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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-ASO-3434</article-id><article-id custom-type="elpub" pub-id-type="custom">mimmun-3434</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>АНТИГЕНПРЕЗЕНТИРУЮЩАЯ СУБПОПУЛЯЦИЯ НЕЙТРОФИЛЬНЫХ ГРАНУЛОЦИТОВ, КАК ДИАГНОСТИЧЕСКИЙ МАРКЕР ДИНАМИКИ КЛИНИЧЕСКОЙ ЭФФЕКТИВНОСТИ ИММУНОМОДУЛИРУЮЩЕЙ ТЕРАПИИ СИНТЕТИЧЕСКИМ ТИМИЧЕСКИМ ГЕКСАПЕПТИДОМ, У ДЕТЕЙ С ОСТРЫМ ГЕМАТОГЕННЫМ ОСТЕОМИЕЛИТОМ</article-title><trans-title-group xml:lang="en"><trans-title>ANTIGENPRESENTING SUBSETS OF NEUTROPHILIC GRANULOCYTES AS A DIAGNOSTIC MARKER OF THE DYNAMICS OF CLINICAL EFFECTIVENESS OF IMMUNOMODULATORY THERAPY WITH SYNTHETIC THYMIC HEXAPEPTIDE IN CHILDREN WITH ACUTE HEMATOGENOUS OSTEOMYELITIS</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6071-4409</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нестерова</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Nesterova</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, 1главный научный сотрудник отдела клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории,</p><p>2профессор кафедры клинической иммунологии, аллергологии и адаптологии факультета непрерывного медицинского образования Медицинского института</p></bio><bio xml:lang="en"><p>Doctor of Medical Sciences (MD), Professor, aChief Researcher, Department of Clinical and Experimental Immunology and Molecular Biology, Central Scientific Research Laboratory,</p><p>bProfessor of the Department of Clinical Immunology, Allergology and Adaptology Faculty of Continuing Medical Education of the Medical Institute</p></bio><email xlink:type="simple">inesterova1@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8005-9325</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чудилова</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Chudilova</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор биологических наук, доцент, заведующая отелом клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории, профессор кафедры клинической иммунологии, аллергологии и лабораторной диагностики</p></bio><bio xml:lang="en"><p>Doctor of Biological Sciences, Associate Professor, Head of the Department of Clinical and Experimental Immunology and Molecular Biology of the Central Research Laboratory, Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics</p></bio><email xlink:type="simple">chudilova2015@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5857-2296</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Барова</surname><given-names>Н. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Barova</surname><given-names>N. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, доцент, 1заведующая кафедрой хирургических болезней детского возраста, 3 заведующая хирургическим отделением № 1</p></bio><bio xml:lang="en"><p>PhD (Medical Sciences), Associate Professor,</p><p>аHead of the Department of Surgical Diseases of Childhood,</p><p>bHead, Surgical Department No. 1</p></bio><email xlink:type="simple">nbarova@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-8972-056X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафонцева</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Safontseva</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>аспирант кафедры клинической иммунологии, аллергологии и лабораторной диагностики, младший научный сотрудник отдела клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории</p></bio><bio xml:lang="en"><p>Postgraduate Student, Department of Clinical Immunology, Allergology and Laboratory Diagnostics, Junior Researcher of the Department of Clinical and Experimental Immunology and Molecular Biology of the Central Scientific Research Laboratory</p></bio><email xlink:type="simple">ensmorbi@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-9203-6847</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Поезжаев</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Poezzhaev</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>аспирант кафедры клинической иммунологии, аллергологии и лабораторной диагностики, младший научный сотрудник отдела клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории</p></bio><bio xml:lang="en"><p>Postgraduate Student, Department of Clinical Immunology, Allergology and Laboratory Diagnostics, Junior Researcher of the Department of Clinical and Experimental Immunology and Molecular Biology of the Central Scientific Research Laboratory</p></bio><email xlink:type="simple">epoezzhaev.ep@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9604-5806</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ковалева</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovaleva</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, доцент, профессор кафедры клинической иммунологии, аллергологии и лабораторной диагностики, старший научный сотрудник отдела клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории</p></bio><bio xml:lang="en"><p>Doctor of Medical Sciences (MD), Associate Professor, Senior Researcher of the Department of Clinical and Experimental Immunology and Molecular Biology of the Central Scientific Research Laboratory, Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics</p></bio><email xlink:type="simple">3483335@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1912-2038</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чапурина</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Chapurina</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, доцент кафедры клинической иммунологии, аллергологии и лабораторной диагностики, старший научный сотрудник отдела клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории</p></bio><bio xml:lang="en"><p>PhD (Medical Sciences), Associate Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics, Senior Researcher of the Department of Clinical and Experimental Immunology and Molecular Biology of the Central Scientific