Inflammatory Activity Index Research Articles

INTEGRATIVE INDICATORS OF ENDOGENOUS INTOXICATION, INFLAMMATORY ACTIVITY, AND SPECIFIC REACTIVITY IN PATIENTS WITH COVID-19

The aim of the study is to identify changes in blood laboratory parameters, integrative indicators of endogenous intoxication, inflammation, and specific reactivity in patients with coronavirus disease. Patients and methods. The study included 77 patients with COVID-19, taking into account the inclusion and exclusion criteria. The comparison group consisted of 68 practically healthy people of the corresponding age. Laboratory blood tests were performed, on the basis of which integrative indicators of endogenous intoxication, inflammation and specific reactivity were calculated. Results. The data of the general blood test showed no significant differences between the patients of the groups, the indicators remained within acceptable limits. A slight inflammatory reaction in patients with COVID-19, especially in the period from 3 to 6 months, is confirmed by an increase in the level of endogenous intoxication (LII, LSI, NLRI, HII) in the group of patients compared to healthy individuals. During the same period, there are signs of activation of the cellular immune system in response to the presence of latent bacterial infection or endogenous intoxication, which is confirmed by a decrease in inflammation activity (LGI, LESRI, CI). Reduced indices of nonspecific reactivity (RC, ILYM, AI) confirmed the activation of the cellular immune system, given the decrease in the number of lymphocytes relative to granulocytes. Changes in integrative indices did not depend on the presence of Long-COVID symptoms. In the period from 12 months after the coronavirus disease, the development of autoimmune processes is possible, since there was a tendency to decrease the indices of endogenous intoxication (NLRI, LSI) simultaneously with an increase in the indices of inflammatory activity (LGI, LESRI, TI) and indices of nonspecific reactivity (RC, Ilymph, AI).

Development of Quantitative Norms for Normal Lung Uptake Based on Three-Dimensional Gallium-67 Single Photon Emission Computed Tomography/Computed Tomography

Abstract Purpose Gallium-67 (Ga-67) lung scans assess alveolitis and interstitial lung disease, with Ga-67 accumulation correlating with inflammation intensity as seen in lung biopsy sections. Both semi-quantitative and quantitative methods have been used, with the latter providing an inflammatory activity index linked to lung lavage and histopathological scores. However, differing reference points result in varying outcomes. This study aimed to establish standard Ga-67 index parameters using semi-quantitative analysis and a linear regression model based on planar and SPECT/CT images. Methods Twenty subjects without lung disease received a 5–6 mCi Ga-67 injection via the ankle. Both planar and SPECT/CT images were analyzed, with semi-quantitative values assessed using GraphPad Prism 9.5.1. Results Compared to planar images, SPECT/CT acquisitions for the lung-to-arm uptake ratio proved the most reliable indicator for assessing lung inflammation. Increased lung Ga-67 uptake was defined as greater than 2 standard deviations from the average Ga-67 uptake for healthy subjects. The normal range was 0.065 ± 0.049 for the right side and 0.076 ± 0.070 for the left side. Conclusion Lung-to-arm ratios in SPECT/CT images are more accurate than those in planar images. This method should be adopted as a standard clinical practice, providing more reliable diagnostic information and improving patient management. Future studies should compare patients without lung disease to those with lung disease to determine the diagnostic benefit of these norms.

The effects of the MTHFR 677C>T (rs1801133) genetic variant on susceptibility and disability worsening in multiple sclerosis patients are mediated by homocysteine

BackgroundInteractions between genetic and environmental variables contribute to the autoimmune inflammatory process in multiple sclerosis (MS). Elevated homocysteine levels, and vitamin D, vitamin B12, and folate deficiencies are some of the environmental factors associated with the pathogenesis of MS. Considering that the relationship between MTHFR 677C>T (rs1801133) genetic variant, homocysteine, and folate in patients with MS remains unclear and that their role were not extensively explored in the clinical course of the disease, we investigated whether this variant and plasma homocysteine and folate levels are associated with MS susceptibility, disability, disability progression, and inflammatory biomarkers. MethodsThe case-control study included 163 patients with MS categorized using the Expanded Disability Status Scale (EDSS) as mild (EDSS<3) and moderate/high (EDSS≥3) disability, and 226 healthy controls (HC). Disability progression was evaluated using Multiple Sclerosis Severity Score (MSSS) and the MTHFR 677C>T variant was genotyped using real time polymerase chain reaction. The plasma levels of some inflammatory biomarkers were determined. Two new composed scores were proposed: the first, namely as inflammatory activity index (IAI), was entered as a latent vector extracted from the macrophage M1 + T helper (Th)1 + Th17 + Th2 + T regulatory (Treg) cytokines, + tumor necrosis factor (TNF)-α+ soluble TNF receptor (sTNFR)-1 + sTNFR2. The second score, namely MS-severity index was entered as a latent vector extracted from the EDSS + MSSS scores + MS diagnosis. ResultsPatients with MS showed higher homocysteine and folate than controls (p < 0.001); homocysteine, and the M1, Th1, Th17, and Th2 Treg cytokine values were different between the three study groups and increased from HC to MS patients with mild disability and to MS patients with moderate/high disability (p < 0.0001). The levels of TNF-α and their soluble receptors sTNFR1 and sTNFR2 were higher in MS patients with EDSS≥3 than in the two other groups (EDSS<3 and HC) (p < 0.001). There was no association between the MTHFR 677 C > T genotypes and MS susceptibility, disability and disability progression (p > 0.05). Moreover, 21.8 % of the disability variance was explained by age, IAI and C-reactive protein (CRP) (all positively associated); 10.9 % of the disability progression variance was predicted by IAI and CRP (both positively) and 25-hydroxyvitamin D (negatively), whereas 54.4 % of the severity index (MS-EDSS-MSSS) was explained by the regression on age, IAI, homocysteine, folate, and CRP (all positively), and adiponectin, body mass index, and 25-hydroxyvitamin D (all negatively), female sex, and the MTHFR 677 TT genotype. In patients and controls, 16.6 % of the variance in the homocysteine was explained by the MTHFR 677 TT genotype and age (both positively), folate (negatively) and male sex. ConclusionThe MTHFR 677C>T variant has an indirect effect on the increase in disability in patients with MS, which also depends on factors such as age, sex, ad folate status.

