Syniachenko O.V., Iermolaieva M.V., Liventsova K.V., Verzilov S.M., Aliieva T.Yu., Potapov Yu.O., Pylypenko V.V., Fedorov D.M.

Summary. Relevance. In patients with rheumatoid arthritis (RA), changes in the levels of middle mass molecules (MMM) of various fractions in biological fluids hypothetically can determine the development of viscerites, the nature of bone-destructive joint injuries and the rate of progression of the disease, but these issues remain unexplored. The purpose and objectives of the study: to establish the clinical and pathogenetic significance of MМM of various fractions in the biological fluids of patients with RA, to study the determining clinical, laboratory and X-ray sonographic factors, to substantiate informative prognostic criteria. Materials and me­thods. 105 patients with RA were under observation. To determine MMM, a screening method was used with the precipitation of proteins with trichloroacetic acid and the determination of the light absorption spectra by the acid-soluble fraction. Results. RA is accompanied by an increase in the serum concentrations of certain fractions of MMM, which is associated with the activity of the disease and the articular syndrome, in particular certain bone-destructive articular injuries and systemic manifestations of the disease. The activity and staging of RA, the rate of its progression, the development of osteoporosis, the formation of bone-destructive lesions are associated with changes in the average molecular hormones, and the level of osteocalcin has prognostic significance. Conclusions: individual fractions of MMM from various biological fluids are involved in the pathogenetic constructions of RA, depend on clinical, laboratory, radiological and sonographic signs of the disease, can be used to predict the course of the pathological process, monitor the effectiveness of treatment and develop new medical treatment technologies.

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