Dynamics of markers of oxidative stress during the complex use of therapeutic physical factors in patients with true eczema associated with metabolic syndrome

Abstract

BACKGROUND: Among various pathological conditions associated with true eczema, metabolic syndrome occupies a special place, the high social significance of which is determined by its dominant influence on the main demographic indicators — life expectancy and mortality of the population.

AIM: Assessment of the dynamics of parameters of pro- and antioxidant systems in patients with true eczema in combination with metabolic syndrome during the course application of broadband medium-wave phototherapy, mesodiencephalic modulation and their combination.

MATERIALS AND METHODS: A prospective, controlled, comparative, randomized study was performed involving 115 patients with true eczema combined with metabolic syndrome, who were divided into 4 groups using simple randomization. The first group (control) received only basic drug therapy. In the second (comparison 1), third (comparison 2), and fourth (main) groups, patients additionally underwent courses of broadband medium-wave phototherapy, mesodiencephalic modulation, and their combination, respectively. The results of the course application of physiofactors were assessed by the dynamics of pro- and antioxidant system indices before and after the end of therapy.

RESULTS: When comparing the main markers of oxidative stress between the group of healthy people and patients with true eczema in combination with metabolic syndrome, a pronounced imbalance in the "prooxidants-antioxidants" system was established, which indicates the development of oxidative stress. Conducting complex therapy had a corrective effect on the parameters of the lipid peroxidation process. More pronounced shifts in lipid peroxide metabolism indicators were revealed in the groups with the additional use of physiotherapeutic factors. The maximum corrective effect in relation to oxidative stress was established in the group with the complex use of physiofactors. An integrative assessment of the dynamics of oxidative stress markers using the antioxidant protection coefficient confirmed the results obtained.

CONCLUSION: The use of therapeutic physical factors in the therapy of true eczema and metabolic syndrome is largely based on their ability to act as redox regulators of intracellular processes, exhibiting a stress-limiting effect and restoring oxidation-reduction homeostasis. The most promising in this regard are broadband medium-wave phototherapy and mesodiencephalic modulation.

Keywords

phototherapy / mesodiencephalic modulation / true eczema / metabolic syndrome / oxidative stress / malondialdehyde / superoxide dismutase / catalase

References

[1] Brown SJ. Molecular mechanisms in atopic eczema: Insights gained from genetic studies. J Pathol. 2017;241(2):140–145. doi: 10.1002/path.4810

[2] Brown S.J. Molecular mechanisms in atopic eczema: Insights gained from genetic studies // J Pathol. 2017. Vol. 241, N 2. P. 140–145. doi: 10.1002/path.4810

[3] Civelek E, Sahiner UM, Yüksel H, et al. Prevalence, burden, and risk factors of atopic eczema in schoolchildren aged 10-11 years: A national multicenter study. J Investig Allergol Clin Immunol. 2011;21(4):270–277.

[4] Civelek E., Sahiner U.M., Yüksel H., et al. Prevalence, burden, and risk factors of atopic eczema in schoolchildren aged 10-11 years: A national multicenter study // J Investig Allergol Clin Immunol. 2011. Vol. 21, N 4. P. 270–277.

[5] Conradi AO, Baranova EI, Gurevich VS, et al. Tactics of management of patients with cardiovascular diseases. Roundtable report. Consilium Medicum. 2021;23(6):504–510. EDN: UIIIWH doi: 10.26442/20751753.2021.6.200950

[6] Конради А.О., Баранова Е.И., Гуревич В.С., и др. Тактика ведения пациентов с сердечно-сосудистыми заболеваниями. Отчет о проведении круглого стола // Consilium Medicum. 2021. Т. 23, № 6. С. 504–510. EDN: UIIIWH doi: 10.26442/20751753.2021.6.200950

[7] Li D, Wang L, Zhou Z, et al. Lifetime risk of cardiovascular disease and life expectancy with and without cardiovascular disease according to changes in metabolic syndrome status. Nutr Metab Cardiovasc Dis. 2022;32(2):373–381. doi: 10.1016/j.numecd.2021.10.014

[8] Li D., Wang L., Zhou Z., et al. Lifetime risk of cardiovascular disease and life expectancy with and without cardiovascular disease according to changes in metabolic syndrome status // Nutr Metab Cardiovasc Dis. 2022. Vol. 32, N 2. P. 373–381. doi: 10.1016/j.numecd.2021.10.014

