Поликлональные легкие цепи иммуноглобулинов у пациентов с ревматоидным артритом
И.В. Пожаров
А.Д. Астахова
З.Ю. Мутовина

Ключевые слова

ревматоидный артрит
легкие цепи иммуноглобулинов
СЛЦ. nasal breathing
endoscopic adenotomy
obstructive sleep apnea syndrome.

Как цитировать

[1]
И. Пожаров, А. Астахова, и З. Мутовина, Поликлональные легкие цепи иммуноглобулинов у пациентов с ревматоидным артритом, КМКВ, вып. 3, дек. 2015.

Аннотация

В статье обобщены данные по истории открытия, биологическим свойствам и участию в патогенезе аутоиммунныхболезней поликлональных цепей имуноглобулинов (СЛЦ). Представлены результаты собственного проспективного иретроспективного исследования, включившего в себя 140 больных ревматоидным артритом (РА). Большинство пациентов(76%) были старше 60 лет. Контрольную группу (n=31) составили пациенты c остеоартритом (ОА). Сывороточнаяконцентрация κ- и λ-цепей у пациентов с активным РА была существенно выше, чем у пациентов с ремиссией РА иОА (РА активность 3 при сравнении с РА ремиссия, Z= -2,3 и -2,4 соответственно; p<0,05). При попарном сравнениидостоверные различия в концентрации СЛЦ наблюдались между группами пациентов с РА в ремиссии и c 3-й степеньюактивности (р=0,0184 и р=0,0148 для κ и λ цепей соответственно). Линейный корреляционный анализ показалположительную корреляцию между κ-цепями и IgG (r=0,9), IgA (r=0,55), ЦИК с IgG (r=0,45), ЦИК с IgA (r=0,37),РФ (r=0,32), γ-глобулинами (r=0,63); λ-цепями и IgG (r=0,74), IgA (r=0,66), тромбоцитами (r=0,32), DAS28 (r=0,3),γ-глобулинами (r=0,69). Выявленная взаимосвязь быстро рециркулирующих поликлональных СЛЦ с активностью РАподтверждает возможность их использования в качестве суррогатного раннего маркера ответа на лечение РА.The article summarizes data on polyclonal immunoglobulin chains (FLC):history of discovery, biological properties and role in the pathogenesis of autoimmune diseases . The authors discussresults of their own prospective and retrospective trial in which 140 patients with rheumatoid arthritis (RA) took part. Mostpatients (76%) were older than 60 . The control group (n = 31) consisted of patients with osteoarthritis (OA). Serum κ andλ chains in patients with active RA were significantly higher than those of patients with RA remission and OA (RA 3 activitycompared to RA remission, Z = -2,3 and -2,4 respectively; p <0 05). With paired comparison, significant differences inFLC concentrations were observed between the groups of patients with RA in remission and in patients with the third level ofactivity (p = 0.0184 and p = 0.0148 for κ and λ chains, respectively). The linear correlation analysis showed a positive correlationbetween κ-chain and IgG (r = 0.9), IgA (r = 0.55), CEC with IgG (r = 0.45), CEC with IgA (r = 0.37) , RF (r = 0.32),γ-globulins (r = 0.63); λ-chains and IgG (r = 0.74), IgA (r = 0.66), platelets (r = 0.32), DAS28 (r = 0.3), γ-globulins (r = 0.69). The revealed correlation between quickly recycling polyclonal FLC and RA activity confirms a possibility to use them assurrogate early markers of RA response to treatment.

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