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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">pulmo</journal-id><journal-title-group><journal-title xml:lang="ru">Пульмонология</journal-title><trans-title-group xml:lang="en"><trans-title>PULMONOLOGIYA</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0869-0189</issn><issn pub-type="epub">2541-9617</issn><publisher><publisher-name>Scientific and Practical Journal “PULMONOLOGIYA” LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18093/0869-0189-2025-35-2-189-200</article-id><article-id custom-type="elpub" pub-id-type="custom">pulmo-4700</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 ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Таргетная терапия у взрослых больных муковисцидозом: влияние на течение инфекции нижних дыхательных путей и эффективность антибактериального лечения по данным регистра Российской Федерации</article-title><trans-title-group xml:lang="en"><trans-title>Targeted therapy in adult patients with cystic fibrosis: impact on the course of lower respiratory tract infections and the effectiveness of antibacterial treatment according to the registry of the Russian Federation</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5356-9415</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Амелина</surname><given-names>Е. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Amelina</surname><given-names>E. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Львовна Амелина, к. м. н., заведующая лабораторией</p><p>лаборатория муковисцидоза</p><p>115682; Ореховый бульвар, 28; Москва</p><p>тел.: (926) 205-03-91</p><p>Author ID: 7003985681</p></bio><bio xml:lang="en"><p>Elena L. Amelina, Candidate of Medicine, Head of the Laboratory</p><p>Cystic Fibrosis Laboratory</p><p>115682; Orekhovyy bul’var 28; Moscow</p><p>tel.: (926) 205-03-91</p><p>Author ID: 7003985681</p></bio><email xlink:type="simple">eamelina@mail.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/0009-0009-2500-663X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кагазежев</surname><given-names>Р. У.</given-names></name><name name-style="western" xml:lang="en"><surname>Kagazezhev</surname><given-names>R. U.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Резуан Уматиевич Кагазежев, аспирант</p><p>лаборатория муковисцидоза</p><p>115682; Ореховый бульвар, 28; Москва</p><p>тел.: (965) 496-28-82</p></bio><bio xml:lang="en"><p>Rezuan U. Kagazezhev, Рostgraduate Student</p><p>Cystic Fibrosis Laboratory</p><p>115682; Orekhovyy bul’var 28; Moscow</p><p>tel.: (965) 496-28-82</p></bio><email xlink:type="simple">kagazezhevru.64@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9642-0947</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Красовский</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Krasovskiy</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Станислав Александрович Красовский, к. м. н., старший научный сотрудник, исполняющий обязанности заведующего лабораторией, ведущий научный сотрудник</p><p>лаборатория муковисцидоза; научно-клинический отдел</p><p>115682; Ореховый бульвар, 28; 115478; ул. Москворечье, 1; Москва</p><p>тел.: (495) 111-03-03</p><p>Author ID: 688178</p></bio><bio xml:lang="en"><p>Stanislav A. Krasovskiy, Candidate of Medicine, Senior Researcher, Acting Head of the Laboratory, Leading Researcher</p><p>Cystic Fibrosis Laboratory; Scientific and Clinical Department</p><p>115682; Orekhovyy bul’var 28; 115522; ul. Moskvorechye 1; Moscow</p><p>tel.: (495) 111-03-03</p><p>Author ID: 688178</p></bio><email xlink:type="simple">sa_krasovsky@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/0000-0001-6395-0407</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондратьева</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondratyeva</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Ивановна Кондратьева, д. м. н., профессор, заместитель директора, руководитель отдела, заведующая кафедрой</p><p>Центр муковисцидоза; научно-клинический отдел муковисцидоза; Институт высшего и дополнительного профессионального образования; кафедра генетики болезней дыхательной системы</p><p>115478; ул. Москворечье, 1; Москва; 141009; ул. Коминтерна, 24А, стр. 1; Московская обл., Мытищи</p><p>тел.: (495) 324-20-24</p><p>Scopus ID: 35196167800; Web of Science Researcher ID: АВВ-9783–2021</p></bio><bio xml:lang="en"><p>Elena I. Kondratyeva, Doctor of Medicine, Professor, Deputy Director, Head of the Department</p><p>Cystic Fibrosis Center; Scientific and Clinical Department of Cystic Fibrosis; Department of Genetics of Diseases of the Respiratory System</p><p>115522; ul. Moskvorechye 1; Moscow; 141009; ul. Kominterna 124A, build. 1; Moskovskaya obl.; Mytishchi</p><p>tel.: (495) 324-20-24</p><p>Scopus ID: 35196167800; Web of Science Researcher ID: АВВ-9783–2021</p></bio><email xlink:type="simple">elenafpk@mail.