An Exploration of Some Predictors of Quality of Life-Related to the Innate Immune System, Inflammation, and Disease Activity in Patients with Behcet's Syndrome: An Analytical Cross-sectional Study.

Behçet's disease (BD) has a growing prevalence in Silk Road countries. The aim of our cross-sectional study was to explore the clinical and molecular predictors of quality of life in BD patients. One hundred and fifty consecutive Iranian BD patients with an age range between 20-50 years were included. The Leeds Behçet's disease quality of life (BDQoL) in Persian form was fulfilled to evaluate the quality of life. Anthropometric measurements were carried out using the calibrated scales. Iranian Behcet's Disease Dynamic Activity Measure (IBDDAM), Behcet's disease current activity form (BDCAF), and Total Inflammatory Activity Index (TIAI) were used to assess BD activity. mRNA expression of toll-like receptors 2 and 4 (TLR2 and TLR4) and tumor-necrosis-factor-alpha (TNF-α) levels in serum were measured by real-time polymerase chain reaction (PCR) and ELISA, respectively. Multiple linear backward regression at P = 0.1 was used to study the potential predictors of quality of life. TLR2 and BDCAF were shown to be the most important predictors of quality of life in BD patients by 22%. There were positive associations between them (β = 0.326, p = 0.013 for BDCAF; β = 0.366, p = 0.006 for TLR2) and BDQoL value. Higher TLR2 expression as a key protein in recognizing pathogens by innate immunity and BDCAF value as a comprehensive BD assessing scale contribute to poor quality of life among BD patients. Emphasizing therapeutically, approaches associated with lower TLR2 expression and BDCAF value can be considered in future studies.

Interobserver Reliability and Sensitivity to Change of a Composite Ocular Inflammatory Activity Index: UVEDAI©.

This was a multicenter, prospective, longitudinal, observational study involving eight Spanish tertiary hospitals to determine the interobserver reliability of an uveitis disease activity index, (UVEDAI) and assess its sensitivity to change in patients with receiving pharmacologic treatment. Patients aged ≥ 18years diagnosed with active noninfectious uveitis were included. A complete baseline assessment was performed by two ophthalmologists who determined ocular inflammatory activity using the UVEDAI index independently of each other. The principal ophthalmologist made a new visit at 4weeks to determine the change in inflammatory activity. The interobserver reliability analysis was performed by calculating the intraclass correlation coefficient (ICC), with the values of the variables and the UVEDAI obtained by both ophthalmologists in the more active eye at the baseline visit. Sensitivity to change in the UVEDAI index was assessed at 4weeks from the start of pharmacologic treatment by determining the clinically relevant change, defined as a change in UVEDAI of ≥ 0.8 points over baseline. The mean change between both measures was compared using the repeated-measures t-test. A total of 111 patients were included. In the interobserver reliability analysis, the ICC for the UVEDAI value was 0.9, and, when compared with the mean UVEDAI values obtained by the ophthalmologists, no statistically significant differences were found (p value > 0.05). As for the sensitivity to change in UVEDAI, statistically significant differences (p value = 0.00) were found for the mean values of the index compared with baseline. In all cases, the index value decreased by > 1 point at the 4-week visit. The interobserver reliability of the UVEDAI was high in the total sample. Furthermore, the index was sensitive in determining the change in inflammatory activity after treatment. We believe that UVEDAI is a disease activity index that enables objective comparison of results in clinical practice and trials.