Research Laboratory</p></bio><email xlink:type="simple">Pavlenkoevi2016@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1459-9926</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чичерев</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Chicherev</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач детский онколог онкологического отделения</p></bio><bio xml:lang="en"><p>Pediatric oncologist at the Oncology department</p></bio><email xlink:type="simple">chicherev3@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3073-5070</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тетерин</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Teterin</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>ассистент кафедры клинической иммунологии, аллергологии и лабораторной диагностики</p></bio><bio xml:lang="en"><p>Assistant of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics</p></bio><email xlink:type="simple">yura.teterin.1989@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7041-7106</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ломтатидзе</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lomtatidze</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук, старший научный сотрудник отдела клинико-экспериментальной иммунологии и молекулярной биологии Центральной научно-исследовательской лаборатории, доцент кафедры клинической иммунологии, аллергологии и лабораторной диагностики</p></bio><bio xml:lang="en"><p>PhD in Biology, senior researcher of the department of clinical and experimental immunology and molecular biology of the Central Scientific Research Laboratory, Associate Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics</p></bio><email xlink:type="simple">llomtatidze@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-2919-4923</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лягуша</surname><given-names>Д. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Lyagusha</surname><given-names>D. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-педиатр хирургического отделения № 1</p></bio><bio xml:lang="en"><p>pediatrician of the surgical department No. 1</p></bio><email xlink:type="simple">darina_hapacheva@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования "Кубанский государственный медицинский университет" Министерства Здравоохранения Российской Федерации, г. Краснодар, Россия;&#13;
Федеральное государственное автономное образовательное учреждение высшего образования "Российский университет дружбы народов имени Патриса Лумумбы" Министерства науки и высшего образования Российской Федерации, г. Москва, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution of Higher Professional Education «Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar, Russia;&#13;
Peoples' Friendship University of Russia named after Patrice Lumumba, Moscow, Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования "Кубанский государственный медицинский университет" Министерства Здравоохранения Российской Федерации, г. Краснодар, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution of Higher Professional Education «Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar, Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования "Кубанский государственный медицинский университет" Министерства Здравоохранения Российской Федерации, г. Краснодар, Россия;&#13;
Государственное бюджетное учреждение здравоохранения «Детская краевая клиническая больница» министерства здравоохранения Краснодарского края, г. Краснодар, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution of Higher Professional Education «Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar, Russia;&#13;
Children's Regional Clinical Hospital of the Ministry of Health of the Krasnodar Territory, Krasnodar, Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Государственное бюджетное учреждение здравоохранения «Детская краевая клиническая больница» министерства здравоохранения Краснодарского края, г. Краснодар, Россия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Children's Regional Clinical Hospital of the Ministry of Health of the Krasnodar Territory, Krasnodar, Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>29</day><month>06</month><year>2026</year></pub-date><volume>0</volume><issue>0</issue><issue-title>Online First</issue-title><elocation-id>3434</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Нестерова И.В., Чудилова Г.А., Барова Н.К., Сафонцева А.Д., Поезжаев Е.А., Ковалева С.В., Чапурина В.Н., Чичерев Е.А., Тетерин Ю.В., Ломтатидзе Л.В., Лягуша Д.Э., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Нестерова И.В., Чудилова Г.А., Барова Н.К., Сафонцева А.Д., Поезжаев Е.А., Ковалева С.В., Чапурина В.Н., Чичерев Е.А., Тетерин Ю.В., Ломтатидзе Л.В., Лягуша Д.Э.</copyright-holder><copyright-holder xml:lang="en">Nesterova I.V., Chudilova G.A., Barova N.K., Safontseva A.D., Poezzhaev E.A., Kovaleva S.V., Chapurina V.N., Chicherev E.A., Teterin Y.V., Lomtatidze L.V., Lyagusha D.E.</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/3434">https://www.mimmun.ru/mimmun/article/view/3434</self-uri><abstract><p>Многофункциональность нейтрофильных гранулоцитов (НГ) ассоциирована с наличием различных субпопуляций и их фенотипов. Ранее у детей с острым гематогенным остеомиелитом (ОГО) и острой деструктивной пневмонией, осложненными сепсисом, выявлена корреляционная связь с тяжестью гнойно-воспалительного процесса и количеством субпопуляции CD66b+CD16+CD33+HLA-DR+НГ (АПК-НГ). Таким образом, определение субпопуляции АПК-НГ может служить ценным диагностическим инструментом и индикатором эффективности комплексной послеоперационной терапии, включающей иммуномодулирующую терапию, при тяжелых гнойно-воспалительных заболеваниях.</p><sec><title>Цель исследования</title><p>Цель исследования: оценить динамические изменения АПК-НГ при остром гематогенном остеомиелите у детей в сопоставлении с динамикой показателей клинической эффективности лечения на фоне проведения иммуномодулирующей терапии официнальным фармпрепаратом, действующей субстанцией которого является синтетический тимический гексапептид (ГП).