rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2015-591-595rsp-2148Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHПрименение многопараметрического анализа лабораторных биомаркеров для оценки активности ревматоидного артритаUSE OF MULTIPARAMETER ANALYSIS OF LABORATORY BIOMARKERS TO ASSESS RHEUMATOID ARTHRITIS ACTIVITYНовиковА. А.NovikovA. A.irramnlab@yandex.ruАлександроваЕ. Н.AleksandrovaE. N.ГерасимовА. Н.GerasimovA. N.КаратеевД. Е.KarateevD. E.ПопковаТ. В.PopkovaT. V.ЛучихинаЕ. Л.LuchikhinaE. L.НасоновЕ. Л.NasonovE. L.ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва, Россия 1115522 Москва, Каширское шоссе, 34АРоссияV.A. Nasonova Research Institute of Rheumatology, Moscow, Russia; 34A, Kashirskoe Shosse, Moscow 115522Russian FederationГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия 119991 Москва, ул. Трубецкая, 8, стр. 2РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia 8, Trubetskaya St., Build. 2, Moscow 119991Russian FederationФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва, Россия 1115522 Москва, Каширское шоссе, 34А ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия 119991 Москва, ул. Трубецкая, 8, стр. 2РоссияV.A. Nasonova Research Institute of Rheumatology, Moscow, Russia; 34A, Kashirskoe Shosse, Moscow 115522 I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia 8, Trubetskaya St., Build. 2, Moscow 119991Russian Federation201505022016536591595Copyright © Новиков А.А., Александрова Е.Н., Герасимов А.Н., Каратеев Д.Е., Попкова Т.В., Лучихина Е.Л., Насонов Е.Л., 20162016Новиков А.А., Александрова Е.Н., Герасимов А.Н., Каратеев Д.Е., Попкова Т.В., Лучихина Е.Л., Насонов Е.Л.Novikov A.A., Aleksandrova E.N., Gerasimov A.N., Karateev D.E., Popkova T.V., Luchikhina E.L., Nasonov E.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2148

Регулярный контроль активности заболевания является ключевым компонентом ведения больных ревматоидным артритом (РА). Количественная оценка статуса пациента дает возможность разрабатывать стандартизованные показания для применения противоревматической терапии. Целью данной работы стало выявление лабораторных биомаркеров, способных отражать активность РА.

Материал и методы

Материал и методы. Обследовано 58 пациентов с РА и 30 здоровых доноров, сопоставимых по полу и возрасту с обследованными больными. Больные РА были разделены на группы c высокой/умеренной и низкой активностью заболевания по DAS28. Концентрации 30 биомаркеров в сывортке крови измеряли с использованием иммунонефелометрического метода, иммуноферментного анализа и технологии xMAP.

Результаты и обсуждение

Результаты и обсуждение. Проведение многофакторного анализа позволило выделить факторы, наиболее связанные с высокой/умеренной активностью РА по DAS28: фактор роста фибробластов 2, моноцитарный хемоаттрактантный белок-1, интерлейкины (ИЛ) 1α, 6 и 15, фактор некроза опухоли α – и создать прогностическую модель оценки активности РА. По данным ROC-анализа, данная модель обладает отличной диагностической эффективностью при дифференциации высокой/средней активности РА от низкой. Таким образом, создание независимого от субъективной оценки иммунологического многопараметрического индекса, обладающего более высокой диагностической точностью по сравнению с рутинно используемыми в клинической практике лабораторными показателями, может являться качественно новым этапом в оценке и контроле активности РА.

The key component in the management of patients with rheumatoid arthritis (RA) is regular control of RA activity. The quantitative assessment of a patient’s status allows the development of standardized indications for anti-rheumatic therapy.

Objective

Objective: to identify the laboratory biomarkers able to reflect RA activity.

Subjects and methods

Subjects and methods. Fifty-eight patients with RA and 30 age- and sex-matched healthy donors were examined. The patients were divided into high/moderate and mild disease activity groups according to DAS28. The serum concentrations of 30 biomarkers were measured using immunonephelometric assay, enzyme immunoassay, and xMAP technology.

Results and discussion

Results and discussion. Multivariate analysis could identify the factors mostly related to high/moderate RA activity according to DAS28, such as fibroblast growth factor-2, monocyte chemoattractant protein-1, interleukins (IL) 1α, 6, and 15, and tumor necrosis factor-α and could create a prognostic model for RA activity assessment. ROC analysis has shown that this model has excellent diagnostic efficiency in differentiating high/moderate versus low RA activity.

Conclusion

Conclusion. To create a subjective assessment-independent immunological multiparameter index of greater diagnostic accuracy than the laboratory parameters routinely used in clinical practice may be a qualitatively new step in assessing and monitoring RA activity.

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The authors declare that there are no conflicts of interest present.