Influence of Peloid Therapy on the Condition and Functional Activity of the Glands of Internal Secretion in Juvenile Rheumatoid Arthritis (Clinical and Experimental Study)

Abstract

The aim of the study was to assess the dynamics of hormones of the pituitary-gonadal-thyroid axis in patients with juvenile rheumatoid arthritis under the influence of peloid therapy and to establish the corresponding morphological changes in the pituitary gland, gonads and the thyroid gland of white Wistar rats with induced adjuvant arthritis during peloid therapy. Material and methods. 46 patients with juvenile rheumatoid arthritis were examined during their rehabilitation at sanatoria. The effect of peloid therapy on the pituitary-gonadal-thyroid axis was evaluated based on the changes in the levels of the main hormones LH, FSH, estradiol, testosterone, TSH, T3, T4. The control group consisted of 15 healthy age-mates. Morphological changes in the pituitary, testes, ovaries and thyroid gland were studied in 24 white Wistar rats with adjuvant arthritis. Results. In juvenile rheumatoid arthritis, the pituitary-gonad-thyroid axis is activated, which is manifested by a decrease in the production of FSH, LH, TSH, testosterone in boys of all age groups and estradiol both in girls regardless of their age and in boys 12–17 years of age. At the same time, an increase in secretion of T3, T4 was observed. The most pronounced deviations were noted in patients with a systemic form of the disease, with a high degree of severity and duration of the disease. The inclusion of mud therapy into the program of sanatorium rehabilitation leads to positive changes in the levels of the studied hormones. The experiment with induced adjuvant arthritis revealed reversible ultrastructural and tinctorial changes in the thyrotropocytes and gonadotropocytes of the pituitary gland, as well as impaired differentiation and partial destruction of the structural elements in the thyroid gland and gonads. The course of peloid therapy had a positive effect on the condition of the thyroid gland and gonads in the experimental animals, which was manifested by the restoration of structural and functional organization. Conclusion. Peloid therapy has a positive effect on the functional activity of the pituitary-gonadal thyroid axis in patients with juvenile rheumatoid arthritis, which has been confirmed by experimental data.