Pub Date : 2024-06-16DOI: 10.14412/1996-7012-2024-3-114-121
O. Zhelyabina, M. S. Eliseev, A. Lila
The best results in combating gout are achieved through a combination of diet and drug therapy. Urate-lowering therapy, which includes febuxostat, has been shown to be more effective and convenient than diet when it comes to achieving and maintaining target uric acid (UA) levels in gout patients. Febuxostat, a xanthine oxidase inhibitor, helps to reduce UA levels in the blood by blocking its formation. This helps prevent the deposition of urate crystals in joints and tissues and reduces the frequency and severity of gout attacks. At the same time, a diet of low purine foods may also have some effect on UA levels. Diet can improve the results of drug treatment by reducing the need for medications and minimizing the risk of side effects. However, without adequate drug therapy, diet will not produce the desired results. Therefore, febuxostat remains the preferred urate-lowering treatment option for gout, especially given its proven efficacy in these patients.
{"title":"Battle of the strategies: diet versus drug therapy for gout","authors":"O. Zhelyabina, M. S. Eliseev, A. Lila","doi":"10.14412/1996-7012-2024-3-114-121","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-114-121","url":null,"abstract":" The best results in combating gout are achieved through a combination of diet and drug therapy. Urate-lowering therapy, which includes febuxostat, has been shown to be more effective and convenient than diet when it comes to achieving and maintaining target uric acid (UA) levels in gout patients. Febuxostat, a xanthine oxidase inhibitor, helps to reduce UA levels in the blood by blocking its formation. This helps prevent the deposition of urate crystals in joints and tissues and reduces the frequency and severity of gout attacks. At the same time, a diet of low purine foods may also have some effect on UA levels. Diet can improve the results of drug treatment by reducing the need for medications and minimizing the risk of side effects. However, without adequate drug therapy, diet will not produce the desired results. Therefore, febuxostat remains the preferred urate-lowering treatment option for gout, especially given its proven efficacy in these patients.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-16DOI: 10.14412/1996-7012-2024-3-128-133
E. S. Aronova, B. Belov, G. Gridneva
Fatigue is a persistent and debilitating feeling of tiredness that limits the ability to perform daily activities and is a common and difficult-to-treat condition in patients with rheumatic diseases (RD). Fatigue is a major challenge for the physician. However, methods to treat it have not yet been developed, as fatigue is usually considered an insignificant background condition. This article provides an overview of the 2023 EULAR recommendations, which outline the guiding principles and strategy for the management of fatigue in patients with RD. The EULAR recommendations are based on an understanding of fatigue as a complex condition that requires an individualized approach in choosing the correction methods. It is important that the assessment of fatigue becomes part of the routine practice of rheumatologists and other physicians. Patient education recommendations emphasize the importance of an individualized approach tailored to the needs of the individual, including optimizing physical activity and psychoeducational interventions.
{"title":"Treatment strategy for fatigue in rheumatic diseases in view of the 2023 EULAR recommendations","authors":"E. S. Aronova, B. Belov, G. Gridneva","doi":"10.14412/1996-7012-2024-3-128-133","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-128-133","url":null,"abstract":" Fatigue is a persistent and debilitating feeling of tiredness that limits the ability to perform daily activities and is a common and difficult-to-treat condition in patients with rheumatic diseases (RD). Fatigue is a major challenge for the physician. However, methods to treat it have not yet been developed, as fatigue is usually considered an insignificant background condition. This article provides an overview of the 2023 EULAR recommendations, which outline the guiding principles and strategy for the management of fatigue in patients with RD. The EULAR recommendations are based on an understanding of fatigue as a complex condition that requires an individualized approach in choosing the correction methods. It is important that the assessment of fatigue becomes part of the routine practice of rheumatologists and other physicians. Patient education recommendations emphasize the importance of an individualized approach tailored to the needs of the individual, including optimizing physical activity and psychoeducational interventions.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-16DOI: 10.14412/1996-7012-2024-3-122-127
E. Aseeva, S. Soloviev, T. Reshetnyak, A. Lila
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by unpredictable exacerbations and outcome. Many SLE patients receiving standard therapy (ST) do not achieve the recommended treatment goal of remission or Lupus Low Disease Activity State (LLDAS). Currently, there is still great dissatisfaction with ST in SLE, especially with long-term treatment with glucocorticoids and immunosuppressants. The recently approved type I interferon receptor antagonist anifrolumab (AFM) may be promising in SLE patients who do not respond adequately to ST. Phase III efficacy studies of AFM have demonstrated higher remission rate and lower LLDAS activity in patients treated with AFM compared to placebo. This publication contains comments from Russian experts on the article by Y. Tanaka “Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice”.
