Objective. To study lymphocytes phenotype in rheumatoid arthritis (RA) and its changes during methotrexate (MT) therapy. Methods. 24 RA pts with high clinical and laboratory activity of the disease and 18 healthy donors (control group) were included. All patients received MT 7,5-15 mg/week. They were followed up for 6 months. Expression of CD3, CD5, CD7, CD8, CD16, CD18, CD19, CD20, CD25, CD26, CD50, CD54, HLA DR, CD95 on peripheral blood lymphocytes was assessed before and after treatment by immunofluorescence method. Results. There was decreased expression of CD8, CD18, and CD50 in RA patients vs control. MT treatment resulted in reduction of CD 50 and CD 26 expression on lymphocytes. Conclusion. Peripheral blood in RA is characterized by decrease of CD8+ lymphocyte percent. Reduction of CD 18 and CD50 adhesion molecules expression may be connected with migration of appropriate effector cells bearing these molecules on there surface into inflamed synovial membrane. Treatment with MT decreased expression of some adhesion molecules. Decrease of CD 26 lymphocytes activation marker expression is one of the mechanisms of MT antirheumatic action.

Objective. To study prevalence and structure of videocapillaroscopic findings in primary Raynaud's phenomenon (PRP) and their relation to clinical picture. Methods. 20 pts with PRP and 15 controls were examined by videocapillaroscopy. Results. The presence of homogenous enlarged (mean loop diameter 33,6±7,7 m, p<0,0005) and elongated (mean loop length 301±109 m, p<0,0005) capillaries, multiple punctate hemorrhages or confluent areas of hemorrhage was characteristic of PRP group. Nonspecific capillary changes often found in PRP consisted of tortuous venular part (50%), bushy capillaries (20%). isolated punctate hemorrhages (19%), increased visibility of subpapillary venous plexus (20%). The prevalence of cyanosis in clinical picture of PRP was accompanied by considerable enlargement of venular parts of the loops, prominence of subpapillary vessels, minor dystrophies (tortuous, bushy capillaries) were more frequently seen in pts with longer disease duration. Conclusion. PRP is characterized by structural capillary changes which must be taken into consideration in diagnosis and differential diagnosis of primary and secondary Raynaud's phenomenon.

C-refctive protein prolongs blood coagulation time in phospholipids-dependent coagulation tests. O.P. Bliznukov, L.D. Kostin, A.J. Martinov, T.A. Lisitsina, T.M. Reshetnyak, V.J. Lauga Objective. To study influence of different CRP forms on blood clotting time in standard phospholipid clotting tests. Material and methods. Purified native CRP. monomeric CRP (0-1.6 M), immune complexes of native CRP and rabbit polyclonal anti-CRP antibodies (1.6 M) were added to blood plasma of healthy donors. Blood clotting time was registered using optical coagulometer. Phospholipid dependent prothrombin time (PT), activated partial tromboplastin time (APTT), kaolin clotting time (KCT) with kaolin and ellagic acid, dilute Russel viper venom time (dRVVT) were determined. Results. Native CRP was able to increase blood clotting time in all mentioned clotting tests, excluding prothrombin time. CRP influence on blood clotting time showed a concentration dependence. Polyclonal rabbit anti-CRP antibodies had no inhibitory effect on CRP prolonged blood clotting time. Monomeric CRP (0-1.6 M) had no influence on blood clotting time in all phospholipid-dependent clotting tests.

Objective. To study relation of SLE pts blood serum atherogenicity to disease activity and corticosteroids (CS) administration. Methods. 40 young women with SLE were included. 20 of them did not received CS (group 1) and 20 were treated with small doses of CS (<15 mg/day) for a long time (group 2). Duration of the disease was longer in group 2 and SLEDAI indexes were higher in group 1. Control group consisted of 20 healthy women. Serum atherogenicity was examined in BALB/c mice peritoneal macrophages culture by accumulation of intracellular cholesterol (CH) induced by pts blood serum. Results. Most of pts blood serum (90%) and only 15% control blood serum possessed atherogenic potential causing 2-fold rise of intracellular cholesterol level. Frequency of serum atherogenic activity in pts having SLE for a long time was higher. Serum atherogenic activity in group 1 was higher than in group 2 (221±13% and 185±11 % respectively, p=0,044). Atherogenicity correlated with SLEDAI index (r=0,82, p=0,04). No correlation was found between atherogenicity and lipid fractions. Conclusion. Serum atherogenecity is directly dependent on disease activity what shows the significance of immunological changes in atherogenesis in SLE pts

