An angiotensin-converting enzyme inhibitor in the combination treatment of rheumatoid arthritis

Комарова, Е Б; Ребров, Б. А.; Knyazeva, Antonina K.

doi:10.14412/1996-7012-2017-3-72-76

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…They significantly influence pathogenesis [16]. The important role of vascular lesions in the development of RA was confirmed by a number of studies [17,18].…”

Section: Discussionmentioning

confidence: 88%

Duration Of Rheumatoid Arthritis Changes Blood Levels Of Angiotensin And Aldosterone

Rebrov,

Komarova,

Knyazeva

2023

Russ Open Med J

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The article presents data on the influence of rheumatoid arthritis (RA) duration on changes in blood levels of angiotensin (ATII) and aldosterone (ALD). Objective — To examine the changes in the activity of the renin-angiotensin-aldosterone system (RAAS) depending on the time elapsed from the onset of RA (i.e., on the stage of the disease development). Methods – We examined 184 patients diagnosed with RA (sensu the ACR/EULAR 2010 criteria) without concomitant pathology. The control group (CG) consisted of 34 virtually healthy individuals. The serum concentrations of ATII and ALD were determined by the enzyme-linked immunosorbent assay (ELISA). Results — When assessing the studied parameters of the RAAS, we discovered that in all examined RA patients, the level of ATII and ALD in the blood was more than twice as high as that in the CG (p<0.001; p<0.010). ATII concentration decreased unevenly with increasing disease duration. The differences of the group of patients with a duration of RA less than 6 months were not statistically significant with the groups of patients of 0.6-1.0 and 2.1-3.0 years (p>0.050), while the differences with patients with a disease duration of 1.1-2.0, 3.1-4.0, and >5 years were statistically significant (p<0.050). Further comparative analysis of the indicators revealed statistically significant differences between the group of patients of 0.6-1.0 years and patients with RA duration of 3.1-4.0 and >5 years (p<0.050), as well between patients with RA duration of 1.1-2.0 and 4.1-5.0 years (p<0.050). The blood content of ALD increased unevenly in patients: from the minimum to the maximum disease duration. In individuals with a duration of RA<0.5 years, the differences were significant (p<0.05), with the exception of the group of 0.6-1.0 years (p>0.05). In patients with a disease duration of 0.6-1.0 and 1.1-2.0 years, the differences were statistically significant with all subsequent groups of RA duration (p<0.05). Further mathematical processing of data using multiple regression analysis and determination of correlations showed the presence of a linear inverse relationship between the ATII level and the duration of the disease (R=-0.44, p<0.001; F=10.98, p=0.001). Data processing also revealed strong direct correlations between the level of ALD in the blood and the duration of the disease (R=0.4999, p<0.001; F=58.27, p<0.001). Conclusion — The RAAS is heterogeneous and its integration into a single system is ambiguous. The significance of various components of the RAAS in RA is determined by the pathophysiological processes in the patient’s body. Blocking of various components of the RAAS should be differentiated and either correspond to some specific levels of indicators for each patient, or match to the stages of RA associated with the duration of the disease.

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“…They significantly influence pathogenesis [16]. The important role of vascular lesions in the development of RA was confirmed by a number of studies [17,18].…”

Section: Discussionmentioning

confidence: 88%

Duration Of Rheumatoid Arthritis Changes Blood Levels Of Angiotensin And Aldosterone

Rebrov,

Komarova,

Knyazeva

2023

Russ Open Med J

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“…TNF-α antagonists (infliximab, adalimumab or etanercept) are capable of decreasing activity of RA by levelling the endothelial dysfunction, inhibition of synthesis of adhesins and vascular endothelial growth factor [11-13, 16, 17]. Certolizumab, in vitro, suppressed TNF-α induced expression of adhesins and secretion of chemokines by endotheliocytes [18], and intake of inhibitors of aldosterone and angiotensin converting enzyme in patients with RA capable of highly expressed decline in the levels of ICAM-1, vascular endothelial growth factor, TNF-α, acute phase proteins in blood, and improved indicators of vasodilation [19].…”

Section: Internal Diseasesmentioning

confidence: 99%

“…Beneficial involvement of treatment procedures on the levels of adhesion molecules in RA are likely related with suppression in production of proinflammatory cytokines [17], since expression of adhesins on significant extent is related by its effects, with decreased oxidative stress [20] and with decreased activity of angiotensin II and aldosterone [19].…”

Section: Internal Diseasesmentioning

confidence: 99%

Biological therapy of rheumatoid arthritis: is it a real prediction of efficacy?

