rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2022-57-63rsp-3117Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHДинамика аутоантител к топоизомеразе I на фоне лечения ритуксимабом у больных системной склеродермиейAnti-topoisomerase 1 antibody level changes after B сell depletion therapy in systemic sclerosishttps://orcid.org/0000-0002-3248-6426АнаньеваЛ. П.AnanyevaL. P.

Ананьева Лидия Петровна

115522, Москва, Каширское шоссе, 34а

Lidia Ananyeva

115522, Moscow, Kashirskoye Highway, 34A

ananieva@irramn.ruhttps://orcid.org/0000-0002-5012-0540ГарзановаЛ. А.GarzanovaL. A.

115522, Москва, Каширское шоссе, 34а

Lyudmila A. Garzanova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-3650-7658КоневаО. А.KonevaO. A.

115522, Москва, Каширское шоссе, 34а

Olga A. Koneva

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-1004-9647СтаровойтоваМ. Н.StarovoytovaM. N.

115522, Москва, Каширское шоссе, 34а

Mayya N. Starovoytova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-0283-9681ДесиноваО. В.DesinovaO. V.

115522, Москва, Каширское шоссе, 34а

Oxana V. Desinova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-2667-4284ОвсянниковаО. Б.OvsyannikovaO. B.

115522, Москва, Каширское шоссе, 34а

Olga B. Ovsyannikova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-4688-9637ШаяхметоваР. У.ShayakhmetovaR. U.

115522, Москва, Каширское шоссе, 34а

Rushana U. Shayakhmetova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-3246-1157ЧеркасоваМ. В.CherkasovaM. V.

115522, Москва, Каширское шоссе, 34а

Mariya V. Cherkasova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0001-6686-0896АлексанкинА. П.AleksankinA. P.

115522, Москва, Каширское шоссе, 34а

Andrey P. Aleksankin

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-1598-8360НасоновЕ. Л.NasonovE. L.

115522, Москва, Каширское шоссе, 34а

119991, Москва, ул. Трубецкая, 8, стр. 2

Evgeny L. Nasonov

115522, Moscow, Kashirskoye Highway, 34A

119991, Moscow, Trubetskaya str., 8, building 2

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияV.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Russian Federation20222802202260157–63Copyright © Ананьева Л.П., Гарзанова Л.А., Конева О.А., Старовойтова М.Н., Десинова О.В., Овсянникова О.Б., Шаяхметова Р.У., Черкасова М.В., Алексанкин А.П., Насонов Е.Л., 20222022Ананьева Л.П., Гарзанова Л.А., Конева О.А., Старовойтова М.Н., Десинова О.В., Овсянникова О.Б., Шаяхметова Р.У., Черкасова М.В., Алексанкин А.П., Насонов Е.Л.Ananyeva L.P., Garzanova L.A., Koneva O.A., Starovoytova M.N., Desinova O.V., Ovsyannikova O.B., Shayakhmetova R.U., Cherkasova M.V., Aleksankin A.P., 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/3117

Целью исследования было изучение связи между динамикой уровней антинуклеарных факторов (АНФ) и аутоантител к топоизомеразе I (анти-Топо 1) у пациентов с системной склеродермией (ССД) и эффективностью терапии ритуксимабом (РТМ).Материал и методы. В исследование было включено 88 пациентов (73 женщины) со средним возрастом 47 (17–71) лет. Средняя длительность болезни составила 5,9±4,8 года. Средний период наблюдения превысил 2 года (27 (12–42) мес.).Результаты. В конце исследования статистически значимо снизились выраженность кожного фиброза и индекс активности заболевания, улучшились показатели легочной функции, была уменьшена суточная доза преднизолона. Статистически значимо уменьшилось число пациентов с высокими титрами АНФ, снизились средние значения титра aнти-Тoпo 1, при этом между АНФ и анти-Топо 1 выявилась умеренная положительная статистически значимая корреляция (r=0,403). В группе пациентов, позитивных по aнтиТoпo 1, снижение индекса активности, увеличение форсированной жизненной емкости и диффузионной способности легких, степень деплеции В-лимфоцитов были статистически значимо более выраженными по сравнению с анти-Топо 1-негативными пациентами.Заключение. У пациентов с системной склеродермией применение РТМ приводит к снижению титров АНФ и анти-Топо 1, ассоциирующемуся с клинической эффективностью терапии. Можно предположить, что терапия РТМ особенно показана при субтипе ССД, связанном с гиперпродукцией анти-Топо 1.

The aim of our study was to assess the relationship between the changes of antinuclear autoantibodies (ANA) and autoantibodies to topoisomerase 1 (anti-Topo 1) in systemic sclerosis (SSc) patients on rituximab (RTX) therapy.Materials and methods. The prospective study included 88 patients (73 women) with a mean age of 47 (17– 71) years. The mean disease duration was 5.9±4.8 years. The mean follow-up period was more than 2 years (27 (12–42) months).Results. We documented a statistically significant change in skin score, the disease activity index, improvement of pulmonary function and reduction of mean dose of prednisolone after RTX treatment. There was a significant decrease in the number of patients with high levels of ANA and overall decrease of the ANA and anti-Topo 1 levels. A moderate positive statistically significant correlation was found between ANA and anti-Topo 1 (r=0.403). In the group of patients positive for anti-Topo 1 there were a more pronounced depletion of B lymphocytes, significantly higher increase in forced vital capacity and diffusion capacity, decrease in the disease activity index, compared with a patients negative for anti-Topo 1.Conclusions. We observed the decline in the level of ANA and anti-Topo 1 in SSc patients after RTX therapy and it was correlated by an improvement of the main outcome parameters of the disease. Therefore, anti-Topo 1 positivity could be considered as a predictor of a better response to RTX treatment, especially in SSc patients with hyperproduction of anti-Topo 1.

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