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/0000-0002-8183-7990</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Воронкова</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Voronkova</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анна Юрьевна Воронкова, к. м. н., ведущий научный сотрудник</p><p>научно-клинический отдел муковисцидоза</p><p>115478; ул. Москворечье, 1; Москва; 141009; ул. Коминтерна, 24А, стр. 1; Московская обл., Мытищи</p><p>тел.: (495) 324-20-24</p><p>Scopus Author ID: 57189352251; Web of Science Researcher ID: M-7191-2014</p></bio><bio xml:lang="en"><p>Anna Yu. Voronkova, Candidate of Medicine, Leading Researcher</p><p>Scientific and Clinical Department of Cystic Fibrosis</p><p>115522; ul. Moskvorechye 1; Moscow; 141009; ul. Kominterna 124A, build. 1; Moskovskaya obl.; Mytishchi</p><p>tel.: (495) 324-20-24</p><p>Scopus Author ID: 57189352251; Web of Science Researcher ID: M-7191-2014</p></bio><email xlink:type="simple">voronkova111@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/0000-0003-0503-6371</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Каширская</surname><given-names>Н. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Kashirskaya</surname><given-names>N. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наталия Юрьевна Каширская, д. м. н., профессор, главный научный сотрудник, профессор</p><p>лаборатория генетической эпидемиологии; кафедрапедиатрии</p><p>115478; ул. Москворечье, 1; 129110; ул. Щепкина, 61 / 2; Москва</p><p>тел.: (499) 320-60-90</p><p>Scopus ID: 6507308033; WoS Researcher ID: C-6404-2012; РИНЦ ID: 93625</p></bio><bio xml:lang="en"><p>Nataliya Yu. Kashirskaya, Doctor of Medicine, Professor, Chief Researcher, Professor</p><p>Laboratory of Genetic Epidemiology; Department of Pediatrics</p><p>115522; ul. Moskvorechye 1; 129110;  ul. Shchepkina 61/2; Moscow</p><p>tel.: (499) 320-60-90</p><p>Scopus ID: 6507308033; WoS Researcher ID: C-6404-2012; РИНЦ ID: 93625</p></bio><email xlink:type="simple">kashirskayanj@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/0000-0002-9522-1142</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Корнеев</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Korneev</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Александр Александрович Корнеев, аналитик</p><p>Научно-технологический парк биомедицины; Институт регенеративной медицины; лаборатория иммунной инженерии</p><p>119991; ул. Трубецкая, 8, стр. 2; Москва</p><p>тел.: (916) 216-69-08</p></bio><bio xml:lang="en"><p>Alexander A. Korneev, Analyst</p><p>Scientific and Technological Park of Biomedicine; Instituteof Regenerative Medicine; Laboratory of Immune Engineering</p><p>119991; ul. Trubetskaya 8, build. 2; Moscow</p><p>tel.: (916) 216-69-08</p></bio><email xlink:type="simple">korneev.alex.a@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства России; Федеральное государственное бюджетное научное учреждение «Медико-генетический научный центр имени академика Н.П.Бочкова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation; Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное научное учреждение «Медико-генетический научный центр имени академика Н.П.Бочкова»; Государственное бюджетное учреждение здравоохранения Московской области «Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation; State Budgetary Healthcare Institution of the Moscow region “Research Clinical Institute of Childhood”, Healthcare Ministry of Moscow Region</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное научное учреждение «Медико-генетический научный центр имени академика Н.П.Бочкова»; Государственное бюджетное учреждение здравоохранения Московской области «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation; State Budgetary Healthcare Institution of the Moscow Region “Moscow Regional Research and Clinical Institute (MONIKI)”</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Федеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский&#13;
университет имени И.М.Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>18</day><month>04</month><year>2025</year></pub-date><volume>35</volume><issue>2</issue><fpage>189</fpage><lpage>200</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Амелина Е.Л., Кагазежев Р.У., Красовский С.А., Кондратьева Е.И., Воронкова А.Ю., Каширская Н.Ю., Корнеев А.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Амелина Е.Л., Кагазежев Р.У., Красовский С.А., Кондратьева Е.И., Воронкова А.Ю., Каширская Н.Ю., Корнеев А.А.</copyright-holder><copyright-holder xml:lang="en">Amelina E.L., Kagazezhev R.U., Krasovskiy S.A., Kondratyeva E.I., Voronkova A.Y., Kashirskaya N.Y., Korneev A.A.</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://journal.pulmonology.ru/pulm/article/view/4700">https://journal.pulmonology.ru/pulm/article/view/4700</self-uri><abstract><p>   При терапии CFTR-модуляторами значительно улучшаются клинические показатели и качество жизни пациентов с муковисцидозом (МВ), однако влияние этих препаратов на микробный профиль респираторного тракта изучено недостаточно.