[9] Forman HJ, Zhang H. Targeting oxidative stress in disease: Promise and limitations of antioxidant therapy. Nat Rev Drug Discov. 2021;20(9):689–709. doi: 10.1038/s41573-021-00233-1

[10] Forman H.J., Zhang H. Targeting oxidative stress in disease: Promise and limitations of antioxidant therapy // Nat Rev Drug Discov. 2021. Vol. 20, N 9. P. 689–709. doi: 10.1038/s41573-021-00233-1

[11] Nagoev BS, Nalchikova MT. Features of lipid peroxidation in patients with eczema. Kuban Scientific Med Bull. 2012;(4):74–77. EDN: PVRDGR

[12] Нагоев Б.С., Нальчикова М.Т. Особенности перекисного окисления липидов у больных экземой // Кубанский научный медицинский вестник. 2012. № 4. С. 74–77. EDN: PVRDGR

[13] Novikova LA, Dontsova EV, Chernov AV, et al. Features of cytokine status, lipid peroxidation and the state of the antioxidant system in patients with true eczema. Pharmateka. 2022;29(14):73–77. EDN: EXPIGA doi: 10.18565/pharmateca.2022.14.73-77

[14] Новикова Л.А., Донцова Е.В., Чернов А.В., и др. Особенности цитокинового статуса, перекисного окисления липидов и состояния антиоксидантной системы у больных истинной экземой // Фарматека. 2022. Т. 29, № 14. С. 73–77. EDN: EXPIGA doi: 10.18565/pharmateca.2022.14.73-77

[15] Cordiano R, Di Gioacchino M, Mangifesta R, et al. Malondialdehyde as a potential oxidative stress marker for allergy-oriented diseases: An update. Molecules. 2023;28(16):5979. doi: 10.3390/molecules28165979

[16] Cordiano R., Di Gioacchino M., Mangifesta R., et al. Malondialdehyde as a potential oxidative stress marker for allergy-oriented diseases: An update // Molecules. 2023. Vol. 28, N 16. P. 5979. doi: 10.3390/molecules28165979

[17] Amin MN, Liza KF, Sarwar MS, et al. Effect of lipid peroxidation, antioxidants, macro minerals and trace elements on eczema. Arch Dermatol Res. 2015;307(7):617–623. doi: 10.1007/s00403-015-1570-2

[18] Amin M.N., Liza K.F., Sarwar M.S., et al. Effect of lipid peroxidation, antioxidants, macro minerals and trace elements on eczema // Arch Dermatol Res. 2015. Vol. 307, N 7. P. 617–623. doi: 10.1007/s00403-015-1570-2

[19] Yu Y, Liu S, Yang L, et al. Roles of reactive oxygen species in inflammation and cancer. Med Comm (2020). 2024;5(4):e519. doi: 10.1002/mco2.519

[20] Yu Y., Liu S., Yang L., et al. Roles of reactive oxygen species in inflammation and cancer // Med Comm (2020). 2024. Vol. 5, N 4. P. e519. doi: 10.1002/mco2.519

[21] Lingappan K. NF-κB in oxidative stress. Curr Opin Toxicol. 2018;(7):81–86. doi: 10.1016/j.cotox.2017.11.002

[22] Lingappan K. NF-κB in oxidative stress // Curr Opin Toxicol. 2018. Vol. 7. P. 81–86. doi: 10.1016/j.cotox.2017.11.002

[23] Iyer SS, Accardi CJ, Ziegler TR, et al. Cysteine redox potential determines pro-inflammatory IL-1beta levels. PLoS One. 2009;4(3):e5017. doi: 10.1371/journal.pone.0005017

[24] Iyer S.S., Accardi C.J., Ziegler T.R., et al. Cysteine redox potential determines pro-inflammatory IL-1beta levels // PLoS One. 2009. Vol. 4, N 3. P. e5017. doi: 10.1371/journal.pone.0005017

[25] Lei Y, Wang K, Deng L, et al. Redox regulation of inflammation: Old elements, a new story. Med Res Rev. 2015;35(2):306–340. doi: 10.1002/med.21330