Formation of specific immunity in piglets during vaccination against circovirus infection

The article presents the results of studying the formation of specific immunity in piglets during vaccination against circovirus infection. Circovirus diseases of pigs, manifested by the defeat of many body systems, are widespread and cause great economic damage in industrial pig farms. The study of the formation of specific immunity during vaccination of piglets against circovirus infection is of scientific and practical interest. The purpose of the research is to study the formation of specific immunity in piglets during vaccination against circovirus infection. It was found that vaccination is accompanied by activation of the innate immunity system, which initiated the launch and formation of an antigen-specific adaptive immune response. In animals 6 days after the introduction of the vaccine, compared with intact piglets, an increase in the content of pro-inflammatory cytokines IL-1ß, TNF-α, IFN-α and IFN-γ and the anti-inflammatory mediator IL-4 was found, indicating a cellular and humoral immune response. An increase in the indices of inflammatory activity of mediators and the ratio of pro- and anti-inflammatory cytokines indicates an increase in the activity of T-helper I and the prevalence of cellular immune response. Under the influence of technological stress caused by weaning from sows and transfer to rearing, animals 14 days after vaccination showed a decrease in the level of IL-2, IFN-α and IFN-γ, inducing cellular immunity, as well as cytokine index, the ratio of pro- and anti-inflammatory mediators, which indicates a shift in the direction of the immune response in the side of activation of the functioning of T-helper II, indicating the predominant formation of humoral immunity.

Methods for monitoring the effectiveness of direct-acting anticoagulants in diabetic retinopathy

Anticoagulants are the basis for the treatment of various diseases that induces the development of arterial and venous thrombosis. One such disease is diabetic retinopathy. However, no consensus has been reached regarding the best way to control the effectiveness of these drugs. Thus, active search is ongoing for specific biomarkers that reflect treatment quality. To this end, this study analyzed scientific papers that presented the results of various laboratory diagnostics aimed at examining the use of anticoagulants in the treatment of diabetic retinopathy.&#x0D; PubMed and eLIBRARY.RU were searched for legible studies. The review analyzed studies that describe the main groups of anticoagulants and methods of laboratory control of their use and published in the past 30 years. Review articles, results of experimental studies, monographs, study guides, and dissertations were analyzed.&#x0D; Anticoagulants are divided into direct and indirect. In modern clinical practice, direct ones are mainly used. To control their effectiveness, traditional methods for determining the coagulogram are mainly used; however, increasingly more often, the authors resort to a more detailed study of the rheological properties of the blood, such as determination of anti-X activity, platelet aggregation using inductors, and activity of clotting factors. In addition, determining their effect on the concentration of pro-inflammatory cytokines and growth factors in the blood serum and lacrimal fluid in diabetic retinopathy remains promising.&#x0D; However, no consensus has been established on which research methods most accurately reflect the effect of anticoagulants on the hemostatic system and indicators of inflammatory activity in various diseases, particularly in diabetic retinopathy. Therefore, a detailed analysis of what laboratory parameters can change under the influence of these drugs is necessary.

Relation of Antioxidant Native Thiol Level with Inflammatory Markers and Disease Activity Index in Pediatric Ulcerative Colitis

Objective: Pediatric ulcerative colitis (PUC) is an inflammatory disease. PUC pathogenesis is associated with an imbalance between reactive oxygen species and antioxidant activity which creates oxidative stress. Native thiol (NT) level is antioxidant capacity which is practical and repeatable marker of inflammation and antioxidan level. We aimed to analyse the relation of NT level with inflammatory markers and pediatric ulcerative colitis activity index (PUCAI). Material and Methods: Thirty-eight PUC patients (SG) and 33 control group (CG) participants were included in the study. PUC patients grouped as in remission, mild, moderate and severe activity according to disease activity according to PUCAI. NT, hemoglobin (Hb), white blood cell (WBC), platelet (PLT), mean platelet volume (MPV), albumin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin 6 (IL-6) levels of all participants were measured at the time they were enrolled in the study and recorded. Results: Mean age and gender ratio of groups were similar (p&amp;gt;0.050). NT level of SG statistically high compared to CG (p=0.001). Hb, PLT, MPV, CRP, ESR, IL-6 levels of SG were statistically different than CG (p=0.045, p=0.026, p=0.001, p=0.001, p=0.001, p=0.001). NT level of SG was positively correlated with Hb, MPV, albumin (p=0.001, for all). NT level of SG was negatively correlated with PLT, CRP, ESR, IL-6 and PUCAI (p=0.001). Conclusion: NT level of PUC is significantly lower than CG. NT level of SG was positively correlated with albumin which is a good prognostic factor in PUC patients. NT may be repeatable, noninvasive candidate serum biomarker for PUC management.

