Coronavirus disease 2019 (COVID-19) pandemic and autoimmune rheumatic diseases: Outcomes and prospects

Rheumatology Science and Practice, Journal Year: 2024, Volume and Issue: 62(1), P. 32 - 54

Published: Feb. 29, 2024

The pandemic of coronavirus disease 2019 (COVID-19), etiologically related to the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus-2), has drawn attention new clinical and fundamental problems in immunopathology human diseases associated with virus-induced autoimmunity autoinflammation. provision that “the experience gained rheumatology process studying pathogenetic mechanisms pharmacotherapy immunoinflammatory rheumatic as most common severe forms autoimmune autoinflammatory pathology humans will be demand for deciphering nature pathological processes underlying COVID-19 developing approaches effective pharmacotherapy” was confirmed numerous studies conducted over next 3 years midst pandemic. main focus on a critical analysis data regarding role inflammation, which basis pathogenesis immune-mediated context COVID-19.

Language: Английский

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Клинический случай применения биореруляционного препарата для лечения энтезопатий при псориатическом артрите

Published: Feb. 21, 2025

У пациентки 50 лет с достоверным диагнозом псориатического артрита на фоне лечения нестероидными противовоспалительными препаратами (НПВП) развилось осложнение в виде экзокринной недостаточности поджелудочной железы синдромом диспепсии, не позволившее продолжить противовоспалительную терапию согласно клиническим рекомендациям. Представленный клинический случай призван продемонстрировать врачам-специалистам возможности применения биорегуляционных препаратов лечении пациентов аутовоспалительными заболеваниями. Особенностью описанного клинического случая является «мягкое» течение артрита, преимущественно проявляющееся у энтезопатиями различной локализации, а также болями и скованностью нижней части спины без ярко выраженных артритов. Окончательный диагноз был верифицирован 2018 году после развертывания полной клинической картины заболевания, позволившей диагностировать псориатический артрит критериям CASPAR. Инициированная базисная противовоспалительная терапия метотрексатом дозе 12,5 мг неделю комбинации нимесулидом 200 день была отменена 2021 виду достижения ремиссии заболевания. В связи рецидивом симптомов летом 2024 года нарастания болей области энтезисов скованности суставах, пациентка возобновила прием НПВП увеличила дозу нимесулида до 400 день, что спровоцировало развитие серьезного нежелательного явления – железы, потребовавшей госпитализации пациентки. последствии амбулаторном этапе лечения, находясь под наблюдением врача-гастроэнтеролога, обратилась к врачу-ревматологу выраженными (70 мм из 100 по визуально-аналоговой шкале) воспалительного характера левом коленном суставе, локализующимися верхнего края надколенника, больших вертелов бедренных костей местах прикрепления ахилловых сухожилий пяточной кости. По результатам УЗИ левого коленного сустава установлена причина - энтезит латеральной головки четырехглавой мышцы бедра признаков артрита. Принимая во внимание невозможность использования НПВП, пациентке было выполнено трехкратное введение Траумель® C (Traumeel® S) 2,2 мл область навигацией периодичностью 1 раз неделю, дополнена назначением таблетированной формы C. Через месяц терапии биорегуляционным препаратом при УЗИ-контроле колена отмечена положительная динамика «стихания» проявлений энтезита, снижение уровня боли суставах 70 10 шкале. Пациентка повторном визите через отметила значительное улучшение своего состояния, практическое полное прекращение спины. практике демонстрирует успешное применение многокомпонентным энтезопатий псориатическим артритом условиях невозможности нестероидных противовоспалительных препаратов.

Language: Русский

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Efficacy, safety and prospects of using a combination of native type II collagen, methylsulfonylmethane, boswellic acids, vitamin C and vitamin D₃ in knee osteoarthritis: a resolution of the Expert panel

Terapevticheskii arkhiv, Journal Year: 2024, Volume and Issue: 96(1), P. 68 - 74

Published: Jan. 25, 2024

A meeting of the Expert Council on September 9, 2023 considered last challenges in treatment osteoarthritis (OA) including OA comorbid patients. Leading experts rheumatology, traumatology and other relevant disciplines participated meeting. The key goal was discussion potential application a combination undenatured (native) type II collagen, methylsulfonylmethane, boswellic acids, vitamins C D (Artneo complex) as part complex therapy. concluded that Artneo for stage I–III knee patients is not just non-inferior comparison with chondroitin sulfate glucosamine hydrochloride but excels it decrease magnetic resonance imaging synovitis markers dynamics Lequesne index severity. proven efficacy favorable safety profile 6-months course deserve attention medical community active implementation into ambulatory practice, first all, mild or moderate and/or burdened comorbidities.