[26] Lei Y., Wang K., Deng L., et al. Redox regulation of inflammation: Old elements, a new story // Med Res Rev. 2015. Vol. 35, N 2. P. 306–340. doi: 10.1002/med.21330

[27] Monserrat-Mesquida M, Quetglas-Llabrés M, Capó X, et al. metabolic syndrome is associated with oxidative stress and proinflammatory state. Antioxidants (Basel). 2020;9(3):236. doi: 10.3390/antiox9030236

[28] Monserrat-Mesquida M., Quetglas-Llabrés M., Capó X., et al. metabolic syndrome is associated with oxidative stress and proinflammatory state // Antioxidants (Basel). 2020. Vol. 9, N 3. P. 236. doi: 10.3390/antiox9030236

[29] Franco C, Sciatti E, Favero G, et al. Essential hypertension and oxidative stress: Novel future perspectives. Int J Mol Sci. 2022;23(22):14489. doi: 10.3390/ijms232214489

[30] Franco C., Sciatti E., Favero G., et al. Essential hypertension and oxidative stress: Novel future perspectives // Int J Mol Sci. 2022. Vol. 23, N 22. P. 14489. doi: 10.3390/ijms232214489

[31] Hachiya R, Tanaka M, Itoh M, et al. Molecular mechanism of crosstalk between immune and metabolic systems in metabolic syndrome. Inflamm Regen. 2022;42(1):13. doi: 10.1186/s41232-022-00198-7

[32] Hachiya R., Tanaka M., Itoh M., et al. Molecular mechanism of crosstalk between immune and metabolic systems in metabolic syndrome // Inflamm Regen. 2022. Vol. 42, N 1. P. 13. doi: 10.1186/s41232-022-00198-7

[33] Jakubczyk K, Dec K, Kałduńska J, et al. Reactive oxygen species: Sources, functions, oxidative damage. Pol Merkur Lekarski. 2020;48(284):124–127.

[34] Jakubczyk K., Dec K., Kałduńska J., et al. Reactive oxygen species: Sources, functions, oxidative damage // Pol Merkur Lekarski. 2020. Vol. 48, N 284. P. 124–127.

[35] Touyz RM, Rios FJ, Alves-Lopes R, et al. Oxidative stress: A unifying paradigm in hypertension. Can J Cardiol. 2020;36(5):659–670. doi: 10.1016/j.cjca.2020.02.081

[36] Touyz R.M., Rios F.J., Alves-Lopes R., et al. Oxidative stress: A unifying paradigm in hypertension // Can J Cardiol. 2020. Vol. 36, N 5. P. 659–670. doi: 10.1016/j.cjca.2020.02.081

[37] Ulashchik VS. Active oxygen species, antioxidants, and the action of therapeutic physical factors. Problems Balneology, Physiotherapy Exercise Therapy. 2013;90(1):60–69. EDN: PYASAR

[38] Улащик В.С. Активные формы кислорода, антиоксиданты и действие лечебных физических факторов // Вопросы курортологии, физиотерапии и лечебной физической культуры. 2013. Т. 90, № 1. С. 60–69. EDN: PYASAR

[39] Zalesskaya GA, Ulashchik VS. Molecular mechanisms of action of photohemotherapy (review). J Applied Spectroscopy. 2009;76(1):51–75. EDN: JVEMET

[40] Залесская Г.А., Улащик В.С. Молекулярные механизмы действия фотогемотерапии (обзор) // Журнал прикладной спектроскопии. 2009. Т. 76, № 1. С. 51–75. EDN: JVEMET

[41] Rathod DG, Muneer H, Masood S. Phototherapy. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.

[42] Rathod D.G., Muneer H., Masood S. Phototherapy // StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024.