Levels of antibodies to adalimumab in children with juvenile idiopathic arthritis at different stages of treatment

Background. Juvenile idiopathic arthritis (JIA) is one of the most common rheumatological diseases of childhood. The central place in the problem of JIA belongs to the question of treatment the timeliness and adequacy of which determine the disease prognosis and, in fact, the entire future of the child. Immunobiological therapy can cause stable clinical and laboratory remission, as well as stop the further progression of structural changes, affecting the pathogenetic link of idiopathic arthritis. But the lack of response to therapy or a decrease in its effectiveness remains a fairly common problem and, in many cases, can be caused by the immunogenicity of immunobiological drugs, especially in case of treatment with tumor necrosis factor inhibitors. Aim of the work: to study the level of antibodies to adalimumab in children with juvenile idiopathic arthritis at different stages of treatment for analysis of immunogenicity. Materials and methods. The concentration of antibodies to adalimumab in 80 serum samples from patients with JIA was studied and evaluated, treatment effectiveness and adverse events were analyzed in 56 patients with JIA at different stages of therapy. Two groups were identified. The first one included 24 patients who had at least a 6-month break in adalimumab administration for non-medical reasons during which treatment was continued with methotrexate with periodic intra-articular injection of glucocorticoids. The level of antibodies to adalimumab was evaluated before the break and 1 month after the reinitiation of adalimumab administration. The second group consisted of 32 children who continued adalimumab without a break during treatment. Disease activity was measured using JADAS-27. Antibodies to adalimumab were detected by enzyme-linked immunosorbent assay. Results. During the examination, an elevated level of antibodies to adalimumab was detected in 10 of 24 serum samples (42 %) before non-medical withdrawal in group I. Among the results of group II, elevated levels of antibodies to adalimumab were found in 12 samples, which was 38 %. The correlation analysis revealed direct statistically significant relationships of moderate strength between the level of antibodies to adalimumab and the indicator of inflammatory activity on JADAS-27 (Spearman’s r = 0.39, p &lt; 0.05), as well as between the level of antibodies and disease duration (Spearman’s r = 0.32, p &lt; 0.05). Conclusions. Monitoring serum antibodies to adalimumab is informative for the correct interpretation of treatment effectiveness and the course of the disease with immunobiological treatment, as it may improve understanding of the clinical consequences of continued therapy, help prevent adalimumab immunogenicity, develop follow-up strategies and, as a result, can affect a long-term outcome of treatment for JIA.

Magnetic resonance enterocolonography for assessing inflammation activity in Crohn’s disease using the CDMI and MEGS indices

AIM: to determine the diagnostic efficiency of magnetic resonance enterocolonography using inflammation indices (CDMI, MEGS) in assessing activity of the inflammatory process in the colon and small intestine in Crohn's disease.PATIENTS AND METHODS: the study included 42 patients with Crohn's disease (age ranged from 19 to 47 years). All patients underwent magnetic resonance enterocolonography (MRE) with intravenous contrast and diffusion-weighted images. According to the results of MRE, were determined MR indices of inflammation activity in the small and large intestine - CDMI and MEGS. The MR inflammatory activity indices CDMI and MEGS were compared with the endoscopic inflammatory activity index SES-CD.RESULTS: the MR inflammation activity index CDMI did not show a statistically significant diagnostic efficiency (p&gt;0.05). The MR inflammation activity index MEGS showed a statistically significant diagnostic efficiency (p&lt;0.0001). According to the nomogram, the MR inflammation activity index MEGS demonstrated a high predictive ability to determine the true activity of the inflammatory process in the small and large intestine. Correlation demonstrated direct strong relationship between the quantitative values of the MEGS inflammation indices and the endoscopic inflammation index (SES-CD) (r=0.843, p&lt;0.0001).CONCLUSION: magnetic resonance enterocolonography using the MEGS activity index has a high diagnostic efficiency in assessing the activity of the inflammatory process in the small and large intestine in Crohn's disease. The MR inflammation activity index CDMI did not show statistically significant diagnostic efficacy. The results of the study should be considered preliminary and require further study of the possibilities of these indices of inflammation activity in a larger sample of patients.

Експериментально-клінічне дослідження перебігу запального процесу м'яких тканин щелепно-лицевої ділянки на тлі хронічної алкогольної інтоксикації

