CLINICO-PATHOGENETIC VALUE OF SILICON IN RHEUMATOID ARTHRITIS
Summary. Risk factors for development and subsequent adverse course of rheumatoid arthritis (RA) are high concentrations of silicon compounds (Si) in atmosphere. The aim and purpose of the work was to evaluate the clinical and pathogenetic significance of silicon microelementoses in RA, its role in the development of secondary osteoporosis and the impact on the state of the markers of bone metabolism, study of the influence of air pollution level in human habitation by silicon-containing pollutants on the prevalence and course of the disease, as well as to the balance of Si in the organism of patients. Materials and methods. 83 patients with RA were under the supervision, they were aged from 22 to 75 years (mean 45 years) among them were 22% male and 78% female. The duration of the disease from the first signs of theirs manifestation was 9 years old. Systemic form of the disease was diagnosed in 19% of cases, seropositive RA by rheumatoid factor is set in 68% of cases, according to cyclic citrullinated peptide antibodies — in 80%. Results. RA is accompanied by a decrease in the accumulation of Si in the hair, which is observed in ¾ of the number of patients in the absence of significant changes in the level of siliconemia that is associated with the clinical, radiographic and sonographic signs of the disease, the degree of activity and severity of arthritis, and silicon imbalance is involved in the pathogenesis constructions of the articular syndrome, involvement of skeletal muscle, the peripheral nervous system and internal organs (lung, heart, kidney), wherein, Si indicators in blood and hair may have prognostic significance. Systemic osteoporosis is accompanied by decrease of the siliconemia parameter in 43% that is closely linked with the indicators of bone density, and they, in turn, with a osteocalcin concentration in serum, in this case there is a dispersion influence and correlations of silicon balance with a serum osteocombined strontium value that has certain predictive concerning to the violations of the Si parameters in the organism. High level of silicon-containing compounds in atmoshere of regions where patient with RA live has an effect of the accumulation Si in organism, which is an additional pathogenetic factor of affection maxillary joints and large joints (shoulder, knee, hip), the occurrence of systemic signs of illness (enthesopathies, digital arteritis), aseptic osteonecrosis, intra-articular Hoff and Shtaydi bodies and contamination of the inhaled air by silica can alter bone density, affecting the serum value of osteocombined macronutrients (Ca, Mg).
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