</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В группу исследования (ГИ) вошли дети 10-15 лет с диагнозом ОГО (n=15), группу сравнения (ГС) составили 13 условно здоровых детей. В периферической крови (ПК) детей оценивали содержание НГ, экспрессирующих рецепторы CD66b, CD16, CD33, HLA-DR (FC500, «Beckman Coulter»), а также плотность экспрессии данных молекул. Для верификации дефектов субпопуляций НГ и контроля эффективности комплексного послеоперационного лечения с включением ГП забор ПК в ГИ проводился до операции, на 10-й день терапии ГП и перед выпиской. Исследование иммунологических параметров у детей ГС проводилось однократно.</p></sec><sec><title>Результаты</title><p>Результаты: Установлено, что количество АПК-НГ, увеличенное в 18 раз в ГИ до лечения, снизилось в 1,9 раза на 10-е сутки на фоне комплексной послеоперационной терапии, включающей иммуномодулирующее лечение ГП, а к моменту выписки (20-25-е сутки) – в 3,8 раза. Однако, содержание АПК-НГ после лечения не достигло показателей ГС. Кроме того, снижение количества АПК-НГ коррелировало с положительной клинической динамикой: отмечалась более ранняя регрессия интоксикационного, болевого синдромов и локальных признаков воспаления. Задержка позитивных количественных изменений АПК-НГ сопоставимо наблюдалась при отсутствии клинической эффективности, что требовало пересмотра терапевтической тактики с необходимостью смены антибактериальной терапии.</p></sec><sec><title>Заключение</title><p>Заключение: Исследование продемонстрировало высокую клиническую эффективность иммуномодулирующей терапии ГП в комплексном послеоперационном лечении детей с ОГО и возможность использования определения количественного содержания субпопуляции АПК-НГ как диагностического маркера для мониторинга клинико-иммунологической эффективности послеоперационного лечения детей с ОГО. Данный маркер также может служить инструментом, ориентируясь на значения которого можно своевременно корректировать лечение пациентов с ОГО на стационарном и амбулаторном этапах.</p></sec></abstract><trans-abstract xml:lang="en"><p>The multifunctionality of neutrophilic granulocytes (NG) is associated with the presence of various subsets and phenotypes. Previously, in children with severe purulent inflammatory diseases, a correlation was found between the severity of disease and the number of CD66b+CD16+CD33+HLA-DR+NG (APC-NG) subset. Thus, the determination of the APC-NG subset can serve as a valuable diagnostic tool and an indicator of the effectiveness of complex therapy in severe purulent-inflammatory diseases.</p><sec><title>Goal</title><p>Goal: to assess the dynamic changes in APC-NG level in children with AHO in comparison with the dynamics of indicators of clinical effectiveness during immunomodulatory therapy with a synthetic thymic hexapeptide (HP).</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study group (SG) included children aged 10-15 years with AHO (n=15), the comparison group (CG) consisted of 13 conditionally healthy children. In the peripheral blood (PB) of children, the content of NG expressing CD66b, CD16, CD33, HLA-DR (FC500, Beckman Coulter) and the expression density of these molecules was evaluated. The PB was collected before surgery, on the 10th day of therapy, and before discharge. The immunological parameters of children with CG were studied once.</p></sec><sec><title>Results</title><p>Results: It was found that the amount of APC-NG, which was increased by 18 times in SG before treatment, decreased by 1,9 times on the 10th day after the beginning of treatment and by 3,8 times by the time of discharge (20-25th day). However, the content of APC-NG after treatment did not reach the CG indicators. In addition, a decrease in the number of APC-NG correlated with positive clinical dynamics: there was an earlier regression of general and local symptoms. A delay in the positive changes of APC-NG was observed in the absence of clinical effectiveness, which required a revision of therapeutic tactics and the need to change antibacterial therapy.</p></sec><sec><title>Conclusion</title><p>Conclusion: The study demonstrated the high clinical efficacy of HP in the complex treatment of children with AHO and the possibility of using the content of the APC-NG subset as a diagnostic marker for monitoring efficacy of postoperative treatment of children with AHO. This marker can also serve as a tool that allows for timely adjustment of the treatment of patients with AHO.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>нейтрофильные гранулоциты</kwd><kwd>антиген-презентирующая субпопуляция</kwd><kwd>острый гематогенный остеомиелит</kwd><kwd>гексапептид</kwd><kwd>иммуномодулирующая терапия</kwd><kwd>дети.</kwd></kwd-group><kwd-group xml:lang="en"><kwd>neutrophilic granulocytes</kwd><kwd>antigen presenting subset</kwd><kwd>acute hematogenous osteomyelitis</kwd><kwd>hexapeptide</kwd><kwd>immunomodulatory therapy</kwd><kwd>children.</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование выполнено в рамках государственного задания «Инновационный метод диагностики дефектов молекулярного сигналлинга клеток врожденного иммунитета у пациентов с гнойно-воспалительными заболеваниями различной степени тяжести» номер государственного учета НИОКР 125072208862-7 от 22.07.2025 г.</funding-statement><funding-statement xml:lang="en">The study was carried out within the framework of the state assignment «An innovative method for diagnosing defects in the molecular signaling of innate immune cells in patients with purulent-inflammatory diseases of varying severity » - State R&amp;D registration number 125072208862-7 dated 22.07.2025.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Воробьева Н.В. 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