Disruption of endometrial regeneration, fibrosis formation, and intrauterine adhesions underlie the development of “thin” endometrium and/or Asherman’s syndrome (AS) and are a common cause of infertility and a high risk for adverse obstetric outcomes. The methods used (surgical adhesiolysis, anti-adhesive agents, and hormonal therapy) do not allow restoration of the regenerative properties of the endometrium. The experience gained today with cell therapy using multipotent mesenchymal stromal cells (MMSCs) proves their high regenerative and proliferative properties in tissue damage. Their contribution to regenerative processes is still poorly understood. One of these mechanisms is based on the paracrine effects of MMSCs associated with the stimulation of cells of the microenvironment by secreting extracellular vesicles (EVs) into the extracellular space. EVs, whose source is MMSCs, are able to stimulate progenitor cells and stem cells in damaged tissues and exert cytoprotective, antiapoptotic, and angiogenic effects. This review described the regulatory mechanisms of endometrial regeneration, pathological conditions associated with a decrease in endometrial regeneration, and it presented the available data from studies on the effect of MMSCs and their EVs on endometrial repair processes, and the involvement of EVs in human reproductive processes at the level of implantation and embryogenesis.

The article presents theses of the resolution of the Interdisciplinary Council of Experts in Psychiatry and Neurology (Moscow, 2024) on the issue of comorbid anxiety disorders (AD) in patients with neurological pathologies. The authors highlight the high prevalence of comorbid ADs and their significant negative impact on the course of underlying diseases, such as epilepsy, pain syndromes and post-stroke conditions. Modern approaches to the diagnosis and treatment of ADs in this group of patients are discussed. Special attention is given to the role of etifoxine as an effective anxiolytic in the comprehensive therapy of ADs. Etifoxine, due to its dual mechanism of action on GABA receptors, demonstrates high efficacy in reducing anxiety and has neuroprotective, neurotrophic, neuroplastic, analgesic, and anti-inflammatory properties, making it an important tool in the treatment of comorbid ADs in patients with neurological pathologies. The article also reviews recently published data confirming its efficacy and favourable safety profile compared to traditional benzodiazepines and other anxiolytic drugs.

Chronic inflammation underlies the progression of many human systemic disorders, including a number of gynecological diseases such as endometriosis and chronic endometritis. Inflammasomes play a special role in the regulation of intercellular interactions under physiological and pathological conditions. The pathogenesis of chronic inflammation assumes a gradual course, accompanied by prolonged maintenance active state of inflammasomes due to the excessive accumulation of intracellular and extracellular endogenous molecules released from destroyed cells – DAMPs (damage-associated molecular patterns), their ineffective utilization by autophagy and stress-reducing cell systems, local production of pro-inflammatory cytokines (IL-1β, IL-18), as well as ROS (reactive oxygen species), accumulation of macrophages and T-lymphocytes, tissue damage and the development of fibrosis. The proteins of the inflammasome complex can serve as targets for drugs, which will increase the efficiency of therapy for inflammation-associated diseases. This review presents the current data on the role of NLRP3-inflammasomes in immune regulation and the molecular mechanisms underlying the pathogenesis of endometriosis and chronic endometritis. Understanding the molecular mechanisms of inflammasome activation and the discovery of their effective inhibitors, as well as the assessment of the therapeutic potential in these pathologies, is an important direction of future research. Keywords: inflammasome, inflammation, innate immunity, endometriosis, chronic endometritis