The purpose of the study was to investigate, under experimental conditions, the peculiarities of the healing of infected wounds in experimental animals with long-term alcohol consumption; in patients with phlegmons of maxillofacial region against the background of alcohol intoxication, to evaluate the dynamics of hematological indices for determining the activity of the inflammatory process, predicting the course of the pathological process. Materials and methods. Experimental studies were conducted on 16 female Wistar rats weighing 80 g. The animals were divided into 2 equal groups: group I – experimental, group II – control. The water for the rats of the experimental group was replaced with beer, the alcohol content of which did not exceed 6%. 6 weeks after the start of the experiment, 2 rats from each group were removed from the experiment and material was taken for histological examination, the remaining 12 rats were anesthetized and wounds were created on the lower lip by cutting out a fragment of the mucous membrane measuring 0.4 x 0.3 cm. After the wounds were created, the animals were removed from the experiment by overdose with ether anesthesia on the 3rd and 7th day, the wounds were photographed, the mucous membrane of the lower lip was taken for histological examination. Results. In the experiment, during the histological examination of the tissues of the lower lip of rats with a model process of beer alcoholism, deformation of the sweat and sebaceous glands of the lower lip, and thinning of the epithelial layer were revealed. The healing of infected wounds of the lower lip in experimental animals was slowed down against the background of replacing drinking water with beer, and an objective decrease in proliferative processes was established. In particular, on the 7th day in the subepithelial layer, mixed cellular infiltration with lymphocytes, single leukocytes and macrophages was maintained, at the same time foci of young granulation tissue appeared in animals of the control group, which indicated the healing process. A retrospective analysis of 50 case histories of patients with odontogenic phlegmons of the maxillofacial region, localized in one topographical and anatomical space, was conducted, 16 of them abused alcoholic beverages. Before the phlegmon opening operation, on the 5th and 9th days, hematological indices of activity were determined – the lymphocyte-granulocyte index, the leukocyte to erythrocyte sedimentation rate ratio. The lymphocyte-granulocyte index was significantly lower (by 3.3 times) in patients who abused alcohol. On the 5th day, a significant increase in the lymphocyte-granulocyte index was found in the group of patients who abused alcohol. The analysis of the leukocyte to erythrocyte sedimentation rate ratio showed an increase in indicators in patients with phlegmons from the normal level. In patients with alcohol intoxication, on the 9th day, a 2.6-fold increase in the leukocyte to erythrocyte sedimentation rate ratio was found compared to the indicators of practically healthy individuals and 2-fold compared to the group of patients without harmful habits (p&lt;0.05). Conclusion. According to hematological indices of inflammatory activity, it is possible to determine the degree of activation of the pathological process in patients, in particular, those who abuse alcohol, and to choose the tactics of treatment of phlegmon of maxillofacial region

IL-31 and IL-33 in rheumatoid arthritis patients

Objective – to investigate clinical and diagnostic significance of IL-31 and IL-33 determination in patients with rheumatoid arthritis (RA).Material and methods. 154 patients with a reliable diagnosis of RA were examined. Serum levels of IL-31 and IL-33 were studied using multiplex xMAP technology on Bio-PlexTM 200 System analyzer (BIO-RAD, USA). The upper limit of the norm in the study of 20 healthy donor sera was (M+3σ): IL-31 – 15.08 pg/ml, IL-33 – 3.40 pg/ml.Results. IL-31 (Me (25th; 75th percentile) – 13.75 (5.63; 308.52) and 6.10 (2.87; 8.62) pg/ml (p&lt;0.001), IL-33 – 18.86 (7.45; 65.95) and 0.52 (0.17; 0.78) pg/ml (p&gt;&lt;0.001) levels were observed in RA patients in comparison with the control group. An increase in IL-33 concentration (more than 3.40 pg/ml) was observed in 87.0% of patients, and IL-31 (more than 15.08 pg/ml) in 48.1% of patients with RA. An increase in IL-33 alone was observed in 42.2% (65 of 154 patients) with RA, while an isolated increase in IL-31 concentration was observed in only 2 (1.3%) patients. Simultaneous hyperproduction of IL-33 and IL-31 occurred in 69 (44.9%) patients. We revealed positive correlation of clinical and laboratory parameters of RA with cytokine concentration: SDAI correlated with IL-33 (r=0.36; p&gt;&lt;0.05); CRP – with IL-31 (r=0.49; p&gt;&lt;0,05) and IL-33 (r=0.40; p&gt;&lt;0.05). Conclusion. Concentrations of IL-31 and IL-33 are elevated in RA patients and correlate with the indices of inflammatory activity of the disease.&gt;&lt; 0.001), IL-33 – 18.86 (7.45; 65.95) and 0.52 (0.17; 0.78) pg/ml (p&lt;0.001) levels were observed in RA patients in comparison with the control group. An increase in IL-33 concentration (more than 3.40 pg/ml) was observed in 87.0% of patients, and IL-31 (more than 15.08 pg/ml) in 48.1% of patients with RA. An increase in IL-33 alone was observed in 42.2% (65 of 154 patients) with RA, while an isolated increase in IL-31 concentration was observed in only 2 (1.3%) patients. Simultaneous hyperproduction of IL-33 and IL-31 occurred in 69 (44.9%) patients. We revealed positive correlation of clinical and laboratory parameters of RA with cytokine concentration: SDAI correlated with IL-33 (r=0.36; p&gt;&lt;0.05); CRP – with IL-31 (r=0.49; p&gt;&lt;0,05) and IL-33 (r=0.40; p&gt;&lt;0.05). Conclusion. Concentrations of IL-31 and IL-33 are elevated in RA patients and correlate with the indices of inflammatory activity of the disease.&gt;&lt; 0.001) levels were observed in RA patients in comparison with the control group. An increase in IL-33 concentration (more than 3.40 pg/ml) was observed in 87.0% of patients, and IL-31 (more than 15.08 pg/ml) in 48.1% of patients with RA. An increase in IL-33 alone was observed in 42.2% (65 of 154 patients) with RA, while an isolated increase in IL-31 concentration was observed in only 2 (1.3%) patients. Simultaneous hyperproduction of IL-33 and IL-31 occurred in 69 (44.9%) patients. We revealed positive correlation of clinical and laboratory parameters of RA with cytokine concentration: SDAI correlated with IL-33 (r=0.36; p&lt;0.05); CRP – with IL-31 (r=0.49; p&gt;&lt;0,05) and IL-33 (r=0.40; p&gt;&lt;0.05). Conclusion. Concentrations of IL-31 and IL-33 are elevated in RA patients and correlate with the indices of inflammatory activity of the disease.&gt;&lt; 0.05); CRP – with IL-31 (r=0.49; p&lt; ,05) and IL-33 (r=0.40; p&lt;0.05)Conclusion. Concentrations of IL-31 and IL-33 are elevated in RA patients and correlate with the indices of inflammatory activity of the disease.