系统性红斑狼疮（SLE）是一种异质性自身免疫性疾病，其特点是病情恶化和预后难以预测。许多接受标准疗法（ST）的系统性红斑狼疮患者无法达到推荐的治疗目标，即缓解或狼疮低疾病活动状态（LLDAS）。目前，人们对系统性红斑狼疮的标准疗法仍然很不满意，尤其是长期使用糖皮质激素和免疫抑制剂的治疗。最近获批的Ⅰ型干扰素受体拮抗剂阿尼夫单抗（AFM）可能对ST治疗无效的系统性红斑狼疮患者很有希望。AFM的III期疗效研究显示，与安慰剂相比，接受AFM治疗的患者缓解率更高，LLDAS活性更低。本刊物收录了俄罗斯专家对 Y. Tanaka 的文章 "关于系统性红斑狼疮患者使用阿尼洛单抗的观点以及临床实践中尚未满足的大量需求 "的评论。
{"title":"Position on the use of anifrolumab in patients with systemic lupus erythematosus with insufficient efficacy of standard therapy in real-life clinical practice. Comments from Russian experts","authors":"E. Aseeva, S. Soloviev, T. Reshetnyak, A. Lila","doi":"10.14412/1996-7012-2024-3-122-127","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-122-127","url":null,"abstract":" Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by unpredictable exacerbations and outcome. Many SLE patients receiving standard therapy (ST) do not achieve the recommended treatment goal of remission or Lupus Low Disease Activity State (LLDAS). Currently, there is still great dissatisfaction with ST in SLE, especially with long-term treatment with glucocorticoids and immunosuppressants. The recently approved type I interferon receptor antagonist anifrolumab (AFM) may be promising in SLE patients who do not respond adequately to ST. Phase III efficacy studies of AFM have demonstrated higher remission rate and lower LLDAS activity in patients treated with AFM compared to placebo. This publication contains comments from Russian experts on the article by Y. Tanaka “Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice”.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"12 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-16DOI: 10.14412/1996-7012-2024-3-134-139
A. Lila, V. I. Mazurov, E. Nasonov, S. Lukyanov, T. Dubinina, I. Z. Gaidukova, A. Klimenko, S. A. Lapshina, G. V. Lukina, M. A. Korolev, R. Dreval, P. I. Pchelnikova, N. V. Shatalova
On 30 May, 2024, an expert meeting was held to update the approaches for the treatment of axial spondyloarthritis (axSpA). A new approach to the treatment of axSpA was considered, which consists of depleting autoreactive TRBV9+ T- lymphocytes by introducing a monoclonal antibody – the drug seniprutug. The value of the drug seniprutug in the treatment of the disease was discussed and key aspects for the incorporation of the drug seniprutug into real-world clinical rheumatological practice were agreed.