[43] Gornov SV, Shestopalov AE, Litvinenko AB, et al. The program of hardware correction of the neuropsychic state of highly qualified athletes using mesodiencephalic modulation. Russ J Environmental Rehab Med. 2022;(2):70–80. EDN: QZTTSN

[44] Горнов С.В., Шестопалов А.Е., Литвиненко А.Б., и др. Программа аппаратной коррекции нервно-психического состояния спортсменов высокой квалификации с применением мезодиэнцефальной модуляции // Russian Journal of Environmental and Rehabilitation Medicine. 2022. № 2. С. 70–80. EDN: QZTTSN

[45] Yumashev AV. Fundamental principles and practical results of the prevention and treatment of distress using mesodiencephalic modulation. Azimut nauchnykh issledovanii: pedagogika i psikhologiya. 2017;6(4):376–379. EDN: YLVFTU

[46] Юмашев А.В. Фундаментальные основы и практические результаты профилактики и лечения дистресса с помощью мезодиэнцефальной модуляции // Азимут научных исследований: педагогика и психология. 2017. Т. 6, № 4. С. 376–379. EDN: YLVFTU

[47] Romanenko KV, Borovaya OO, Ermilova NV. Transcranial mesodiencephalic modulation and prospects for its use in dermatovenereology. Torsuevskie chteniya. 2020;(3):22–25. EDN: KMWYKK

[48] Романенко К.В., Боровая О.О., Ермилова Н.В., и др. Транскраниальная мезодиэнцефальная модуляция и перспективы ее использования в дерматовенерологии // Торсуевские чтения: научно-практический журнал по дерматологии, венерологии и косметологии. 2020. № 3. С. 22–25. EDN: KMWYKK

[49] Hanifin JM, Baghoomian W, Grinich E, et al. The eczema area and severity index: A practical guide. Dermatitis. 2022;33(3):187–192. doi: 10.1097/DER.0000000000000895

[50] Hanifin J.M., Baghoomian W., Grinich E., et al. The eczema area and severity index: A practical guide // Dermatitis. 2022. Vol. 33, N 3. P. 187–192. doi: 10.1097/DER.0000000000000895

[51] Recommendations for the management of patients with metabolic syndrome: Clinical guidelines. Moscow; 2013. 43 p. (In Russ.)

[52] Клинические рекомендации. Рекомендации по ведению больных с метаболическим синдромом. Москва, 2013. 43 с.

[53] Clinical guidelines: Eczema. Moscow: Russian Society of Dermatovenerologists and Cosmetologists; 2021. 60 p. (In Russ.)

[54] Клинические рекомендации. Экзема. Москва: Российское общество дерматовенерологов и косметологов, 2021. 60 с.

[55] Gavrilov VB, Gavrilova AR, Mazhul LM. Analysis of methods for determination of lipid peroxidation products in serum by thiobarbituric acid test. Voprosy medicinskoj himii. 1987;33(1):118–122. (In Russ.) EDN: SMPWZH

[56] Гаврилов В.Б., Гаврилова А.Р., Мажуль Л.М. Анализ методов определения продуктов перекисного определения липидов в сыворотке крови по тесту с тиобарбитуровой кислотой // Вопросы медицинской химии. 1987. Т. 33, № 1. С. 118–122. EDN: SMPWZH

[57] Volchegorsky IA, Nalimov AG, Yarovinsky BG, et al. Comparison of different approaches to the determination of lipid peroxidation products in heptanisopropanol extracts of blood. Voprosy medicinskoj himii. 1989;35(1):127–131. (In Russ.) EDN: SKGMSF

[58] Волчегорский И.А., Налимов А.Г., Яровинский Б.Г., и др. Сопоставление различных подходов к определению продуктов перекисного определения липидов в гептанизопропанольных экстрактах крови // Вопросы медицинской химии. 1989. Т. 35, № 1. С. 127–131. EDN: SKGMSF

[59] Umnyagina IA, Strakhova LA, Blinova TV. Serum of 8-OHDG as a potential biomarker of oxidative dna damage in workers exposed to harmful working environments. Russ J Occupational Health Industrial Ecology. 2019;59(9):783–784. EDN: OEPPZZ doi: 10.31089/1026-9428-2019-59-9-783-784

[60] Умнягина И.А., Страхова Л.А., Блинова Т.В. Сывороточный 8-OHdG как потенциальный биомаркер окислительного повреждения ДНК у работающих во вредных условиях труда // Медицина труда и промышленная экология. 2019. Т. 59, № 9. С. 783–784. EDN: OEPPZZ doi: 10.31089/1026-9428-2019-59-9-783-784

[61] Korolyuk MA, Ivanova LI, Mayorova IG, Tokarev VE. Method for determination of catalase activity. Laboratornoe delo. 1988;(1):16–19. EDN: SICXEJ