Language: Английский

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Pharmacotherapy of autoimmune rheumatic diseases – from monoclonal antibodies to CAR T cells: 20 years later

Rheumatology Science and Practice, Journal Year: 2024, Volume and Issue: 62(3), P. 262 - 279

Published: June 26, 2024

Autoimmunity is a pathological process associated with violation of immunological tolerance to normal structural components the body (autoantigens), predominance active (adaptive) immunity and manifested by hyperproduction autoantibodies. Systemic autoimmune rheumatic diseases (SARDs) are among most common severe nosological forms this pathology autoimmunity. Problems pharmacotherapy SARDs subject intensive research. At beginning 21st century, more than 20 biologic agents were developed for treatment rheumatoid arthritis – monoclonal antibodies (mAbs) recombinant proteins that control inflammation overproduction “pro-inflammatory” cytokines, use which has dramatically improved results pharmacotherapy. However, much less research been devoted studying possibilities aimed at selective suppression “autoimmune” component pathogenesis SADRs uncontrolled activation B cells restoration autoantigens. In spectrum drugs whose mechanism action cells, leading place occupied rituximab (RTM). It noteworthy years ago (2004), group researchers led prof. J.C. Edwards first demonstrated effectiveness RTM in patients RA, was soon successfully repositioned treat wide range SARDs. A major achievement CAR (сhimeric antigen receptor) T cell therapy, refractory hematological tumors. The main CART-cells genetically engineered T-cell receptor recognizes target without participation histocompatibility complex. Although limited, extremely impressive data regarding high remission rates have obtained adapting CD19 CART-cell therapy systemic lupus erythematosus (SLE) other standard immunosuppressive medications. article discusses SLE prospects further

Language: Английский

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The role of NETosis in the pathogenesis of immunoinflammatory rheumatic diseases

Rheumatology Science and Practice, Journal Year: 2023, Volume and Issue: 61(5), P. 513 - 530

Published: Oct. 27, 2023

Uncontrolled activation of neutrophils is considered an important mechanism thromboinflammation and fibrosis in immunemediated rheumatic diseases (IMRD), malignant neoplasms, atherosclerosis, COVID-19 many other acute chronic inflammatory humans. Particular attention has been drawn to the ability form “network” (web-like) structures, called “neutrophil extracellular traps” NETs. The process associated with formation NETs weakening their degradation “NETosis”. publication summarizes data on role NETosis pathogenesis IMRD discusses prospects for pharmacotherapy aimed at preventing destruction

Language: Английский

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Relation of cytokine profile and antibody values to post-translational protein modifications in patients with rheumatoid arthritis (preliminary data)

Rheumatology Science and Practice, Journal Year: 2024, Volume and Issue: 62(2), P. 186 - 191

Published: April 28, 2024

The aim of the study was to investigate relationship between cytokine levels and values antibodies cyclic citrullinated peptide (anti-CCP) carbamylated proteins (anti-CarP) in patients with rheumatoid arthritis (RA). Materials methods. 106 a reliable diagnosis were included study. Determination anti-CarP anti-CCP performed by enzyme immunoassay. Patients divided into subgroups depending on anti-CarP. concentration 27 cytokines serum determined using multiplex xMAR technology. Results discussion. When comparing immunological subgroups, anti-CCP(+) had higher concentrations interleukin (IL) 1β, IL-1Ra, IL-2, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IL-17, fibroblast growth factor, granulocyte colony-stimulating factor (CSF), granulocyte-macrophage CSF, interferon (IFN) γ, IFN0γ-induced protein 10, monocyte chemoattractant 1, macrophage inflammatory 1α (MIP-1α), transforming bb, tumor necrosis α vascular endothelial factor. IL-5, IL-9, eotaxin, MIP-1β RANTES (regulated activation, normal T cell expressed secreted) anti-CCP(–) patients. In subgroup patients, an inverse correlation found IL-5 total Sharpe score, IL-9 DAS28-CRP (Disease Activity Score C-reactive calculation). anti-Carp(–) (n=73) IL-17 recorded. Conclusion. Our data support concept RA heterogeneity, characterised existence different clinical subtypes, which may have implications for improving personalised therapy.

Language: Английский

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Achievements of rheumatology in the XXI century: contribution of Russian rheumatology

Clinical Medicine (Russian Journal), Journal Year: 2024, Volume and Issue: 102(3), P. 197 - 204

Published: June 1, 2024

Rheumatology is one of the most rapidly developing medical specialties, which effectively adapts achievements and contributes to progress world fundamental clinical science [1]. Such immuno-inflammatory rheumatic diseases (IVRS) both rheumatoid arthritis (RA) systemic lupus erythematosus (SLE) are not only severe chronic inflammatory human diseases, but also “models” for studying mechanisms pathogenesis approaches pharmacotherapy other associated with development autoimmunity and/or auto-inflammation. The relevance problem IVR modern medicine determined by their high prevalence in population, difficulty early diagnosis, rapid disability an unfavorable life prognosis. Deciphering immunopathogenesis, improving diagnostics, molecular taxonomy, prevention, searching new “targets” therapy based on “omix” technologies artificial intelligence among priority areas biology XXI century.

