[Pro- and antioxidant blood system in patients with rheumatoid arthritis and systemic lupus erythematosus].

AIM: To estimate the levels of prooxidants (malonic dialdehyde-MDA and nitric oxide-NO), Zn, activity of antioxidant enzymes (superoxide dismutase--SOD and glutathione peroxidase--GPO) in the blood of patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). MATERIAL AND METHODS: Pro- and antioxidant system was assessed in 45 RA patients and 32 SLE patients by content of MDA estimated by reaction with thiobarbituric acid, NO (Boehringer Manheim kits, Germany), Zn (Unicam SP 190/191, Great Britain), activity of SOD and GPO (kits Ransod, Ransel; Randox, Great Britain). RA activity was evaluated by DAS index, SLE--by SLEDAI. RESULTS: MDA and NO concentrations were found elevated while SOD and GPO activity low in RA and SLE. The level of Zn was subnormal in RA. The activity of RA and SLE did not influence the above indices significantly. CONCLUSION: RA and SLE patients have high levels of prooxidants (MDA and NO) whereas their antioxidant enzymes (SOD and GPO) activity was low. This may promote oxidant stress.

[Prognostic value of some serological markers of rheumatoid arthritis in assessment of x-ray outcome of the disease].

AIM: To specify significance of some serological markers for diagnosis and x-ray prognosis of rheumatoid arthritis (RA). MATERIAL AND METHODS: A total of 115 RA patients with the disease history not longer than 4 years were examined for serum antibodies to cyclic citrullated peptide (ACCP), rheumatoid factor (RF), antikeratine antibodies (AKA) using enzyme immunoassay and indirect immunofluorescence. RESULTS: ACCP, AKA, IgA-RF, IgM-RF were detected in 79.15%, 47.8%, 64.3%, 89.6% patients, respectively. ACCP was found to be directly correlated with negative x-ray changes in hand and foot joints. ACCP specificity reached 97%, the highest specificity (up to 100%) being in determination of RF and ACCP. CONCLUSION: ACCP is an independent factor increasing significance of x-ray indices and thus allowing prognosis of x-ray outcome of RA.

[Hemostasis in patients with rheumatoid arthritis].

AIM: To study hemostasis with reference to rheumatoid arthritis (RA) activity, extraarticular manifestations and vascular damage. MATERIAL AND METHODS: We studied hemostasis in 104 RA patients. The following parameters were tested: partial thromboplastin time activation (PTTA), fibrinolytic activity (FA), prothrombin index, lupus anticoagulant (LA), mean platelet volume (PV), antibodies against cardiolipin (aCL) and antibodies against beta2-glycoprotein 1 (alphabeta2-GP1). The disease activity index was estimated by DAS-28 including tender and swelling joints count, erythrocyte sedimentation rate and disease global activity rated by the patient. RESULTS: We found out an increased number of platelets in 54.4%, prolongation of FA and PTTA in 72.5 and 12.5% patients. The rest blood coagulation tests were normal in most the examinees. The LA antibodies were absent, while aCL and alphabeta2-GP1 antibodies were identified in 10.6 and 14.4%, respectively. The number of platelets increased while hemoglobin decreased in relation to higher disease activity and PV was significantly lower in patients with extraarticular manifestations. No significant influence of vascular damage or comorbidities on hemostasis was found. CONCLUSION: No relation was established between coagulation factors and the disease activity except for increased number of platelets in patients with higher activity and lower PV in patients with extraarticular manifestations. However, patients with aCL and alphabeta2-GP1 need constant monitoring because of the risk to develop thrombosis.

[Antineutrophil cytoplasmic antibodies in patients with diffuse diseases of connective tissue]. / Antineitrofil'nye tsitoplazmaticheskie antitela u bol'nykh s diffuznymi bolezniami soedinitel'noi tkani.

AIM: To investigate the significance of antibodies against neutrophil cytoplasmic antigens (ANCA) in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SS), their relations with the syndromes and laboratory indices. MATERIAL AND METHODS: The sera from 277 patients suffering from connective tissue disease and 31 healthy persons were examined. Of patients, 103, 126 and 48 had RA, SLE and SS, respectively. The patients in each group were subdivided into ANCA positive (ANCA+) and ANCA negative (ANCA-). The patients were matched within the groups by age, sex and disease duration. There were 41 such pairs in RA group, 23 in SLE and 13 in SS group. Questionnaires and laboratory tests (ANA, RF, a-DNA, a-MPO, a-Scl-70, a-PR3, a-CL) were used in the examination. RESULTS: The sensitivity of ANCA in SLE patients group was as high as 58.7%, specificity--93.5%. In other groups ANCA were less frequent. ANCA were significantly associated with skin vasculitis and ANA prevalence but the disease activity in SLE was not related to this feature. Anemia and antibodies against cardiolipin were found significantly more frequently in ANCA positive RA group. In SS group the inverted clinical association with kidney damage was seen but a-DNA were more prominent in ANCA+ group. Subspecificity for a-MPO and a-PR3 and lactoferin by ELISA were revealed less often than a-ANCA by immunofluorescence. Only two SLE patients with a-lactoferin antibodies were evidently different in prognosis while the other ones did not differ in the disease course within their group. CONCLUSION: The ANCA pattern in connective tissue diseases is found rather often but only few clinical and laboratory associations could be established such as skin vasculitis and ANA domination in SLE group, anemia and a-CL in RA group and a-DNA in SS ANCA+ groups. The validity of ANCA test is not so significant as it is in vasculitis patients.