Оценка факторов риска в течении ревматоидного артрита и анкилозирующего спондилита

Abstract

The purpose — to study individual risk factors and their influence on the course of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Material and methods. Patients with RA and AS took part in the research; the group of comparison was practically healthy people. We evaluated clinical condition and laboratory indicators (the level of cytokines, lymphocyte subpopulation, rheumatoid factor, antibodies to the cyclic citrullinated peptide, S-reactive protein, proinflammatory cytokines, monocyte-macrophage protein, vascular endothelial factor, and cell cycle analysis). The obtained data were processed with Statistics 7.0 software. The results were considered to be statistically reliable at р < 0.05. Results. Hyper production of proinflammatory cytokines was marked in sick patients compared with healthy ones. The analysis of peripheral blood lymphocytes in patients showed their excess in comparison to healthy people. The assessment of lymphocytes ability for blast transformation defined the lymphocytes activation with the growth of cells at apoptosis stage (G1-phase); with the decrease in the proportion of resting cells (GO-phase) in patients, the activation coefficient was significantly growing. More apoptosis activation markers were found in the group of RA patients. Changes in apoptosis were revealed with the decreased proportion of lymphocytes in unstimulated cultures of patients; at the same time, the amount of cells in apoptosis increased four times in the examined patients compared to the healthy ones. Conclusions. In patients with RA and AS, changes of the factors of the immune system wee noted as the amount of pro-inflammatory cytokines IL—1β, IL-6, TNF—α and the concentration of MSR-1, VEGF, SPB, RF increased. The enhancement of cellular apoptosis is due to the increase of the apoptosis inducer — CD95+9(FaS) lymphocytes, TNF- α, the growth of cells at pre-synthetic stage of apoptosis G1-phase and the activation coefficient.