</p><p>   Целью исследования явилась оценка изменений микробного профиля и клинических характеристик у взрослых пациентов с МВ на фоне патогенетической терапии, определение зависимости этих показателей от длительности приема CFTR-модуляторов.</p><sec><title>   Материалы и методы</title><p>   Материалы и методы. В исследование включены данные пациентов старше 18 лет, внесенные в российский регистр больных МВ, из национального регистра больных муковисцидозом за 2021–2023 гг. Анализировались микробиологические, функциональные и антропометрические показатели, а также информация о приеме CFTR-модуляторов и антибактериальных препаратов.</p></sec><sec><title>   Результаты</title><p>   Результаты. В исследование включены данные совершеннолетних пациентов (n = 1 141; средний возраст – 25,32 года; 50,74 % – мужчины) за 2021–2023 гг. CFTR-модуляторы принимали 450 пациентов. Только в этой группе отмечено достоверное улучшение объема форсированного выдоха за 1-ю секунду (p &lt; 0,001) и увеличение индекса массы тела. Pseudomonas aeruginosa являлся доминирующим патогеном, чаще всего в форме хронического инфицирования. Группы по доминирующему патогену оставались стабильными, смена групп у 283 из 1 141 пациентов не была связана с приемом CFTR-модуляторов или его длительностью. В начале терапии CFTR-модуляторами (&lt; 1 года) отмечено увеличение числа больных, получающих таблетированную антибактериальную терапию (АБТ). При более длительном приеме таргетных препаратов число курсов АБТ снижалось.</p></sec><sec><title>   Заключение</title><p>   Заключение. По данным национального регистра пациентов с МВ за 2021–2023 гг., число взрослых, получающих CFTR-модуляторы, увеличивается. При таргетной терапии значительно улучшаются респираторная функция и нутритивный статус, однако микробиологический профиль респираторного тракта пациентов старше 18 лет не изменился в первые годы лечения.</p></sec></abstract><trans-abstract xml:lang="en"><p>   CFTR modulators significantly improve clinical parameters and quality of life in people with cystic fibrosis (CF), but the effect of this treatment on the microbial profile of the respiratory tract has not been sufficiently studied.</p><sec><title>   The aim</title><p>   The aim. To assess changes in the microbial profile and clinical characteristics in adult CF patients during targeted therapy, to determine the correlation of these parameters with the duration of CFTR modulators treatment.</p></sec><sec><title>   Methods</title><p>   Methods. The study included data on patients over 18 years of age from the national registry of patients with cystic fibrosis for 2021 – 2023. Data on microbiological, functional and anthropometric parameters of patients, as well as information on the use of CFTR modulators and antibiotics were analyzed.</p></sec><sec><title>   Results</title><p>   Results. The study included 1 141 adult patients, the average age was 25.32 years, the proportion of men was 50.74 %. CFTR modulators were taken by 450 patients. Only in this group was a significant improvement in forced expiratory volume in the first second (p &lt; 0.001) and an increase in body mass index observed in 2021 – 2023. Pseudomonas aeruginosa is the dominant pathogen, most often in the form of chronic infection. The groups by the dominant pathogen remained stable; the change in groups in 283 of 1,141 patients was not associated with the use of CFTR modulators or its duration. At the beginning of therapy with CFTR modulators (less than one year), an increase in the number of patients receiving oral antibacterial therapy was noted. With a longer use of targeted therapies, the number of courses of antibacterial therapy decreases.</p></sec><sec><title>   Conclusion</title><p>   Conclusion. According to the national registry of patients with cystic fibrosis for 2021 – 2023, the number of adults receiving CFTR modulators is increasing. Targeted therapy significantly improves respiratory function and nutritional status, but the microbiological profile of the respiratory tract of patients over 18 years of age did not change in the first years of treatment.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>муковисцидоз</kwd><kwd>CFTR-модуляторы</kwd><kwd>таргетная терапия</kwd><kwd>патогенетическое лечение</kwd><kwd>микробный профиль</kwd><kwd>регистр</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cystic fibrosis</kwd><kwd>CFTR modulators</kwd><kwd>targeted therapy</kwd><kwd>pathogenetic treatment</kwd><kwd>microbial profile</kwd><kwd>registry</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена при использовании данных регистра больных муковисцидозом Российской Федерации</funding-statement><funding-statement xml:lang="en">The work was carried out using data from the cystic fibrosis patient registry of the Russian Federation</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">de Boeck K. 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