>98</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дерябина С.С., Тузанкина И.А., Шершнев В.Н., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Дерябина С.С., Тузанкина И.А., Шершнев В.Н.</copyright-holder><copyright-holder xml:lang="en">Deryabina S.S., Tuzankina I.A., Shershnev V.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.mimmun.ru/mimmun/article/view/1435">https://www.mimmun.ru/mimmun/article/view/1435</self-uri><abstract><p>В ходе подготовительного этапа работы по внедрению генетического тестирования на тяжелый комбинированный иммунодефицит в программу неонатального скрининга в Свердловской области проведено исследование по количественному определению маркеров Т- и В-клеточного неогенеза (TREC и KREC соответственно) в крови условно здоровых новорожденных. Материалом исследования служили архивные образцы сухих пятен крови, собранных на тест-бланки для рутинного неонатального скрининга у 26 девочек и 26 мальчиков, родившихся доношенными и не имевших тяжелых заболеваний на первом году жизни. Дополнительно исследовано влияние гестационного возраста плода на количество данных маркеров (TREC и KREC) у недоношенных новорожденных разного срока гестации. Обследованы образцы крови 55 недоношенных детей, родившихся преждевременно (23-36 недель гестации). Показано, что уровни TREC и KREC последовательно возрастали с увеличением срока гестации, однако динамика данных изменений концентрации маркеров оказалась различной. В связи с этим рекомендуемый срок взятия образца крови для скрининга на ТКИН полностью соответствует срокам взятия образцов, принятым для большинства наследственных скринируемых заболеваний. Исключение составляет получение результата с полным отсутствием TREC или KREC в образце крови новорожденного любой степени недоношенности (при валидном количестве копий контрольного гена), что должно служить сигналом для незамедлительного назначения этому ребенку консультации врача-иммунолога и проведения углубленного иммунологического обследования, поскольку это может явиться первым прогностическим признаком фатального заболевания. Для получения корректных пороговых уровней TREC/KREC необходимы дополнительные исследования на большей выборке новорожденных (1000-5000) с последующей валидацией полученных референсных границ в исследованиях с включением больных с разными формами первичных иммунодефицитов.</p><p> </p></abstract><trans-abstract xml:lang="en"><p>As a preparatory stage for implementation of genetic testing for severe combined immunodeficiency under a neonatal screening program, a study was performed in Sverdlovsk Region which concerned quantitative determination of T and B cell neogenesis markers (TREC and KREC, respectively) in blood of conditionally healthy newborns. Archived samples of dry blood spots collected in test-forms for routine neonatal screening were used as biological material for the study of full-term 26 girls and 26 boys who did not exhibit serious illnesses during first year of their life. In addition, we investigated potential effects of foetal gestational age upon the number of TREC and KREC in preterm infants. Blood samples from 55 preterm infants (23 to 36 gestational weeks) were also examined. It was shown that the levels of TREC and KREC increased sequentially with the increased gestation terms, but the quantitative changes of markers showed different dynamics. In this respect, the recommended terms of blood sample collection for SCID screening is entirely consistent with timing of blood sampling for routine newborn screening. An alternative result was obtained with a complete absence of TREC or KREC in blood sample of a newborn, irrespectively of prematurity degree (at valid copy numbers of a control gene) which should serve as an indication for immediate consulting of the child by immunologist and in-depth immunological examination, because it may be a first prognostic sign of a fatal disease. In order to obtain correct cut-off levels for TREC/KREC, additional studies are needed on a larger sample of newborns (1.000 to 5.000), followed by validation of the obtained reference boundaries in studies involving patients with different forms of primary immunodeficiencies.</p><p> </p></trans-abstract><kwd-group xml:lang="ru"><kwd>тяжелая комбинированная иммунная недостаточность</kwd><kwd>первичные иммунодефициты</kwd><kwd>TREC</kwd><kwd>KREC</kwd><kwd>массовое обследование новорожденных</kwd><kwd>ретроспективная диагностика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>severe combined immunodeficiency</kwd><kwd>primary immunodeficiency</kwd><kwd>TREC</kwd><kwd>KREC</kwd><kwd>newborn screening</kwd><kwd>retrospective diagnosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Валиуллина А.Я., Ахмадеева Э.Н., Крывкина Н.Н. 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