Objective. To assess efficacy of new immunoactive peptide thymodepressine (TD) selectively inhibiting T-cell immunity in rheumatic diseases Methods. Spleen, kidneys and synovial membrane morphological changes and survival were assessed in 100 MRL/1 female mice. 20 and 40 per animal TD injections in doses 10 mcg/kg and 10+100 mcg/kg were made. Control group animals received placebo (saline solution). Results were assessed by double blind method. Results. Survival of treated mice (10+100 mcg/kg) at the 6 months age was two times higher than in control group. Morphometric indices of immunogenesis in spleen of treated animals were comparable with parameters of one month age mice. White and red pulp area, number of mature and immature plasmacytes per 1 mm 2, number of megacariocytes were increased. Results of the spleen examination shows immunosuppressive action of TD suppressing lymphoprolipherative process and increasing survival of animals having lpr/lpr gen. But TD does not influence course of autoimmune process providing rheumatoid like changes in kidneys and synovial membrane of mice. Conclusion. TD has dose-dependent effect on survival and morphological indices in MRL/1 mice. Survival of animals at dose 10+100 mcg/kg was higher but dose 10 mcg/kg more expressively effected morphological indices of immuno- and hemopoiesis. Additional examinations are needed to determine optimal dose and scheme of treatment.

Objective. To investigate effect of different disease modifying drugs (DMARDs) on X-ray progression, functional disability and quality of life in RA patients with disease duration of at least 10 years. Methods. 238 pts with RA (according to ARA 1987 criteria) with the beginning of disease at 1992 or later (30 male and 208 female) were included. Mean follow up duration was I5,5±6,4 years. X-ray changes were evaluated by Larsen method. Functional disability was assessed by HAQ and quality of life - by RAQol scale. Information about antirheumatic therapy was obtained by questioning of patients and from medical documentation. Results. There was no significant positive effect of DMARDs therapy on X-ray progression. Patients receiving gold salts (tauredon or chrisanol) for a long time had lower HAQ functional index (1,34±0,76 in comparison with 1,74±0,83 in patients without aurotherapy, p<0,0l) and less prominent quality of life decrease according to RAQoL scale (19,2±6,3 in comparison with 22,11:5.8. p<0,05). Other DMARDs had no significant independent positive effect on functional disability and quality of life at the end of long-term follow up. Conclusion. Retrospective evaluation of the results of long-term follow up showed that gold salts remained the drugs of choice in RA.

Objective. To assess efficacy and tolerance of varfarin in prophylaxis and therapy of thrombotic complications in patients with antiphospholipid syndrome (APS). Methods. 20 pts with APS (5 male and 15 female) received varfarin during a year. 8 of them had primary APS (PAPS) and 12 -systemic lupus erythematosus with APS (SLE+APS). 2 other pts (I with SLE+APS and I with PAPS) received varfarin during the last 4 years. Nobody from 9 pts with PAPS received corticosteroids (CS). In SLE+APS pts CS dose varied from 4 to 20 mg/day and was not increased during follow up. During the study prothrombine time (PT) was examined with thromboplastin ( manufactured by Renam) having international sensitivity index 1,2 and international normalization relation (INR). Depending on treatment scheme APS pts were divided into 3 groups. Group 1 included 8 pts with INR<2,0, Group 2-7 with INR >3,0, group 3 - 7 pts with INR<2,0 receiving as additional treatment thrombo ASS 100 mg/day and vasonit from 600 to 1200 mg/day. Results. Two pts with INR = 1,8 had thrombosis recurrence (due to leg thrombophlebitis). There were no recurrences in other groups. 2 from 22 pts had "large" bleedings. "Small" bleedings episodes were noted in 7 from 22 pts. Largely that were subcutaneous bleedings (in 4 pts) no more than 5 cm of size. Two pts receiving varfarin with INR 1,8 and 2,4 had renal colic. Conclusion. Our preliminary results prove the necessity of inclusion of varfarin in the treatment of pts with APS and thrombosis but intensive anticoagulant effect is not always desired.

Objective. To study efficacy of combined therapy with prospidin (P) and methotrexate (MT) in rheumatoid arthritis (RA). Methods. 60 pts with RA (53 female and 7 male) aged 20 to 72 years were included. The mean disease duration was 5,6 years. 51 patients had 2 and 9-3 degree of RA activity. The pts received P 200-300 mg/week intravenously dropwise with 200 ml of 5% glucose solution during 4 weeks. Intramuscular injections of MT 10 mg/week were given at the third day after the administration of P. Maintenance treatment included P 100-200 mg/week and MT 10 mg/week. Results. Combined therapy provided fast and marked clinical effect in pts with unfavorable variants of RA. 50-70% improvement according to ACR criteria was achieved in 50% of pts received P and MT during 12 months. Amelioration of some laboratory indices of RA activity was also noted. Side effects of combined therapy were reversible and not severe. They led to discontinuation of therapy only in 14,8% .

Objective. To assess the efficace and safety of Chondroxide ointment in OA pts. Methods. 27 OA pts were included in clinical investigation. All the pts used Chondroxide preparation as a topical application. Results. Considerable and marced improvement were achieved in 18 OA pts (66,6%). In 9 cases the efficacy of treatment was abcent. Conclusion. Chondroxide ointment is highly effective and safe preparation in OA pts treatment