Garmish O.O. , Levchenko V.G.

Summary. The aim of the study was to determine the dynamics of changes in subpopulations of blood monocytes and B-lymphocytes in patients with rheumatoid arthritis (RA) and their relationship with RA activity, proatherogenic disorders of lipid and LP metabolism, the content of apo-AI and apo-B in the blood. Materials and methods. In all patients, the spectrum of lipids and lipoproteins in the blood was assessed with additional determination of the apoB and apoA-1 plasma levels. The cells subpopulation composition (lymphocytes and monocytes) of peripheral blood was determined by flow cytometry using reagents for determining differentiation clusters CD3, CD4, CD5, CD8, CD19, CD14, CD16, and CD45 manufactured by Beckman Coulter Іnc. Cytofluorometric analysis was performed on a NAVIOS apparatus (Beckman Coulter Inc.). Results. In patients with RA, traditional indicators of blood lipid and LP metabolism remain within the normal range with an increased content of C-reactive protein and ESR in their blood. At the same time, the concentration of apoA-1 in the blood was 35% lower than in the control group (p <0.01). The concentration of apoB — the main apo-protein of LDL and VLDL, on the contrary, was 16.5% higher than the control value (p <0.05). As a result, the atherogenic index was 70% higher than the normal value (p <0.001). The increase in RA activity was associated with a decrease in the number of the classical (CD14 + hiCD16-) and patrolling (CD14 + hiCD16 +) monocytes subpopulations with an increase in the monocytes count of the intermediate subpopulation. In parallel, a decrease in the B1 lymphocytes subpopulation of with a decrease in the number of of the B2 lymphocytes subpopulation was noted. Conclusions. In patients with RA, in parallel with an increase in the activity of systemic inflammation, an increase in the proatherogenic potential of the blood is noted. The traditional indicators of lipid and LP metabolism in patients with high RA activity remains within the normal range, which significantly complicates the diagnosis of preclinical stages of atherosclerosis, determining the prognosis, and therefore delays the treatment start and reduces its effectiveness. The pathogenetic mechanisms of proatherogenic disorders of blood LP in patients with RA may be changes in the subpopulation composition of blood MC and LP.

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