[62] Королюк М.А., Иванова Л.И., Майорова И.Г., Токарев В.Е. Метод определения активности каталазы // Лабораторное дело. 1988. № 1. С. 16–19. EDN: SICXEJ

[63] Kostyuk VA, Potapovich AI, Kovaleva ZhI. A simple and sensitive method of determination of superoxide dismutase activity based on the reaction of quercetin oxidation. Voprosy medicinskoj himii. 1990;36(2):88–91. EDN: SCXIZD

[64] Костюк В.А., Потапович А.И., Ковалева Ж.И. Простой и чувствительный метод определения супероксиддисмутазы, основанный на реакции окисления кверцитина // Вопросы медицинской химии. 1990. Т. 36, № 2. С. 88–91. EDN: SCXIZD

[65] Sharifi-Rad M, Anil Kumar NV, Zucca P, et al. Lifestyle, oxidative stress, and antioxidants: Back and forth in the pathophysiology of chronic diseases. Front Physiol. 2020;11:694. doi: 10.3389/fphys.2020.00694

[66] Sharifi-Rad M., Anil Kumar N.V., Zucca P., et al. Lifestyle, oxidative stress, and antioxidants: back and forth in the pathophysiology of chronic diseases // Front Physiol. 2020. Vol. 11. P. 694. doi: 10.3389/fphys.2020.00694

[67] Raimondo A, Serio B, Lembo S. Oxidative stress in atopic dermatitis and possible biomarkers: Present and future. Indian J Dermatol. 2023;68(6):657–660. doi: 10.4103/ijd.ijd_878_22

[68] Raimondo A., Serio B., Lembo S. Oxidative stress in atopic dermatitis and possible biomarkers: Present and future // Indian J Dermatol. 2023. Vol. 68, N 6. P. 657–660. doi: 10.4103/ijd.ijd_878_22

[69] Sies H. Oxidative eustress: On constant alert for redox homeostasis. Redox Biol. 2021;41:101867. doi: 10.1016/j.redox.2021.101867

[70] Sies H. Oxidative eustress: On constant alert for redox homeostasis // Redox Biol. 2021. Vol. 41. P. 101867. doi: 10.1016/j.redox.2021.101867

[71] Nagornev SN, Sytnik SI, Bobrovnitsky IP, et al. Pharmacological correction of lipoperoxidation in hypoxia and the possibility of increasing human altitude tolerance with the help of drugs of metabolic type of action. Ann Russ Acad Med Sci. 1996;(7):53–60. (In Russ.)

[72] Нагорнев С.Н., Сытник С.И., Бобровницкий И.П., и др. Фармакологическая коррекция процесса липопероксидации при гипоксии и возможность повышения высотной устойчивости человека с помощью препаратов метаболического типа действия // Вестник РАМН. 1996. № 7. С. 53–60.

[73] Liu J, Han X, Zhang T, et al. Reactive oxygen species (ROS) scavenging biomaterials for anti-inflammatory diseases: From mechanism to therapy. J Hematol Oncol. 2023;16(1):116. doi: 10.1186/s13045-023-01512-7

[74] Liu J., Han X., Zhang T., et al. Reactive oxygen species (ROS) scavenging biomaterials for anti-inflammatory diseases: From mechanism to therapy // J Hematol Oncol. 2023. Vol. 16, N 1. P. 116. doi: 10.1186/s13045-023-01512-7

[75] Liu T, Zhang L, Joo D, et al. NF-κB signaling in inflammation. Signal Transduct Target Ther. 2017;2:17023. doi: 10.1038/sigtrans.2017.23

[76] Liu T., Zhang L., Joo D., et al. NF-κB signaling in inflammation // Signal Transduct Target Ther. 2017. Vol. 2. P. 17023. doi: 10.1038/sigtrans.2017.23

[77] Dominic A, Le NT, Takahashi M. Loop between NLRP3 inflammasome and reactive oxygen species. Antioxid Redox Signal. 2022;36(10-12):784–796. doi: 10.1089/ars.2020.8257

[78] Dominic A., Le N.T., Takahashi M. Loop between NLRP3 inflammasome and reactive oxygen species // Antioxid Redox Signal. 2022. Vol. 36, N 10-12. P. 784–796. doi: 10.1089/ars.2020.8257

