1-FGBVOU VPO "Military Medical Academy named after S.M. Kirov" Defense of the Russian Federation, St. Petersburg, Lebedeva str., 6.
2-St. Petersburg State Clinical Hospital "Clinical Rheumatological Hospital No. 25", St. Petersburg, BolshayaPodyacheska Street, 30.
Rheumatoid arthritis as an autoimmune disease is characterized by the presence of various autoantibodies with different clinical and prognostic significance. The aim of the work was to identify the characteristics of groups of patients with different immunophenotypes of the disease, which was understood as a specific specific immunological characteristic. Patients with rheumatoid arthritis and rheumatoid arthritis in combination with autoimmune thyroiditis were examined, of whom subgroups of patients with only a diagnostically significant level in the blood of the RF (RF +), only a diagnostic level of blood in the ACCP (ACCP +) and a combination of this type of antibodies (ACCP + RF +). When analyzing the characteristics of these groups of patients, the term "modifiable factors" of rheumatoid arthritis was used, which meant the presence of dismetabolic disorders and an infectious factor (ie, an infection preceding the joint debut).
The group of RA patients and the immunophenotype ?RF +? has disease mechanisms closely associated with the mechanisms of aging, including a cluster of components of the chronic insulin-resistant syndrome, which is manifested by dismetabolic disorders (elevated blood glucose, creatinine and uric acid) and an increase in the overall inflammatory indexes,including also the close association of age and C-reactive protein in serum, compared with other immunophenotypic groups. A group of patients who had a combination of RA and AIT and immunophenotype ?ACCP + RF+? demonstrated a reliable association with the presence of an infectious factor in the history.
Thus, the isolation of immunophenotypes of rheumatoid arthritis in combination with autoimmune thyroiditis and modified factors allows verifying pathogenetic differences in the mechanisms of the disease.
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