{"title":"Resolution of the Expert Council “New approaches to the treatment of axial spondyloarthritis”","authors":"A. Lila, V. I. Mazurov, E. Nasonov, S. Lukyanov, T. Dubinina, I. Z. Gaidukova, A. Klimenko, S. A. Lapshina, G. V. Lukina, M. A. Korolev, R. Dreval, P. I. Pchelnikova, N. V. Shatalova","doi":"10.14412/1996-7012-2024-3-134-139","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-134-139","url":null,"abstract":" On 30 May, 2024, an expert meeting was held to update the approaches for the treatment of axial spondyloarthritis (axSpA). A new approach to the treatment of axSpA was considered, which consists of depleting autoreactive TRBV9+ T- lymphocytes by introducing a monoclonal antibody – the drug seniprutug. The value of the drug seniprutug in the treatment of the disease was discussed and key aspects for the incorporation of the drug seniprutug into real-world clinical rheumatological practice were agreed.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.14412/1996-7012-2024-3-99-106
A. Santimov, S. Grechanyi, G. A. Novik
Patients with immune-inflammatory rheumatic diseases (IIRDs) often present with non-inflammatory musculoskeletal pain associated with nociceptive dysfunction, central sensitization, and secondary fibromyalgia (FM). In recent years, an increasing number of publications have appeared dealing with FM in rheumatoid arthritis and systemic connective tissue diseases in adult patients, while this problem is little discussed in pediatric rheumatology, partly due to the differences between the existing diagnostic criteria in children and adults, which complicate the diagnosis of juvenile secondary FM. The consequence of this is often the unfounded prescription or switching of synthetic disease-modifying antirheumatic drugs (DMARDs) or biologic DMARDs in patients who do not require intensified antirheumatic therapy, but rather psychotherapy and psychopharmacotherapy, as well as the wider use of physical and rehabilitation medicine methods. In a brief narrative review, we tried to trace the investigation of FM in a rheumatological clinic, including children with IIRD, from a historical perspective, to summarize current literature data on this problem and to point out possible solutions.
{"title":"Secondary fibromyalgia in children with immune-inflammatory rheumatic diseases","authors":"A. Santimov, S. Grechanyi, G. A. Novik","doi":"10.14412/1996-7012-2024-3-99-106","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-99-106","url":null,"abstract":" Patients with immune-inflammatory rheumatic diseases (IIRDs) often present with non-inflammatory musculoskeletal pain associated with nociceptive dysfunction, central sensitization, and secondary fibromyalgia (FM). In recent years, an increasing number of publications have appeared dealing with FM in rheumatoid arthritis and systemic connective tissue diseases in adult patients, while this problem is little discussed in pediatric rheumatology, partly due to the differences between the existing diagnostic criteria in children and adults, which complicate the diagnosis of juvenile secondary FM. The consequence of this is often the unfounded prescription or switching of synthetic disease-modifying antirheumatic drugs (DMARDs) or biologic DMARDs in patients who do not require intensified antirheumatic therapy, but rather psychotherapy and psychopharmacotherapy, as well as the wider use of physical and rehabilitation medicine methods. In a brief narrative review, we tried to trace the investigation of FM in a rheumatological clinic, including children with IIRD, from a historical perspective, to summarize current literature data on this problem and to point out possible solutions.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"1 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.14412/1996-7012-2024-3-85-91
A. Datsina, S. Erdes
Despite the high efficacy of currently available targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) and biologic DMARDs (bDMARDs), approximately 40 % of patients with ankylosing spondylitis (AS) fail to achieve treatment goals according to clinical, laboratory and imaging tests. In addition, comorbidities in AS, which require an integrated approach involving different specialists, may limit the use of such therapy. In view of the above, as well as the peculiarities of bone metabolism in AS, new therapeutic approaches for this disease have recently been sought, one of which is the use of bisphosphonates. This article discusses some aspects of bone metabolism and unconventional therapeutic options – the use of bisphosphonates in AS complicated by severe comorbidities, in patients with insufficient efficacy of bDMARDs and/or DMARDs.
