rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2022-72-79rsp-3119Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHСвязь динамики уровня цитокинов с отдаленными результатами терапии раннего ревматоидного артритаRelationship of cytokine level dynamics with longterm results of early rheumatoid arthritis therapyhttps://orcid.org/0000-0003-1404-4963РыбаковаВ. В.RybakovaV. V.

Рыбакова Валерия Владимировна

115522, Москва, Каширское шоссе, 34а

Valeriya Rybakova

115522, Moscow, Kashirskoye Highway, 34A

rybakova.doc@yandex.ruhttps://orcid.org/0000-0003-3057-9175АвдееваА. С.AvdeevaA. S.

115522, Москва, Каширское шоссе, 34а

Anastasia S. Avdeeva

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-3183-0464ДибровД. А.DibrovD. A.

115522, Москва, Каширское шоссе, 34а

Danil A. Dibrov

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-1598-8360НасоновЕ. Л.NasonovЕ. 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 Federation20220103202260172–79Copyright © Рыбакова В.В., Авдеева А.С., Дибров Д.А., Насонов Е.Л., 20222022Рыбакова В.В., Авдеева А.С., Дибров Д.А., Насонов Е.Л.Rybakova V.V., Avdeeva A.S., Dibrov D.A., Nasonov Е.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/3119

Цель работы – изучить связь между динамикой уровня цитокинов в ранний период (первые 12 и 24 недели) фармакотерапии ревматоидного артрита (РА) и отдаленными исходами у пациентов с этим заболеванием.Материал и методы. В анализ было включено 93 пациента с ранним РА. Большинство больных составили женщины (n=77) среднего возраста (58 [49; 66] лет) с ранней стадией болезни (длительность заболевания – 4–11,5 мес.), серопозитивные по IgM ревматоидному фактору (81,7%) и антителам к циклическому цитруллинированному пептиду (73,1%), имевшие высокую (59,7%) или умеренную (38,8%) активность заболевания по DAS28-СОЭ.Концентрацию 27 цитокинов в сыворотке крови, включая интерлейкин (ИЛ) 1β, ИЛ-1 Рa, ИЛ-2, ИЛ-4, ИЛ-5, ИЛ-6, ИЛ-7, ИЛ-8, ИЛ-9, ИЛ-10, ИЛ-12, ИЛ-13, ИЛ-15, ИЛ-17, эотаксин, основной фактор роста фибробластов, гранулоцитарный колониестимулирующий фактор, гранулоцитарно-макрофогальный колониестимулирующий фактор, интерферон γ, интерферон-γ-индуцибельный белок, моноцитарный хемотаксический белок 1, макрофагальный белок воспаления 1α и 1β, трансформирующий фактор роста, хемокин, выделяемый Т-клетками при активации, фактор некроза опухоли альфа, васкулоэндотелиальный фактор роста, определяли с помощью мультиплексной технологии хMАР на анализаторе Bio-Plex Array System (BIORAD, США). Повторно клиническое обследование пациентов проводилось через 6 лет.Результаты. У больных, достигших ремиссии/низкой активности заболевания по SDAI через 6 лет, через 12 недель от начала терапии отмечались более низкие уровни ИЛ-6 (7,7 [7,4; 23,3]) и ИЛ-9 (13,5 [9,1; 18,9]) и через 24 недели от начала лечения – более низкий уровень ИЛ-9 (12,6 [6,8; 16,2]) по сравнению с группой пациентов с умеренной и высокой воспалительной активностью (23,5 [12,4; 69,5], 17,8 [15; 29] и 18,5 [14,2; 22,8] соответственно).Выводы. Оценка уровня провоспалительных цитокинов (ИЛ-6, ИЛ-17), иммунорегуляторного цитокина ИЛ-9 позволяет более полно оценить активность заболевания и выявить группу пациентов, нуждающихся в интенсификации терапии.

The aim of the work – to research the relationship between the dynamics of cytokine levels in the early period (the first 12 and 24 weeks) of pharmacotherapy for rheumatoid arthritis (RA) and long-term outcomes in patients with the disease.Material and methods. The analysis included 93 patients with early RA. The majority of patients were women (n=77), middle-aged (58 [49; 66] years), with an early stage of the disease (the duration of the disease is 7 [4–11.5] months), seropositive according to IgM rheumatoid factor and cyclic citrullinated peptide antibodies, who had high (59.7%) or moderate (38.8%) disease activity.The concentration of 27 cytokines in the blood serum was determined with the help of multiplex xMAP technology on the Bio-Plex array system analyzer (BIORAD, USA). Repeated clinical examination of patients was carried out after 6 years.Results. Patients who achieved remission/low disease activity SDAI after 6 years had a lower level of IL-6 (7.7 [7.4; 23.3]), IL-9 (13.5 [9.1; 18.9]) 12 weeks after the start of therapy; lower IL-9 level (12.6 [6.8; 16.2]) 24 weeks after the start of the treatment, compared with the group of patients with moderate and high inflammatory activity (23.5 [12.4; 69.5], 17.8 [15; 29] and 18.5 [14.2; 22.8] respectively).Findings. The assessment of the level of proinflammatory cytokines (IL-6, IL-17), immunoregulatory cytokine IL-9 allows to evaluate the activity of the disease more fully and identify a group of patients, who needs the therapy intensification.

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