[79] Lu Y, Wang M, Bao J, et al. Association between oxidative balance score and metabolic syndrome and its components in US adults: A cross-sectional study from NHANES 2011–2018. Front Nutr. 2024;13(11):1375060. doi: 10.3389/fnut.2024.1375060

[80] Lu Y., Wang M., Bao J., et al. Association between oxidative balance score and metabolic syndrome and its components in US adults: A cross-sectional study from NHANES 2011–2018 // Front Nutr. 2024. Vol. 13, N 11. P. 1375060. doi: 10.3389/fnut.2024.1375060

[81] Nono Nankam PA, Nguelefack TB, Goedecke JH, et al. Contribution of adipose tissue oxidative stress to obesity-associated diabetes risk and ethnic differences: Focus on women of African ancestry. Antioxidants (Basel). 2021;10(4):622. doi: 10.3390/antiox10040622

[82] Nono Nankam P.A., Nguelefack T.B., Goedecke J.H., et al. Contribution of adipose tissue oxidative stress to obesity-associated diabetes risk and ethnic differences: Focus on women of African ancestry // Antioxidants (Basel). 2021. Vol. 10, N 4. P. 622. doi: 10.3390/antiox10040622

[83] Čolak E, Pap D. The role of oxidative stress in the development of obesity and obesity-related metabolic disorders. J Med Biochem. 2021;40(1):1–9. doi: 10.5937/jomb0-24652

[84] Čolak E., Pap D. The role of oxidative stress in the development of obesity and obesity-related metabolic disorders // J Med Biochem. 2021. Vol. 40, N 1. P. 1–9. doi: 10.5937/jomb0-24652

[85] Nakai K, Yoneda K, Kubota Y. Oxidative stress in allergic and irritant dermatitis: From basic research to clinical management. Recent Pat Inflamm Allergy Drug Discov. 2012;6(3):202–209. doi: 10.2174/187221312802652839

[86] Nakai K., Yoneda K., Kubota Y. Oxidative stress in allergic and irritant dermatitis: From basic research to clinical management // Recent Pat Inflamm Allergy Drug Discov. 2012. Vol. 6, N 3. P. 202–209. doi: 10.2174/187221312802652839

[87] Chen PY, Chen CW, Su YJ, et al. Associations between levels of urinary oxidative stress of 8-OHdG and risk of atopic diseases in children. Int J Environ Res Public Health. 2020;17(21):8207. doi: 10.3390/ijerph17218207

[88] Chen P.Y., Chen C.W., Su Y.J., et al. Associations between levels of urinary oxidative stress of 8-OHdG and risk of atopic diseases in children // Int J Environ Res Public Health. 2020. Vol. 17, N 21. P. 8207. doi: 10.3390/ijerph17218207

[89] Kotenko KV, Frolkov VK, Nagornev SN, et al. Prospects for the use of drinking mineral waters in the rehabilitation of patients with coronavirus (COVID-19) infection: Analysis of the main sanogenetic mechanisms. Problems Balneology, Physiotherapy Exercise Therapy. 2021;98(6-2):75–84. EDN: RDBRST doi: 10.17116/kurort20219806275

[90] Котенко К.В., Фролков В.К., Нагорнев С.Н., и др. Перспективы применения питьевых минеральных вод в реабилитации пациентов с коронавирусной (COVID-19) инфекцией: анализ основных саногенетических механизмов // Вопросы курортологии, физиотерапии и лечебной физической культуры. 2021. Т. 98, № 6-2. С. 75–84. EDN: RDBRST doi: 10.17116/kurort20219806275

[91] Petrova MS, Ruzova TK, Kotenko KV, Korchazhkina NB. Dynamics of metabolic exchange and circulation after lower limb traction elongaton in patients with lumbosacral dorsopathies. Physiotherapist. 2013;(6):25–30. EDN: RKPOQH

[92] Петрова М.С., Рузова Т.К., Котенко К.В., Корчажкина Н.Б. Динамика показателей метаболического обмена и состояния кровообращения нижних конечностей после проведения тракционного вытяжения у пациентов с пояснично-крестцовыми дорсопатиями // Физиотерапевт. 2013. № 6. С. 25–30. EDN: RKPOQH