{"title":"Some features of osteogenesis in ankylosing spondylitis and the possibilities of treatment with bisphosphonates","authors":"A. Datsina, S. Erdes","doi":"10.14412/1996-7012-2024-3-85-91","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-85-91","url":null,"abstract":" Despite the high efficacy of currently available targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) and biologic DMARDs (bDMARDs), approximately 40 % of patients with ankylosing spondylitis (AS) fail to achieve treatment goals according to clinical, laboratory and imaging tests. In addition, comorbidities in AS, which require an integrated approach involving different specialists, may limit the use of such therapy. In view of the above, as well as the peculiarities of bone metabolism in AS, new therapeutic approaches for this disease have recently been sought, one of which is the use of bisphosphonates. This article discusses some aspects of bone metabolism and unconventional therapeutic options – the use of bisphosphonates in AS complicated by severe comorbidities, in patients with insufficient efficacy of bDMARDs and/or DMARDs.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.14412/1996-7012-2024-3-107-113
A. Karateev
Hyaluronic acid (HA) is an effective and safe medication for local injection therapy (LIT) widely used in the treatment of osteoarthritis (OA) of large joints. The therapeutic effect of HA is determined both by the replacement of the lubricating function of natural hyaluronate (viscosupplementation), which leads to an improvement in the biomechanical parameters of the joint, and by the biological effects that unfold when interacting with cellular receptors (CD44, RHAMM, etc.), resulting in an anti-inflammatory, anti-nociceptive and anabolic effect of HA. HA therapy has a reliable evidence base. According to a number of clinical studies and meta-analyses, LIT with HA – reduces pain intensity by 28–54 % and improves the function of the affected joint by 9–32 % compared to baseline over a 12-24 week observation period. Repeated administration of HA can delay the need for orthopedic surgery. HA extremely rarely causes serious adverse events and can also be prescribed to patients with concomitant diseases. The use of HA for the treatment of OA is included in Russian and several foreign clinical guidelines (in particular OARSI and ESCEO). A new direction in LIT for OA is therapy with combined (hybrid) HA preparations containing high molecular weight (HMW) and low molecular weight (LMW) fractions. A new HA preparation has appeared in our country, which is a stabilized, highly purified hydrogel containing 80 % HMW HA (molecular weight – 30,000 kDa) with transverse "crosslinking" BDDE (innovative ECHATM technology) and 20 % "uncluttered" linear HA (molecular weight – 1500 kDa). This product is characterized by favorable rheological parameters, which guarantee a long-term improvement in the biomechanics of the affected joint and a rapid onset of biological effects, reduction in pain and inflammation and activation of the synthesis of natural hyaluronate.
{"title":"Local injection therapy with hyaluronic acid preparations: in focus of rheumatologists and orthopedic traumatologists","authors":"A. Karateev","doi":"10.14412/1996-7012-2024-3-107-113","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-107-113","url":null,"abstract":" Hyaluronic acid (HA) is an effective and safe medication for local injection therapy (LIT) widely used in the treatment of osteoarthritis (OA) of large joints. The therapeutic effect of HA is determined both by the replacement of the lubricating function of natural hyaluronate (viscosupplementation), which leads to an improvement in the biomechanical parameters of the joint, and by the biological effects that unfold when interacting with cellular receptors (CD44, RHAMM, etc.), resulting in an anti-inflammatory, anti-nociceptive and anabolic effect of HA. HA therapy has a reliable evidence base. According to a number of clinical studies and meta-analyses, LIT with HA – reduces pain intensity by 28–54 % and improves the function of the affected joint by 9–32 % compared to baseline over a 12-24 week observation period. Repeated administration of HA can delay the need for orthopedic surgery. HA extremely rarely causes serious adverse events and can also be prescribed to patients with concomitant diseases. The use of HA for the treatment of OA is included in Russian and several foreign clinical guidelines (in particular OARSI and ESCEO). A new direction in LIT for OA is therapy with combined (hybrid) HA preparations containing high molecular weight (HMW) and low molecular weight (LMW) fractions. A new HA preparation has appeared in our country, which is a stabilized, highly purified hydrogel containing 80 % HMW HA (molecular weight – 30,000 kDa) with transverse \"crosslinking\" BDDE (innovative ECHATM technology) and 20 % \"uncluttered\" linear HA (molecular weight – 1500 kDa). This product is characterized by favorable rheological parameters, which guarantee a long-term improvement in the biomechanics of the affected joint and a rapid onset of biological effects, reduction in pain and inflammation and activation of the synthesis of natural hyaluronate.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"26 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.14412/1996-7012-2024-3-92-98