Coronavirus infection and psoriasis: relationship and consequences

As numerous scientific data show, despite the fact that patients with severe psoriasis have a high risk of coronavirus infection, COVID-19 in this group proceeds quite easily. However, many specialists have encountered an unusual exacerbation of the psoriatic process already after the infection, the reasons for which may be several. On the one hand, the skin is one of the target organs for SARS-CoV-2, on the other hand, exacerbations may be caused by the immune system response to the infection. The influence of specific therapy on the course of the psoriatic process is also not excluded. But interleukin status of patients with psoriasis is of the greatest interest. It is known that interleukin-6 (IL-6) plays an active role in pathogenesis of COVID-19 and cytokine storm arising at infection. It is also regarded as an indicator of inflammatory activity in psoriasis. In addition, IL-6 is involved in lipid and hepatobiliary disorders in this group of patients. It is also associated with IL-17, the role of which has been well studied in psoriasis and autoimmune hepatitis. Patients with psoriasis often have changes in biochemical blood parameters, similar to those seen with COVID-19. Combinations of all these factors can lead to exacerbation of psoriasis with predominance of erythroderma and toxic component. In our opinion, in such cases it is necessary to include in the therapy a systemic hepatoprotective drug containing glycyrrhizic acid. It has a pronounced anti-inflammatory effect, inhibits IL-6 production and allows to achieve significant improvement of psoriatic process in a short time.

Difficult-to-treat rheumatoid arthritis in the clinical practice of a rheumatological hospital. First look

Objective: to compare the course of the disease and therapy in rheumatoid arthritis (RA) patients who meet and do not meet the criteria for difficult- to-treat RA (D2T).Patients and methods. The study included RA patients who met the 2010 ACR/EULAR criteria and who were hospitalized in the V.A. Nasonova Research Institute of Rheumatology from March to October 2021. All patients underwent a conventional clinical and laboratory examination, radiography of the hands and distal feet, and the radiological stage of RA according to Steinbroker was assessed. To determine the inflammatory activity, the DAS28-ESR and DAS28-CRP indices were calculated.Results and discussion. The study included 303 patients with RA, 25 (8.4%) of them had D2T RA. The duration of RA in the D2T group was significantly longer than in other patients (15.9±11.8 and 11.9±9 years, respectively; p=0.04). X-ray changes in the joints in D2T were more pronounced. Patients with D2T had higher inflammatory activity at the time of hospitalization than patients who had continued prior therapy with biologic/targeted synthetic DMARDs. The dose of glucocorticoids (GC) in patients with D2T RA was higher compared to patients of other groups: on average 8.3±5.1 and 6.4±2.9 mg/day, respectively (p=0.02).Conclusion. The results of this study suggest that in Russia, as well as abroad, the treat-to-target principle has not yet become widespread, and the selection of adequate therapy takes too much time. At the same time, Russian rheumatologists primarily use GC to suppress inflammatory activity. The introduction of modern recommendations for the management of patients with RA into routine clinical practice, could possibly restrain the formation of D2T RA.

Immunomodulatory and clinical responses to zinc gluconate supplementation in patients with Behçet's disease: A double-blind, randomized placebo-controlled clinical trial

Toll-like receptor (TLR) 2 and 4 are involved in the pathogenesis of Behçet's disease (BD). The current study aimed to investigate the effect of zinc supplementation on TLR-2/4 expression and the clinical manifestations of BD. In this double-blind placebo-controlled randomized clinical trial, 50 BD patients were randomly allocated into either zinc gluconate (30mg/day) or placebo groups for 12 weeks. Before and after the intervention, the surface and mRNA expression level of TLR-2 and TLR-4 in the leukocytes, serum level of zinc and tumor necrosis factor-α (TNF-α), quality of life, anthropometric measures, and blood pressure of patients were collected. BD activity was studied using the nonocular Iranian Behçet's disease dynamic activity measure (IBDDAM), Behçet's disease current activity form (BDCAF), and total inflammatory activity index (TIAI) at the pre-and post-intervention phases. The effect sizes were compared between two groups using analysis of covariance. There were significant decrease in TLR-2 mRNA (P=0.038) and protein expression (P=0.034) and nonocular IBDDAM score (P=0.046) in the zinc group compared to placebo at the endpoint. The serum level of zinc was increased in the zinc group (P<0.001). Zinc supplementation significantly decreased the TLR-4 surface (P=0.012) and mRNA expression (P=0.028) within the group. However, this decrease was not significant compared to the placebo group. There was no significant difference between the two groups regarding the serum level of TNF-α, BDCAF, TIAI, quality of life, anthropometric measures, and blood pressure (P>0.05). The present study revealed that zinc supplementation significantly improved nonocular IBDDAM score and TLR-2 expression in BD patients. NCT05098678.

