Abstract:The article presents data on the effectiveness of the impact of selenium on clinical and laboratory parameters of rheumatoid arthritis (RA) in patients with subclinical hypothyroid dysfunction (SHTD). Aim -to study the influence of selenium on the clinical and laboratory parameters in patients with RA and SHTD. Material and Methods -The study included 78 patients with RA and SHTD. All patients underwent a complete clinical and functional, instrumental and laboratory examination for RA and thyroid dysfunction. Sodium selenite was added to the standard therapy of rheumatoid arthritis drug. Results -Our study showed that RA patients with concomitant SHTD after treatment with a complex scheme, which included the preparation of sodium selenite, improved articular syndrome activity of rheumatoid inflammation, reduced levels of thyroid stimulating hormon (TSH) and antithyroidperoxidase (aTPO), reduced the number of patients with elevated levels of aTPO (p<0.05). Conclusion -The use of sodium selenite in the treatment of RA patients with SHTD is an effective method of correction of the articular syndrome, reducing the levels of markers of inflammation and autoimmune manifestations of the whole process, which is very important and necessary to prevent the progression of the disease.
Ингибиторы ангиотензинпревращающего фермента (иАПФ) обладают противовоспалительными, антипролиферативными свой-ствами и могут влиять на процессы ангиогенеза через снижение эффектов ангиотензина II (АТІІ). Применение иАПФ в комплекс-ной терапии ревматоидного артрита (РА) может быть эффективно и для контроля активности заболевания, и для снижения ри Angiotensin-converting enzyme (ACE) inhibitors have anti-inflammatory and antiproliferative properties and can affect the processes of angiogenesis, by reducing the effects of angiotensin II (ATII). The use of ACE inhibitors in the combination
The aim of the investigation was to evaluate the impact of genetically engineered biologic drugs (gEBD) -infliximab and rituximab -on endothelium functional state in patients with rheumatoid arthritis (RA) without any concomitant cardiovascular diseases.Materials and Мethods. The study involved 77 patients with RA aged from 18 to 50. The patients matched ACR (1987) or ACR/EuLAR (2010) classification criteria, had no concomitant cardiovascular diseases, and had at least a two-year RA history. Based on the immunological subtype and the type of therapeutic intervention, the patients were divided into 4 groups. We assessed vasomotor endothelial function at micro-and macrocirculatory levels using AngioScan-01 device (AngioScan-Electronics, Russia) before treatment and after 12 months of treatment.Results. RA patients were found to have the signs of endothelial dysfunction in micro-and macrocirculatory vasculature, being more prominent in RF/CCPA-positive (rheumatoid factor/cyclic citrullinated peptide antibodies) disease subtype. Endothelial dysfunction manifestations included the decrease of occlusion index in amplitude and the value of phase shift between the channels after a reactive hyperemia test; the values of these parameters correlating to RA duration, DAS 28 (disease activity score), rheumatoid factor level and CCPA concentration. The use of genetically engineered biologic drugs in RA patients was accompanied by a significant decrease of DAS 28 index, as well as by the reduction of endothelial vasomotor dysfunction signs. Both groups of RF/CCPA-negative patients, regardless of a therapeutic intervention type, were found to have the increase of occlusion index in amplitude up to the control values; as compared with the baseline values, the phase shift between the channels increased on average by 1.5 times (p=0.008) during infliximab use, and during rituximab treatment it grew by 1.6 times (p=0.024). In RF/CCPA-positive RA occlusion index in amplitude increased by 23.5% (p=0.005) after infliximab therapy and by 48.8% (p=0.001) during rituximab treatment; the value of phase shift between the channels increased on average by 1.3 times (p=0.028) in RA patients receiving infliximab, while in a group of patients taking rituximab this value was no different from that in the control group.Conclusion. genetically engineered biologic drug therapy, along with its high anti-inflammatory activity, produces a vasoprotective effect characterized by improved endothelial functional state in the system of small resistive vessels as well as in large muscular arteries. The higher activity of rituximab endothelial protective effect is achieved in RF/CCPA-positive disease subtype, and the use of infliximab has the greater effect on endothelial function in RF/CCPA-negative RA.
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