A. A. Shaykhutdinova, D. A. Burbeza, S. I. Strelchenko, K. Fathallah, K. P. Rayevsky
Systemic lupus erythematosus (SLE) is a complex, multifactorial autoimmune disease characterized by multisystem involvement. Although the pathogenesis of SLE is not fully understood, numerous studies have shown that the composition of the microbiota can influence the course of the disease. The microbiota plays a key role in the development of immune defense and is an integral part of immune homeostasis. Dysbiosis of the intestinal, oral and vaginal microbiota can have a significant impact on the development of inflammatory and autoimmune diseases. The review addresses recent studies on the microbiota, with a particular focus on changes in the composition of the gut microbiota and their impact on SLE. Data from several studies suggest that there is a link between SLE and certain patterns of dysbiosis.
{"title":"Identification of patterns of microbiota influence on the pathogenetic mechanisms of systemic lupus erythematosus development","authors":"A. A. Shaykhutdinova, D. A. Burbeza, S. I. Strelchenko, K. Fathallah, K. P. Rayevsky","doi":"10.14412/1996-7012-2024-3-92-98","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-92-98","url":null,"abstract":" Systemic lupus erythematosus (SLE) is a complex, multifactorial autoimmune disease characterized by multisystem involvement. Although the pathogenesis of SLE is not fully understood, numerous studies have shown that the composition of the microbiota can influence the course of the disease. The microbiota plays a key role in the development of immune defense and is an integral part of immune homeostasis. Dysbiosis of the intestinal, oral and vaginal microbiota can have a significant impact on the development of inflammatory and autoimmune diseases. The review addresses recent studies on the microbiota, with a particular focus on changes in the composition of the gut microbiota and their impact on SLE. Data from several studies suggest that there is a link between SLE and certain patterns of dysbiosis.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"88 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14DOI: 10.14412/1996-7012-2024-3-63-70
E. B. Chetina, G. A. Markova, K. E. Glemba, M. Makarov
Objective: to evaluate differences in the expression of genes associated with β-oxidation and de novo synthesis of fatty acids (FAs) in the blood of patients with the late stage of knee osteoarthritis (OA) before total knee arthroplasty (TA) depending on the development of postoperative pain (POP) in order to determine the molecular mechanisms responsible for the development of chronic POP. Material and methods. Blood of 50 patients with stage III–IV knee OA complaining of constant pain and joint dysfunction was analyzed prior to TA. The control group consisted of 26 healthy individuals. Pain intensity was assessed using a visual analogue scale (VAS) and the BPI questionnaire. In addition, pain, stiffness and physical functioning were assessed using WOMAC index and the presence of neuropathic pain was assessed using the DN4 and PainDETECT questionnaires. The development of POP was assessed 3 and 6 months after TA. Total RNA isolated from blood was used to determine the expression of ACLY, ACC1, MLYCD, FASN and CPT1A genes by real-time quantitative reverse transcriptase-polymerase chain reaction. Results and discussion. POP ≥ 30 mm by VAS was detected in 17 patients. Before TA, the expression of most of the analyzed genes was significantly increased compared to controls, while the expression of the FASN gene was comparable in patients with OA and healthy individuals. There were no differences in clinical and functional parameters between the groups of patients with and without POP. Before surgery, patients who subsequently developed POP had significantly higher expression of ACLY and CPT1A genes than patients who were satisfied with the results of TA. At the same time, no differences in the expression of ACC1, MLYCD and FASN were found in the groups analyzed. Conclusion. The development of POP is associated with an increased supply of FAs to the mitochondria caused by overexpression of the CPT1A gene, as well as with the accumulation of acetyl-CoA, a product of high expression of the ACLY gene, which can be measured in the blood of OA patients before TA.
