Aim of the study: Evaluation the effect of infliximab (I) on traditional indicators of activity and several cytokine, hormonal and endothelial serum biomarkers in patients with rheumatoid arthritis (RA) with different types of metabolic status. Material and Methods. 37 patients with RA (30 women and 7 men) with DAS28 index 7.2-7.4 (associated with normal body mass index-BMI, obesity and cachexia) treated with I and methotrexate were included in this study. In all patients we determined traditional markers of RA activity (DAS28, ESR, C-reactive protein) and serum biomarkerstumour necrosis factor-α (TNF-α), interleukins-6, 10 (IL-6, IL-10), adiponectin, vascular endothelial growth factor (VEGF), cortisol using enzyme linked immunosorbent assay. Results. In all patients we found high activity of RA traditional markers and high levels of TNF-α, IL-6, VEGF before I started. Low initial levels of adiponectin and high levels of cortisol we found in patients with RA associated with obesity. After 22 weeks of I course we determined decreasing of traditional RA markers and TNF-α, IL-6, VEGF in patients with normal BMI. In patients with RA and obesity we found increasing of adiponectin concentration from 2.1 (0.8-3.9) ng/ml to 5.8 (4.9-7.7) ng/ml, decreasing of high TNF-α initial level and no reduction of high IL-6 initial level. Conclusions. Thus, we have found that in general, infliximab therapy may be effective in any variants of metabolic status in patients with RA through beneficial effect with correction of most traditional and serum biomarkers. Because obese patients present a more pronounced pro-inflammatory activation and decreased adiponectin effectiveness of the biological therapy may be reduced in this group.
Phenotypical and functional heterogeneity of immune regulating subpopulations of T-lymphocytes having suppressor activity is discussed in the article. Natural regulators and inducible regulating cells are characterized in more details.
The aim of the investigation was to study the functional-morphological state of kidney in patients with rheumatoid arthritis (RА). Examination was performed on 75 patients with RA and 25 healthy subjects. In addition to complete clinical and instrumental examination accepted in specialised clinic, biopsy of kidney was conducted. At 62 patients changes in an urinary deposit are taped. According to 25 nephrobiopsies in 12 cases took place mesangioproliferative variant of a chronic glomerulonephritis, the amyloidosis was detected at 5 patients, in 8 cases - vascular changes, the weak and moderate phenomena of a productive vasculitis of arterioles, the capillaries, accompanied by a focal perivascular sclerosis. Nephroprotective effect of basic therapy of RА was found.
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