References

rsp

Научно-практическая ревматология

Rheumatology Science and Practice

1995-44841995-4492

IMA-PRESS, LLC

10.47360/1995-4484-2022-314-326

rsp-3179

Research Article

ФОРУМ МОЛОДЫХ УЧЕНЫХ

YOUNG SCIENTISTS FORUM

АЦЦП-негативный ревматоидный артрит — клинические и иммунологические особенности

ACCP-negative rheumatoid arthritis – clinical and immunological features

https://orcid.org/0000-0003-3183-0464

Дибров

Д. А.

Dibrov

D. A.

аспирант,

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

dibrovd995@gmail.com

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation

2022

09072022

603314326

2022

Дибров Д.А.

Dibrov D.A.

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/3179

В зависимости от наличия лабораторных биомаркеров: IgM ревматоидного фактора и антител к циклическому цитруллинированному пептиду (АЦЦП), – выделяют серопозитивный и серонегативный варианты ревматоидного артрита (РА). Иммунологические субтипы различаются по факторам риска, иммунопатогенезу и характеру течения заболевания.

Представлен обзор данных, касающихся иммунологических и клинических особенностей АЦЦП-негативного варианта РА. Присутствие АЦЦП в периферической крови отражает наличие прогрессирующего эрозивного процесса с преобладанием воспалительного компонента и вовлечением В-клеток. При АЦЦП-негативном субтипе преобладают пролиферативные изменения; важное значение в патогенезе играют нарушения, связанные с Т-клеточным звеном, в первую очередь с CD4+ Т-лимфоцитами. Для данного варианта заболевания характерен менее выраженный эрозивный процесс, однако воспалительная активность при обоих субтипах РА может быть сопоставима. Ранняя диагностика, регулярный контроль активности заболевания и стратегия «лечения до достижения цели» рекомендованы как для позитивного, так и для негативного по АЦЦП РА, однако эффективность отдельных препаратов при этих субтипах может значительно различаться.

Depending on the presence of laboratory biomarkers: rheumatoid factor IgM and anti-cyclic citrullinated peptide antibodies (ACCP), “seropositive” and “seronegative” variants of rheumatoid arthritis (RA) are distinguished. Immunological subtypes differ in risk factors, immunopathogenesis, and the course of the disease. A review of data concerning immunology and clinical features of ACCP-negative rheumatoid arthritis is presented. The presence of ACCP in the peripheral blood reflects the progressive erosive process with a predominance of the inflammatory component and involvement of the B cells. Proliferative changes predominate in the ACCPnegative subtype; disorders associated with the T-cell link, primarily with CD4+ T-lymphocytes, play an important role in pathogenesis. This variant of the disease is characterized by a less pronounced erosive process, but the inflammatory activity in both subtypes of RA can be comparable. Early diagnosis, regular monitoring of the disease activity and the «treat to target» strategy are recommended for both positive and negative ACCP RA, however, the effectiveness of individual drugs in these subtypes may vary significantly.

антитела к циклическому цитруллинированному пептидуревматоидный артритАЦЦПнегативный ревматоидный артритсеронегативный ревматоидный артрит

anti-cyclic citrullinated peptide antibodiesrheumatoid arthritisACCP-negative rheumatoid arthritisseronegative rheumatoid arthritis

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