目的：评估全膝关节置换术（TA）前膝关节骨性关节炎（OA）晚期患者血液中与脂肪酸（FAs）的β-氧化和从头合成相关的基因的表达差异，这取决于术后疼痛（POP）的发展情况，从而确定导致慢性POP发展的分子机制。 材料和方法分析了 50 名主诉持续疼痛和关节功能障碍的 III-IV 期膝关节 OA 患者在 TA 术前的血液。对照组由 26 名健康人组成。采用视觉模拟量表（VAS）和BPI问卷评估疼痛强度。此外，还使用 WOMAC 指数评估疼痛、僵硬和身体功能，并使用 DN4 和 PainDETECT 问卷评估是否存在神经性疼痛。TA发生3个月和6个月后，对POP的发展情况进行评估。通过实时定量反转录聚合酶链反应，从血液中分离出的总 RNA 被用于测定 ACLY、ACC1、MLYCD、FASN 和 CPT1A 基因的表达。 结果与讨论17例患者的VAS显示POP≥30 mm。与对照组相比，大多数分析基因在TA发生前的表达量明显增加，而FASN基因在OA患者和健康人中的表达量相当。在临床和功能参数方面，POP 患者组和非 POP 患者组之间没有差异。手术前，随后发展成 POP 的患者的 ACLY 和 CPT1A 基因表达明显高于对 TA 结果满意的患者。同时，ACC1、MLYCD 和 FASN 的表达在分析组中没有发现差异。 结论POP的发生与CPT1A基因过度表达导致线粒体FAs供应量增加以及乙酰-CoA（ACLY基因高表达的产物）积累有关。
{"title":"The development of postoperative pain in patients with late-stage knee osteoarthritis is associated with impaired metabolism and transport of fatty acids in blood cells","authors":"E. B. Chetina, G. A. Markova, K. E. Glemba, M. Makarov","doi":"10.14412/1996-7012-2024-3-63-70","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-63-70","url":null,"abstract":" Objective: to evaluate differences in the expression of genes associated with β-oxidation and de novo synthesis of fatty acids (FAs) in the blood of patients with the late stage of knee osteoarthritis (OA) before total knee arthroplasty (TA) depending on the development of postoperative pain (POP) in order to determine the molecular mechanisms responsible for the development of chronic POP. Material and methods. Blood of 50 patients with stage III–IV knee OA complaining of constant pain and joint dysfunction was analyzed prior to TA. The control group consisted of 26 healthy individuals. Pain intensity was assessed using a visual analogue scale (VAS) and the BPI questionnaire. In addition, pain, stiffness and physical functioning were assessed using WOMAC index and the presence of neuropathic pain was assessed using the DN4 and PainDETECT questionnaires. The development of POP was assessed 3 and 6 months after TA. Total RNA isolated from blood was used to determine the expression of ACLY, ACC1, MLYCD, FASN and CPT1A genes by real-time quantitative reverse transcriptase-polymerase chain reaction. Results and discussion. POP ≥ 30 mm by VAS was detected in 17 patients. Before TA, the expression of most of the analyzed genes was significantly increased compared to controls, while the expression of the FASN gene was comparable in patients with OA and healthy individuals. There were no differences in clinical and functional parameters between the groups of patients with and without POP. Before surgery, patients who subsequently developed POP had significantly higher expression of ACLY and CPT1A genes than patients who were satisfied with the results of TA. At the same time, no differences in the expression of ACC1, MLYCD and FASN were found in the groups analyzed. Conclusion. The development of POP is associated with an increased supply of FAs to the mitochondria caused by overexpression of the CPT1A gene, as well as with the accumulation of acetyl-CoA, a product of high expression of the ACLY gene, which can be measured in the blood of OA patients before TA.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"55 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141342242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14DOI: 10.14412/1996-7012-2024-3-44-51
N. V. Lazareva, O. V. Bugrova, N. E. Artemova, K. Nagornova