The evaluation of bone marrow edema in sacroiliac joint in patients with ankylosing spondylitis using magnetic resonance imaging Dixon sequence

BackgroundBone marrow edema of the sacroiliac joint is the early imaging manifestation, an indicator of inflammatory activity of ankylosing spondylitis (AS) (Yang R, et. al. Medicine (Baltimore) 98:e14620, 2019).ObjectiveThe aim of the study was to investigate the value of magnetic resonance imaging (MRI) Dixon sequence in the diagnosis of marrow edema of the sacroiliac joint in patients with AS.MethodsForty-five patients with AS admitted in our hospital between November 2016 and February 2019 were selected retrospectively as the case group. Forty-five healthy subjects recruited between November 2016 and February 2019 served as the control group. Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were recorded after admission to the hospital. The Dixon sequence water-fat ratio of the iliac and sacral surfaces of the bilateral sacroiliac joints in the study group were compared with indicators above in order to find the correlation.ResultsThe water-fat ratio under the bilateral sacroiliac joints on Dixon sequence images in the case group was significantly higher than that in the healthy control group (P<0.05). The Dixon sequence water-fat ratio of the iliac and sacral surfaces of the bilateral sacroiliac joints in the study group were positively correlated with spinal arthritis research (SPARCC), BASFI and BASDAI score (all P < 0.05), but did not correlate with ESR and CRP.ConclusionThe water-fat ratio of magnetic resonance Dixon sequence can be used as a reference index to evaluate the degree of bone marrow edema in active stage of sacroiliac arthritis.

Nonspecific adaptive reactions of hen’s body under the influence of light wavelength

The sources of artificial light of the latest generation in poultry farming are LED lamps, which are able to give monochrome light. It is known that the wavelength of light affects the behavior, well-being and productivity of birds, but the effect of changing the wavelength of light under monochrome light has not yet been studied. Nonspecific adaptive reactions of hens under the influence of light wavelength of monochrome light have been studied. For this purpose, in the conditions of a modern complex for food eggs production, 4 groups of hens of industrial herd «Hy-Line W-36» were formed, each of which was kept in a separate poultry house-analogue in terms of area and cage equipment. Hens of the 1st group were kept using LED lamps with a peak light wavelength of 460 nm, the 2nd group — 600 nm, the 3rd group — 630 nm and the 4th group — 650 nm. To assess the adaptive and overall reactive immunological potential of hens, integrated immunohematological indices of intoxication, inflammatory activity and nonspecific reactivity were determined on the ba­sis of an extended general blood test. It was found that a decrease in the wavelength of light increases the indices of leukocyte shift, the heterophiles to leukocytes ratio, immunoreactivity, the heterophiles to monocytes ratio, the lymphocytes to monocytes ratio and the lymphocytes to eosinophils ratio. This indicates a shift of the leukocyte formula to the left, the predominance of nonspecific protective cells due to a functional increase in bone marrow proliferative activity and is expressed in increased heterophiles, increased activity in the microphage-macrophage immune response system and indicates the presence of high levels in the body and impaired immunological reactivity, and can inform about the autoimmune nature of the pathological process. It is shown that at the same time there is a decrease in lymphocytegranulocyte index, leukocyte-ESR ratio, total and lymphocyte indices, which confirms the shift of the leukocyte formula to the left and indicates a predominance of activation of the cellular link due to intoxication. Simultaneous increase in the leukocyte shift index and decrease in the lymphocyte-granulocyte index indicates the development of endogenous intoxication in hens and impaired immunological reactivity due to autointoxication of the body during the destruction of its own cells.

Interrupted course of antitumor necrosis factor alpha therapy versus combined nonsteroidal anti-inflammatory drug therapy and physiotherapy in patients with ankylosing spondylitis: A comparative study

Aim The aim was to evaluate the efficacy of interrupted course of antitumor necrosis factor alpha (TNF-α) blocking agents (etanercept and adalimumab) as 3-month-on-and-3-month-off regimen versus combined regimen of physiotherapy and NSAIDs in patients with ankylosing spondylitis (AS) within a 2-year period. Patients and methods A total of 60 patients who fulfilled the Modified New York Criteria for AS were enrolled in the current study and divided into two equal groups: one received interrupted course of anti-TNFα agents and one received NSAIDs plus physiotherapy. Both groups were subjected to follow-ups at 6, 12, 18, and 24 months. To assess the response, Ankylosing Spondylitis Disease Activity Scores (ASDAS-ESR and ASDAS-CRP) were used, in addition to Bath Ankylosing Spondylitis Disease Activity Index (BASDI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath AS Metrology Index (BASMI). Modified stock Ankylosing Spondylitis Spine Score (M-SASSS) was used to assess the radiological progression. Results The authors found significantly higher improvement in the patient group treated by intermittent course of anti-TNFα agents relative to the other group regarding inflammatory markers, disease activity, and functional index during follow-up. Although there was a significant radiographic progression regarding M-SASSS values in anti-TNFα therapy patients, these values were lower than NSAID patient group. Conclusion Patients with AS can follow regular intermittent course (3 months on and 3 months off) of anti-TNFα blocking agents such as etanercept and adalimumab with possible efficacy and safety. This regimen was found to be successful in improving disease activity and functional impairment in those patients when compared with patients maintained on NSAIDs and physiotherapy.

