[Autoimmune disorders, interleukins 10, 4, 6 and tumor necrosis factor alpha in patients with systemic lupus erythematosus].
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Biomedical subjects
Publications and source records attributed to T A Riazantseva.
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AIM: Determination of the prevalence of spondylarthropathies (SAP) and rheumatoid arthritis (RA) among Finno-Ugrian population of Russia. MATERIALS AND METHODS: A one stage expedition trial was made of representative samples of Mordovian and Mari populations including 1312 citizens aged over 14 years. RESULTS: Incidence rate of SAP among Mordovian and Mari examinees was 0.7 and 0.2%, respectively, ankylosing spondylitis being most frequent finding. RA occurred in 2.5 and 0.6%, respectively. All the RA cases were females without family history of this disease. CONCLUSION: SAP and RA prevalence among Mordovian and Mari populations was high but their course is more favorable than among other population of Russia.
A total of 216 patients with rheumatic fever and rheumatic heart from the Institute of Rheumatology and 126 patients with rheumatic heart diseases alone from the Center of Cardiosurgery were clinically and immunologically studied. The immunological study included the detection of b-hemolytic group A streptococcus, O-antistreptolysin, the measurement of C-reactive protein, immunoglobulins, C3, C4, Ciq-binding, anticardiolipin antibodies, etc. The findings indicated that the secondary penicillin prophylaxis prevents streptococcal pharyngitis and recurrence of acute rheumatic fever after 5 years. The high levels of Ciq-binding and anticardiolipin antibodies were directly proportional to the incidence rates of acute endocarditis and associated with the occurrence of venous and arterial thromboses.
Based on clinico-immunologic studies subtypes of systemic lupus erythematosus (SLE) were distinguished. The ANF-R++H-DNA-CH50 variant determines acute onset of SLE with renal injury in the form of diffuse glomerulonephritis. The ANF-Sp-RNP-RF mirrors the development of Raynaud's syndrome, Sjögren's syndrome, polymyositis, pneumosclerosis and myocarditis. The ANF-Sp-Ro-RF variant is associated with skin derangement in the form of discoid foci, anular, papulosquamous eruption, vitiligo, hyperpigmentation, and cerebrovasculitis. The Ro-anti-Po, La-anti-La system is related to the idea of SLE, seronegative in accordance with ANF, when rat liver sections are used as a substrate in immunofluorescence.
As many as 195 patients with rheumatoid arthritis (RA) were examined for the clinical characteristics of the disease course depending on the presence or lack of antibodies to DNA or of antinuclear factor (ANF). Provided the patients' blood serum contained antibodies to DNA and ANF, RA was noted to run a graver course associated with a high-active process, marked erosive and destructive lesions of the joints, and the development of systemic manifestations. Excess production of the antibodies in question was accompanied by an increase of circulating immune complexes and rheumatoid factor, and a decrease of serum IgG. Glucocorticoids were demonstrated to be effective in suppression of autoimmune disorders. The presence of antibodies to DNA and of ANF is a prognostically unfavourable sign, indicating the development of systemic manifestations.
Methods are described that are used for the titration of antinuclear, anticentromere, and anti-Scl-70 antibodies in systemic scleroderma, systemic lupus erythematosus, and rheumatoid arthritis: indirect immunofluorescence with various antigenic substrates (sections of fresh-frozen rat liver and Hep-2 cell culture), counter-current immunoelectrophoresis, isolation of Scl-70 antigen. Use of Hep-2 cells as a substrate for indirect immunofluorescence was found clinically and diagnostically more effective since it permitted the detection of anticentromere antibodies and anti-Scl-70. Nucleolar, mottled, homogeneous, marginal immunofluorescence types were observed when rat liver sections and Hep-2 cells were used for substrates. Anticentromere antibodies and anti-Scl-70 were isolated significantly more frequently in systemic lupus erythematosus or rheumatoid arthritis.
A comparative study of the synovial fluid (SF) composition was conducted in 72 patients with rheumatoid arthritis (RA) with relation to the presence of the rheumatoid factor (RF) and clinical manifestations of this disease. A statistically significant difference in the SF composition (the number of leukocytes, neutrophils and ragocytes) was shown in seropositive and seronegative RA. The content of total protein and glucose in SF did not practically differ in both cases. In the common group of the RA patients correlation was established between the number of neutrophils, the level of total protein, percentage of ragocytes, the level of complement in SF and a degree of general inflammatory activity of disease. A subgroup of RA patients (32%) was identified with the prevalence of lymphocytes, a slight rise of the level of total protein, a low percentage of ragocytes and rather a high level of complement. In 87% of the above patients noticeable osteochondrous destruction (III-IV roentgenological stage) was noted against a background of low inflammatory activity. The data obtained confirmed an important role of SF investigation for the elucidation of the mechanisms of pathogenesis, differential diagnosis and prognosis.
Altogether 95 patients with systemic lupus erythematosus, 36 patients with rheumatoid arthritis, 10 with sclerodermia systematic, 10 with Bekhterev's disease, 9 with rheumatic fever, and 20 healthy persons were examined. An analysis of the results made it possible to establish that in SLE, sclerodermia systematic and Bekhterev's disease the frequency of detection of higher levels of antibodies to n-DNA using enzyme immunoassay and radionuclide methods was approximately the same. SLE patients were characterized by a 2-fold increase in the level of antibodies to n-DNA as compared to patients with sclerodermia systematic, Bekhterev's disease and rheumatic fever suggesting usefulness for differentiation of these diseases. In rheumatic fever and rheumatoid arthritis antibodies to n-DNA in minimal elevated levels were revealed more frequently under enzyme immunoassay than in radionuclide ones. In SLE high levels of antibodies to n-DNA under the method of radionuclide binding showed significant correlation with a decrease in complement hemolytic activity, high levels of circulating immune complexes, with a higher frequency of detection of the antinuclear factor, and reflected lupus nephritis severity. Enzyme immunoassay used for the detection of antibodies to n-DNA showed correlation of high levels of these antibodies with signs of developing cerebrovasculitis and pulmonary lesion.
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The authors consider that the development of immunopathological reactions in SLE, AIDS depends on the reduction in normal gamma-globulin level in the patient's serum. The sera with anti-DNA, anti-HIV antibodies show a decreased binding of corresponding antigens and decreased concentrations of gamma-globulin with normal features.
The authors studied the activity of peripheral blood natural killer cells in 25 patients with rheumatoid arthritis by 51 Cr release assays with K-568 target cells. Data on the comparative clinico-immunological analysis by the cytotoxicity index are submitted. There is a relation between the nature of rheumatoid arthritis course and the presence of systemic manifestations such as nodules, polyneuropathy, proteinuria, carditis, levels of the rheumatoid factor, anti-DNA, CRP, cryoglobulinemia and changed activity of peripheral blood natural killer cells. Patients with rheumatoid arthritis having a combination of marked changes of humoral immunity with changed cytotoxicity of the peripheral blood natural killer cells activity can be referred to the group of risk.
The authors used the blind method for evaluation of the morphological picture of the joints and the level of circulating immune complexes to study the effect of prolonged oral administration of dimethyl sulfoxide (DMSO) and its main metabolite dimethyl sulfone on the development of spontaneous arthritis in 36 Mrl/Mn/lnr female mice. It was found that DMSO and dimethyl sulfone lessen the destructive changes in the joints, while DMSO also inhibits the manifestation of immune disorders, i. e. produces a "basal" effect on the course of spontaneous chronic arthritis in experimental animals.