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Alemtuzumab (Lemtrada) is a recombinant humanized IgG1 kappa monoclonal antibody to the surface cell glycoprotein, a CD52 differentiation cluster. The drug is approved for use in more than 65 countries, including the Russian Federation. The drug is one of the most effective methods of treating patients with aggressive multiple sclerosis, but the risk management plan should be followed. The safety profile of the drug includes infusion-associated reactions, thyroid dysfunction, immune cytopenia, acute cardiovascular events, infections, and other autoimmune diseases. This publication provides updated practical recommendations for the use of the drug and ensuring the safety of patients treated with alemtuzumab.

The impact of industrial pollutions on the thyroid is one of the main causes of thyroid diseases. Intraoperative thyroid samples from 144 patients residing in some technogenically polluted towns of the Saratov Region were the subject of the study. The morphological features of various thyroid abnormalities were directly correlated with the level of environmental pollution with heavy metal salts that might play a leading role in the occurrence of goiter transformation. The exception is diffuse toxic goiter wherein such relationship has not been revealed. The correlation of thyroid pathology groups with Saratov districts having a heavy metal salt-polluted snow cover enables one to identify risk areas for their inhabitants.

It has been noticed that the morphofunctional organization of the thyroid gland is similar in representatives of two different classes of vertebrates: in fishes and in rats. Exposure of experimental animals to ecological factors with increased lead levels was followed by a phase response (activation, depression) of various structural elements of the thyroid gland. Obvious differences in morphofunctional mechanisms of adaptation to chemical stress factors in fishes and rats were found. A possible relationship is discussed between the environmental pollution with heavy metals and the increased incidence of thyroid gland disease in human population.