Diagnostic accuracy of anti-DNase I antibodies measurement in a differentiation between SLE and other autoimmune rheumatic diseases was evaluated. The share of anti-DNase I and actin in the DNase I activity decrease in SLE was established. Serum samples were obtained from 54 patients with verified SLE, 52 control patients with other autoimmune rheumatic diseases, and 44 healthy persons. Anti-DNase I concentrations were measured by ELISA. Free and actin inhibited DNase I activities were evaluated in the fresh serum samples. The appraisal of antibodies and actin effects on DNase I activity was made using multiple regression. Anti-DNase I antibodies were positive in 35 SLE and 8 control patients, without significant difference between the mean antibody concentrations. Sensitivity of this test was 64.81 %, and specificity-84.62 %. Mean free DNase I activity in SLE was somewhat lower than in the control group as a result of augmented frequency of extremely low enzyme activities. On the contrary, after the exclusion of the latter cases we have revealed elevated mean free DNase I activity in the other SLE patients comparing to the similar control subgroup. Unlike the controls, low serum DNase I activity in SLE arose not only from actin and antibody action, but also, in half of the cases, from unidentified factor, related to active SLE. The accuracy of the anti-DNase I antibodies measurement is approximate to the present reference standard of SLE diagnostics. We first demonstrated that neither antibodies nor actin caused DNase I activity decrease in SLE.

: This review highlights the issue of psychosomatic conditions in rheumatoid arthritis, paying a special attention to new researches and trends in this field. Emerging concepts in all the major parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain on emotional state to disease influence over quality of life, socio-psychological, and interpersonal relationships. Chronic pain is closely related to emotional responses and coping ability, with pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading to further decrease of quality of life, low compliance, and high suicide risk. Influence of psychosomatic conditions on overall treatment effect is usually underestimated by rheumatologists and general practitioners. Psychosomatic considerations are of great importance for up-to-date management of rheumatoid arthritis, as they strongly influence quality of life, compliance, and thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping with pain through regulation of emotion and psychotherapeutic intervention, which not only helps patients in coping with the disease, but also aimed at improving the overall adaptation of the patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy. Current data about efficacy of the additional correcting therapies for patients with rheumatoid arthritis, both emerging and common ones, are discussed in the review.

Objective: Consolidation of current research findings as well as the most important concepts regarding neutrophil extracellular traps (NETs) in rheumatoid arthritis. Data sources: Relevant publications released from 2004 to 2018 were identified using PubMed, Web of Science, Scopus, and eLibrary databases. Primary search terms used were “neutrophil extracellular traps” or “NETs” in combination with “rheumatoid arthritis”. Data synthesis: NETs are distinctive structures promoting capture and non-phagocytic cleavage of foreign substances. NETs usually consist of thin chromatin fibers decorated with various molecules of granular, cytosolic, and cytoskeletal origin. NETosis could develop in two ways: either with neutrophil death or when the viability of the cell prolongs. ROS generation and pronounced protein citrullination are essential during the initial phase of NETs formation. NETosis is considered to have certain immunological consequences, including DAMPs-mediated signalling, proinflammatory cytokine secretion, and contact of extensively modified self and foreign epitopes with antigen presenting cells. There are several putative pathogenetic links between NETosis, citrullination, neoepitope formation, and production of anticitrulline autoantibodies that can strongly influence rheumatoid arthritis progression. NET-induced vascular injury in rheumatoid arthritis could arise both directly from NETs and indirectly through enhanced thrombosis and atherosclerosis. Conclusion. NETs are currently estimated as a possible influential factor of rheumatoid arthritis initiation and/or progression, especially in the context of vascular involvement. NETs can also serve as a source of novel antigenic biomarkers for the diagnosis of rheumatoid arthritis.

BackgroundRecent studies report various metabolic disturbances in systemic scleroderma (SSc) patients. Purine and pyrimidine metabolic pathways are closely interrelated, underlying the central processes of cellular life. Alterations of the enzymes that control these metabolic conversions can disturb proliferation and differentiation of lymphocytes, therefore contributing initiation and progression of the immunopathological phenomena.Objectivesto characterise enzymatic patterns of the major purine and pyrimidine metabolic pathways enzymes in blood plasma and lysed lymphocytes depending on the SSc activity.Methods51 SSc patients and 30 healthy controls were enrolled in the study. Mean age of patients (Mean ±SD) was 42,8±1,3 years, mean SSc duration was 7,9±0,7 years. The diagnosis was verified in accordance with the international standards (ACR/.EULAR 2013 Disease activity was assessed in accordance with the national classification.1 Adenosine deaminase (ADA; EC 3.5.4.4); adenosine kinase (AK; EC 2.7.1.20); guanylate kinase (GK; EC 2.7.4.8), dihydroorotate dehydrogenase (DODH; EC 1.3.1.14); IMP dehydrogenase (IMPDH; EC 1.1.1.205); purine nucleoside phosphorylase (PNP; EC 2.4.2.1); thymidine kinase (TK; EC 2.7.1.21); thymidine phosphorylase (TP; EC 2.4.2.4); uracil/thymidine dehydrogenase (UDH; EC 1.17.99.4); cytidine deaminase (CDA; EC 3.5.4.5) activities were measured in blood plasma and lysed lymphocytes.ResultsWe revealed substantial changes in enzymatic activities related to both purine and pyrimidine metabolism in SSc. The increased DODH (p<0,001), IMPDH (p<0,001), PNP (p<0,001), TK (p<0,001), TP (p<0,01), UDH (p<0,001) activities in plasma and AK (p<0,001), IMPDH (p<0,001), TK (p<0,001) activities in lysed lymphocytes; the decreased ADA (p<0,001), GK (p=0,02), PNP (p<0,001) activities in lysed lymphocytes were observed in SSc patients in comparison with healthy controls. Plasma AK, DODH, IMPDH, PNP, TK, UDH activities positively correlated with SSc activity, as well as lymphocytic AK, IMPDH, TK activities did. Negative correlations with SSc activity were revealed for plasma ADA, GK, TP, and also for lymphocytic ADA, GK, DODH, PNP, TP, UDH, CDA. Plasma and lymphocytic adenosine deaminase as well as adenosine kinase activities were the most informative for minimal SSc activity detection, being a promising candidate marker.ConclusionsThe changes in enzymatic activity of purine and pyrimidine metabolism participate in pathogenesis of SSc. The enzymatic patterns studied can be used as auxiliary markers of SSc activity. The correction of purine and pyrimidine metabolism changes can be considered as one of the promising ways of increasing the effectiveness of SSc treatment.Reference[1] Guseva NG. Systemic scleroderma. M: Medicine1993;268.Disclosure of InterestNone declared

No abstract