Vladimirovich¹,

Jawahar²,

Valentinovich³

2018

Medical news of the North Caucasus

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БИоЛоГИЧЕСКая ТЕраПИя рЕвмаТоИдНоГо арТрИТа: рЕаЛЬНа ЛИ ПрЕдИКЦИя ЭФФЕКТИвНоСТИ? П. в. Корой, в. д. Саритхала, а. в. ягода Ставропольский государственный медицинский университет, российская Федерация Relationship of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), plateletendothelial cell adhesion molecule-1 (PECAM-1), E-, P-and L-selectins blood levels with results of three-monthly combination treatment by biological agents and methotrexate was studied in 35 patients with rheumatoid arthritis (29 women, 6 men) at age from 40 to 66 with previous noneffective methotrexate treatment. Tocilizumab was applied in 20 patients, in 15 cases etanercept was used. The moderate effect of treatment was observed in 74.3 % of cases, remission or low activity of rheumatoid arthritis were reached in 22.9 % of patients, 9 patients were non-responders. Increase of blood concentration of all immunoglobulins superfamily molecules and of P-selectin was observed in rheumatoid arthritis. After 3 months of therapy decrease in VCAM-1, PECAM-1 blood levels and normalization of ICAM-1, P-selectin values were observed, especially in cases of effective treatment, in non-responders there was reduction only of ICAM-1 levels. The favorable response to treatment was associated with high initial levels of ICAM-1, РЕСАМ-1 and low levels of P-selectin in blood that opens new possibilities of use of adhesion molecules in prediction of successful therapy of RA.

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Endothelial function and its role in the formation of cardiovascular pathology in patients with rheumatoid arthritis

et al. 2019

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Currently rheumatoid arthritis is considered as an immune inflammatory disease of unknown origin characterized by chronic erosive arthritis and systemic damage of internal organs, leading to early disability and reduced life expectancy. Cardiovascular diseases are most often mentioned as factors of poor prognosis in rheumatoid arthritis. Pathology of the cardiovascular system in rheumatoid arthritis is usually associated with the macro- and microvascular changes and rheumatoid lesions of the heart. The leading factor in the damage of the vascular wall in rheumatoid arthritis is systemic inflammation affecting its viscosity and elastic properties, increased rigidity, impaired endothelial function. Endothelial dysfunction is currently regarded to as an initial stage of morphogenesis of various vascular disorders. It is considered as a subclinical marker of cardiovascular diseases and the earliest predictor of cardiovascular complications. From this point of view study of endothelial dysfunction in patients with rheumatoid arthritis aimed at determining cardiovascular risk is a perspective direction. Only single and fragmentary information about certain endothelial functions in patients with rheumatoid arthritis and substances released in this. There is no clear analysis of relationship between them and dependence on the process activity. Not clear is their role in the pathology of the vascular wall in rheumatoid arthritis. This literature review discusses the problem of endothelial dysfunction in rheumatoid arthritis patients as well as its role in the development of cardiovascular diseases in these patients. The development mechanisms and the role of immune inflammation in its formation are considered. Also the association was found between chronic inflammatory activity indicators in rheumatoid arthritis and various biological markers and development of endothelial dysfunction. The effects of antirheumatic treatment on endothelial dysfunction in these patients were analyzed.

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An angiotensin-converting enzyme inhibitor in the combination treatment of rheumatoid arthritis

Cited by 3 publications

References 14 publications

Duration Of Rheumatoid Arthritis Changes Blood Levels Of Angiotensin And Aldosterone

Duration Of Rheumatoid Arthritis Changes Blood Levels Of Angiotensin And Aldosterone

Biological therapy of rheumatoid arthritis: is it a real prediction of efficacy?

Endothelial function and its role in the formation of cardiovascular pathology in patients with rheumatoid arthritis

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