Currently, the prognosis for systemic lupus erythematosus (SLE) has improved significantly, but the relative risk of death in these patients is stillhigher than in the general population. Thrombotic complications are one of the leading causes of death in SLE. Objective: to analyze the survival rate and structure of lethal outcomes in Orenburg population of patients with SLE, including deaths due to thrombotic complications. Material and methods. A two-stage study of SLE progression and patient survival was conducted from 2007 to 2022. Clinical signs of the diseasewere analyzed in all patients at baseline (n = 68) and in survivors (n = 50) after 15 years. The median age at the time of enrolment in the study was 35 [29; 45] years, the disease duration – 7.5 [3; 13.5] years. During the second stage, the characteristics of the course of the disease in the survived patients and the causes of death in those who died over 15-year period were determined. Results and discussion. The 10-, 15- and 20-year survival rates in Orenburg population of patients with SLE reached 98.5, 95.5 and 86.3%, respectively. During this period, 18 (26.5 %) deaths were registered, the median age of the deceased was 48.5 [39; 57] years, and the duration of the disease was 22 [16; 30] years. The most common causes of death were thrombotic complications (n = 14, 78 %) due to antiphospholipid syndrome, lupus nephritis, and arterial hypertension. Less frequently, infectious complications were the cause of death (n = 4, 22 %). Patients with thrombotic complications had a 20-year survival rate of 80.2% that was significantly lower than in the SLE group without thrombosis. Conclusion. The results obtained allow to consider the presence of thrombotic complications in patients with SLE in Orenburg population as an unfavorable prognostic factor.
{"title":"Survival and lethal outcomes in Orenburg population of patients with systemic lupus erythematosus","authors":"N. V. Lazareva, O. V. Bugrova, N. E. Artemova, K. Nagornova","doi":"10.14412/1996-7012-2024-3-44-51","DOIUrl":"https://doi.org/10.14412/1996-7012-2024-3-44-51","url":null,"abstract":" Currently, the prognosis for systemic lupus erythematosus (SLE) has improved significantly, but the relative risk of death in these patients is stillhigher than in the general population. Thrombotic complications are one of the leading causes of death in SLE. Objective: to analyze the survival rate and structure of lethal outcomes in Orenburg population of patients with SLE, including deaths due to thrombotic complications. Material and methods. A two-stage study of SLE progression and patient survival was conducted from 2007 to 2022. Clinical signs of the diseasewere analyzed in all patients at baseline (n = 68) and in survivors (n = 50) after 15 years. The median age at the time of enrolment in the study was 35 [29; 45] years, the disease duration – 7.5 [3; 13.5] years. During the second stage, the characteristics of the course of the disease in the survived patients and the causes of death in those who died over 15-year period were determined. Results and discussion. The 10-, 15- and 20-year survival rates in Orenburg population of patients with SLE reached 98.5, 95.5 and 86.3%, respectively. During this period, 18 (26.5 %) deaths were registered, the median age of the deceased was 48.5 [39; 57] years, and the duration of the disease was 22 [16; 30] years. The most common causes of death were thrombotic complications (n = 14, 78 %) due to antiphospholipid syndrome, lupus nephritis, and arterial hypertension. Less frequently, infectious complications were the cause of death (n = 4, 22 %). Patients with thrombotic complications had a 20-year survival rate of 80.2% that was significantly lower than in the SLE group without thrombosis. Conclusion. The results obtained allow to consider the presence of thrombotic complications in patients with SLE in Orenburg population as an unfavorable prognostic factor.","PeriodicalId":18651,"journal":{"name":"Modern Rheumatology Journal","volume":"43 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141339768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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