Two fundamental pathologic processes are central to the spectrum of chronic inflammation mechanisms: autoimmunity and autoinflammation.  Autoimmunity and autoinflammation are mutually potent pathologic processes; their development is considered within the framework of the “immunoinflammatory” continuum, reflecting the close relationship between innate and acquired types of immune response. Autoimmunity is the leading mechanism of pathogenesis of a large group of chronic inflammatory human diseases, defined as autoimmune diseases, the frequency of which in the population exceeds 10%. Advances in molecular biology, pharmacogenetics and bioinformatics have created prerequisites for individualization of therapy of autoimmune rheumatic diseases within the concept of personalized medicine.  The study of immunopathogenesis mechanisms, improvement of diagnostics, deciphering the nature of molecular taxonomy, development of approaches to prevention and personalized therapy of human autoimmune diseases is among the priority directions of medicine of the 21st century.

The main indications for colchicine treatment until recently were gout, pericarditis, familial Mediterranean fever and some other auto-inflammatory diseases. The expansion of indications (repositioning) for the use of colchicine in the direction of prevention of cardiovascular complications should be considered as one of the major events in medicine of the XXI century. Deciphering the role of inflammation as the most important mechanism for the development of atherosclerosis has created prerequisites for the development of the concept of anti-inflammatory therapy of atherosclerosis, in which low-dose colchicine therapy can take an important place, complementing the effects of aspirin, statins and antihypertensive therapy. The analysis of materials from randomized placebo-controlled studies of colchicine indicates a decrease in the frequency of cardiovascular complications in patients with coronary heart disease (by 31%) and in patients who have recently suffered a myocardial infarction (by 23%), as well as myocardial infarction (by 33%), stroke, the need for myocardial revascularization and cardiovascular mortality. The use of colchicine in a low dose (0.5 mg/day) is approved by the U.S. Food and Drug Administration for the prevention of cardiovascular complications in patients with coronary heart disease. It can be assumed that in the future colchicine will take an important place in the prevention and treatment of cardiovascular pathology associated with atherosclerotic vascular disease.

Rheumatoid arthritis (RA) is an immune-mediated rheumatic disease (IMRDs) characterized by chronic erosive arthritis and systemic damage to internal organs, leading to early disability and reduced life expectancy in patients. A particularly important place among the systemic manifestations of RA is occupied by interstitial lung diseases (ILD) – the most severe form of pulmonary pathology in RA, defined as RA-ILD, which is pathogenetically associated with risk factors (smoking, etc.) and autoimmune mechanisms underlying RA. RA-ILD is a subtype of RA characterized by a severe course and a poor prognosis и неблагоприятным прогнозом. The review presents new data regarding risk factors and biomarkers for RA-ILD; modern diagnostic capabilities based on the use of functional lung tests, high-resolution computed tomography, ultrasound examination of the lungs. Particular attention is paid to the efficacy and safety of pharmacotherapy, including methotrexate, biologics, JAK inhibitors, and antifibrotic therapy. An algorithm for the pharmacotherapy of RA-ILD has been proposed.