[93] Orekhova EM, Konchugova TV, Kulchitskaya DB, et al. Modern approaches to the use of transcerebral magnetic therapy for arterial hypertension. Problems Balneology, Physiotherapy Exercise Therapy. 2016;93(3):53–55. EDN: VZLSJFdoi: 10.17116/kurort2016353-55

[94] Орехова Э.М., Кончугова Т.В., Кульчицкая Д.Б., и др. Современные подходы к применению трансцеребральной магнитотерапии при артериальной гипертензии // Вопросы курортологии, физиотерапии и лечебной физической культуры. 2016. Т. 93, № 3. С. 53–55. EDN: VZLSJF doi: 10.17116/kurort2016353-55

[95] Kotenko KV, Kovalev SA, Abuseva GR, et al. Physical and rehabilitation medicine: National guidelines. 2nd ed, revised and expanded. Moscow: GEOTAR-Media; 2023. 912 p. (In Russ.) EDN: STQNKB

[96] Котенко К.В., Ковалев С.А., Абусева Г.Р., и др. Физическая и реабилитационная медицина: национальное руководство. 2-е изд., перераб. и доп. Москва: ГЭОТАР-Медиа, 2023. 912 с. EDN: STQNKB

[97] Epifanov VA, Korchazhkina NB. Medical and social rehabilitation of patients with various pathologies. In 2 parts. Part II. Moscow: GEOTAR-Media; 2019. 560 p. (In Russ.) EDN: ULZAFF

[98] Епифанов В.А., Корчажкина Н.Б. Медико-социальная реабилитация пациентов с различной патологией. В 2-х частях. Часть II. Москва: ГЭОТАР-Медиа, 2019. 560 с. EDN: ULZAFF

[99] Schwarz A, Schwarz T. Molecular determinants of UV-induced immunosuppression. Exp Dermatol. 2002;11(Suppl. 1):9–12. doi: 10.1034/j.1600-0625.11.s.1.3.x

[100] Schwarz A., Schwarz T. Molecular determinants of UV-induced immunosuppression // Exp Dermatol. 2002. Vol. 11, Suppl. 1. P. 9–12. doi: 10.1034/j.1600-0625.11.s.1.3.x

[101] Johnson-Huang LM, Suárez-Fariñas M, Sullivan-Whalen M, et al. Effective narrow-band UVB radiation therapy suppresses the IL-23/IL-17 axis in normalized psoriasis plaques. J Invest Dermatol. 2010;130(11):2654–2263. doi: 10.1038/jid.2010.166

[102] Johnson-Huang L.M., Suárez-Fariñas M., Sullivan-Whalen M., et al. Effective narrow-band UVB radiation therapy suppresses the IL-23/IL-17 axis in normalized psoriasis plaques // J Invest Dermatol. 2010. Vol. 130, N 11. P. 2654–2263. doi: 10.1038/jid.2010.166

[103] Grewe M, Gyufko K, Krutmann J. Interleukin-10 production by cultured human keratinocytes: Regulation by ultraviolet B and ultraviolet A1 radiation. J Invest Dermatol. 1995;104(1):3–6. doi: 10.1111/1523-1747.ep12613446

[104] Grewe M., Gyufko K., Krutmann J. Interleukin-10 production by cultured human keratinocytes: Regulation by ultraviolet B and ultraviolet A1 radiation // J Invest Dermatol. 1995. Vol. 104, N 1. P. 3–6. doi: 10.1111/1523-1747.ep12613446

[105] Chekman IS, Syrovaya AO, Makarov VA, et al. Ozone and ozone therapy. No. 1. Kyiv-Kharkov: Tsifrovaya pechat'; 2013. 144 p. (In Russ.)

[106] Чекман И.С., Сыровая А.О., Макаров В.А., и др. Озон и озонотерапия. Вып. 1. Киев-Харьков: Цифрова друкарня, 2013. 144 с.

[107] Chelombitko EG, Gusakova EV. Systemic manifestations of post-Covid syndrome. Russ J Environmental Rehab Med. 2022;(3):48–60. EDN: ODNJGX

[108] Челомбитько Е.Г., Гусакова Е.В. Системные проявления постковидного синдрома // Russ J Environmental Rehab Med. 2022. № 3. С. 48–60. EDN: ODNJGX

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