Language: Английский

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Some features of osteogenesis in ankylosing spondylitis and the possibilities of treatment with bisphosphonates

Modern Rheumatology Journal, Journal Year: 2024, Volume and Issue: 18(3), P. 85 - 91

Published: June 15, 2024

Despite the high efficacy of currently available targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) and biologic DMARDs (bDMARDs), approximately 40 % patients with ankylosing spondylitis (AS) fail to achieve treatment goals according clinical, laboratory imaging tests. In addition, comorbidities in AS, which require an integrated approach involving different specialists, may limit use such therapy. view above, as well peculiarities bone metabolism new therapeutic approaches for this disease have recently been sought, one is bisphosphonates. This article discusses some aspects unconventional options – bisphosphonates AS complicated by severe comorbidities, insufficient bDMARDs and/or DMARDs.

Language: Английский

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The clinical significance of iron metabolism disorders in patients with high activity of rheumatoid arthritis

Rheumatology Science and Practice, Journal Year: 2024, Volume and Issue: 62(3), P. 286 - 292

Published: June 26, 2024

Aim – to study the clinical manifestations of rheumatoid arthritis (RA) and spectrum concomitant diseases, depending on level hepcidin in patients with high inflammatory activity. Material methods. The analysis included 78 (48.9±15.5 years) RA, disease duration 108 [48; 204] months. All were diagnosed or medium activity (DAS28-ESR (Disease Activity Score 28 erythrocyte sedimentation rate detection 5.2). Indicators iron metabolism, levels interleukin 6 determined. Three subgroups identified: subgroup I serum below reference values (less than 40 pg/ml); II within (40–120 III (more 120 pg/ml). Results. It was found that RA activity, regardless hemoglobin level, disorders metabolism noted 83% cases. Reduced 40% cases (subgroup I), average, very detected every second (n=34; III). main DAS28 comparable all three subgroups. largest number diseases hepcidin. Chronic obstructive pulmonary (26%), endocrine pathology 22% (diabetes mellitus, thyroid obesity), chronic kidney (21%) cardiovascular (60%) significantly more common (p<0.05). With deficiency, most gastrointestinal tract damage 35% (erosive gastritis, peptic ulcer stomach duodenum, etc.), system (32%). In same subgroup, one ten had a change two classes bDMARDs/tsDMARDs by time study. Conclusion. results this illustrate need for further pathogenetic pathways order form scientifically sound approaches personalized treatment wide range immunoinflammatory rheumatic including RA.

Language: Английский

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Classical proinflammatory cytokines in patients with rheumatoid arthritis: immunologic and clinical relationships

Patient-Oriented Medicine and Pharmacy, Journal Year: 2024, Volume and Issue: 2(3), P. 13 - 20

Published: Oct. 31, 2024

Relevance. Activation of innate and acquired immunity, accompanied by increased production classical (interleukin (IL) IL-1β, IL-6, tumor necrosis factor-α (TNF-α) interferon-γ (INF-γ)) proinflammatory cytokines in synovial fluid blood serum, plays an important role the pathogenesis rheumatoid arthritis (RA). Objective. To determine concentration TNF-α INF-γ RA patients advanced stage disease, to evaluate relationship between them, clinical indices disease activity, presence factor (RF), antibodies cyclic citrullinated peptide (ACCP). Material methods. We examined 154 with (41 men 113) who were middle-aged (56.0 (50.0; 64.0) years), duration (9.4 (3.0; 13.0) seropositive 129 (83.8 %) for IgM RF and/or 106 (68.8 ACCP moderate high (DAS28-ESR — 5.40 (4.65; 6.00)) activity. The serum determined multiplex technology. Results. IL-1β was not significantly different controls. values IL-6 higher, lower than donors. hyperproduction detected most frequently (51.6 %), whereas elevated levels (38.96 (26.62 (23.38 less common. Significant positive correlations observed concentrations all their levels. strongest characteristic INF-γ. No statistically significant differences cytokine or negative IgM-RF ACCP. alone positively correlated (DAS28-ESR, CDAI, SDAI) activity (p<0.05). Conclusions. There are frequencies among advanced-stage RA. In a close there certain associations laboratory indicators

Language: Английский

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