Эффективность применения голимумаба в лечении анкилозирующего спондилоартрита и ревматоидного артрита (собственный опыт)

Genetic engineering drugs are used to treat rheumatic diseases. Based on the results of multicenter studies, the effectiveness and safety of golimumab, a representative of the group of tumor necrosis factor inhibitors in various categories of patients, was proved.. Purpose of research.To evaluate the effectiveness of golimumab in the treatment of ankylosing spondylitis and rheumatoid arthritis. Material and methods. The efficacy of golimumab was analyzed based on clinical and laboratory data in 7 patients with ankylosing spondylitis and 6 patients with rheumatoid arthritis. These studies are described against the background of a one-year follow-up of patients. Results and discussion. The observation group consisted of 7 patients with ankylosing spondylarthritis (as) and 6 patients with a diagnosis of rheumatoid arthritis. In all patients with (as) at the beginning of the study, the BASDAI index &gt;6 points, and in 5 patients, the ASDASRB index was 3.5±0.45. In 4 patients with the diagnosis (as), the BASFI index was 7±0.67, and in three patients-5±0.3. the BASMI Index in all studied patients revealed pronounced disorders and was 7.5±0.85. Positive dynamics was observed during golimumab therapy. A patient with a high degree of BASDAI activity &gt;6 showed improvement on the 4th injection of golimumab, the Average score of BASDAI and BASFI indices on golimumab was lower by the 20th week, compared with the start of therapy. By the 24th week of therapy, the BASDAI index was down 31%. The follow-up group with the diagnosis of rheumatoid arthritis consisted of 6 patients, including 1 male and 5 female, with an average age of 38±0.5 years. In a male patient, the DAS-28 index was 5.2±0.06, the SDAI index was 27±0.05, and the CDAI index was 23±0.03. In women, the DAS-28 index was 3.8±0.03, and the SDAI index was 19±0.3 in 5 patients, and the CDAI index was 20±0.3. after adding golimumab, the General condition of all patients improved clinically after the second injection, and all indicators of inflammatory activity decreased. Golimumab is a human monoclonal antibody to tumor necrosis factor (TNF)α. The effect of golimumab is due to the binding and neutralization of soluble and membrane-bound forms of TNF)α. TNF)α. it is a cytokine detected in patients with rheumatoid arthritis, ankylosing spondylarthritis. Conclusion. Against the background of the use of golimumab, the clinical effect was noted in the form of complete relief of joint pain and positive dynamics according to the studied laboratory parameters. Keywords: rheumatoid arthritis, ankylosing spondylitis, golimumab, efficacy.

Effects of Anticoagulants on Experimental Models of Established Chronic Liver Diseases: A Systematic Review and Meta-Analysis.

Objective The role of anticoagulants in chronic liver diseases is inconclusive. A meta-analysis was thus undertaken to evaluate treatment-related survival and antifibrotic effects in animal models of chronic liver diseases. Methods A systematic search of the literature took place (up to November 2020), screening for preclinical studies that evaluated anticoagulant effects in animal models of chronic liver diseases. We assessed the quality of methods and the certainty of evidence. Data on outcomes were extracted and pooled into random-effects models. Results Sixteen studies proved eligible, each assessing anticoagulant use in animals with chronic liver diseases. Generally, the pooled evidence demonstrated that the administration of anticoagulants is preventive against fibrogenesis, as indicated by METAVIR fibrosis scores (risk ratio = 0.66, 95% confidence interval: 0.47 to 0.94), portal pressure determinations (mean difference = −1.39, 95% confidence interval: −2.33 to −0.44), inflammatory activity (mean difference = −169.69, 95% confidence interval: −257.64 to −81.74), and indices of hepatic injury, specifically alanine aminotransferase (mean difference = −82.7, 95% confidence interval: −107.36 to −58.04), aspartate aminotransferase (mean difference = −186.12, 95% confidence interval: −254.90 to −117.33), albumin (mean difference = 0.59, 95% confidence interval: 0.16 to 1.01), and total bilirubin (mean difference = −0.96, 95% confidence interval: −1.46 to −0.46), and it had no impact on animal survival (risk ratio = 1.03, 95% confidence interval: 0.94 to 1.13). Conclusions Our assessments indicate that in animal models of chronic liver diseases, anticoagulants may alleviate the degree of fibrosis evaluated by the METAVIR score system, portal pressure, inflammatory activity, and serum indices of hepatocellular injury, without impacting survival. High-quality experimental studies are still required.