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Background:Rheumatoid arthritis (RA), associated with Chlamydial Infection, has some clinical and immunological particulars that interfere with the early diagnosis and require significant changes in treatment strategy [1].Objectives:To estimate the distribution of some non-HLA genetic markers such as STAT4 rs7574865, IL6 rs1800795, IL6R rs2228145 and rs4845618 in Chlamydia positive and negative RA patients and healthy controls.Methods:We examined 380 healthy blood donors and 187 RA patients classified according to the ACR/EULAR 2010 criteria for RA [2]. Twenty-three of the RA patients were positive for Chlamidia trachomatis (n=17) or Chlamidia pneumonia (n=6) persistence. DNA from peripheral blood samples was extracted by phenol-chloroform method. SNPs were genotyped by the real-time PCR with fluorescent probes. Statistical significance of SNPs’ frequency was estimated by two-way Fisher exact test (F, p2-t) with Bonferroni correction for multiple comparisons (pcor). Moreover, diagnostic odds ratio (dOR), the likelihood ratio of positive (LR+) and negative (LR–) tests and corresponding confidence intervals (CI) were calculated.Results:We revealed statistically significant increase of genotype СС frequency (IL6 rs1800795) in Chlamydia-associated RA (60.9%) vs healthy donors (20.7%): p2-t=0.000065; pcor=0.00026; dOR=5.95 (CI95%2.53-13.94); LR+=2.94 (CI95%1.90-3.29); LR–=0.49 (CI95%0.28-0.75) as well as in Chlamydia-associated RA (60.9%) vs Chlamydia-negative RA (23.9%): p2-t=0.00051; pcor=0.002; dOR=4.99 (CI95%2.04-12.16); LR+=2.56 (CI95%1.60-3.57); LR–=0.51 (CI95%0.29-0.78). Significant differences in STAT4 rs7574865, IL6R rs2228145 and IL6R rs4845618 distribution between studied groups were not found.Conclusion:Our data suggest the association between СС genotype of IL6 rs1800795 and Chlamydia-associated RA.References:[1]Soroka N.F. Rheumatoid Arthritis, associated with Chlamydial infection // Healthcare 2009; 1: 5-9.[2]Aletaha D. et al. 2010 Rheumatoid arthritis classification criteria// Arthritis Rheum 2010; 62 (9): 2569-81.Disclosure of Interests:Tatiana Zybalova: None declared, Viktor Yagur: None declared, Roza Goncharova: None declared, Nikolaj Soroka Grant/research support from: JSC BIOCAD, Natalia Dostanko: None declared, Valery Apanasovich: None declared, Anastasiya Tushina: None declared

Вданной обзорной статье рассмотрены основные понятия и подходы к оценке трофологического статуса пациентов с ревматическими заболеваниями, применимые также в общей терапевтической практике. Кратко изложена история и подробно описаны важнейшие принципы и методика определения состава тела с помощью биоимпедансного анализа. Приведены традиционные классификации и фенотипы, используемые при определении трофологического статуса. Рассмотрены ключевые показатели компонентного состава тела, используемые вотечественной и зарубежной литературе. Обосновано применение современных методов оценки компонентного состава тела. Рассмотрены причины изменения компонентного состава тела у пациентов с ревматическими заболеваниями. Даны практические советы по интерпретации результатов биоимпедансного анализа состава тела. Изложены развернутые показания для использования биоимпедансного анализа при ревматических заболеваниях. In this review article, there are discussed the basic concepts and approaches to assessing the trophological status in patients with rheumatic diseases that are also applicable in general therapeutic practice. The history is briefly outlined and the most important principles and methodology for determination of body composition using the bioimpedance analysis are described in detail. The traditional classifications and phenotypes used in determination of the trophological status are presented. The key indices of body composition used in domestic and foreign literature are considered. The application of modern methods for assessing the composition of the body is substantiated. The reasons for change in the composition of the body in patients with rheumatic diseases are considered. The practical advice is given on the interpretation of the results of bioimpedance analysis of body composition. Expanded indications for the use of bioimpedance analysis in rheumatic diseases are presented.

В обзоре приведены основные свойства, формы, метаболизм, фармакокинетика кокаина, возможные результаты его взаимодействия с другими веществами и лекарственными средствами, различные аспекты влияния кокаина на сердечно-сосудистую систему. Подробно рассмотрены механизмы действия кокаина, лежащие в основе развития основных широко распространенных патологических процессов в сердце и сосудах. Проанализированы данные большого числа опубликованных исследований, посвященных влиянию кокаина на развитие различных нарушений проводимости и ритма сердца, артериальной гипертензии, эндотелиальной дисфункции, расслоение крупных артерий и аорты. Также обсуждены особенности действия кокаина в разных группах пациентов и в зависимости от длительности его употребления. Приведены рекомендации по диагностике и выбору терапии при ряде патологических состояний, связанных с употреблением кокаина. Особое внимание уделено спорным вопросам лечения и влияния кокаина на сердце и сосуды, диагностическим возможностям различных методов исследования. The review presents the main properties, forms, metabolism, pharmacokinetics of cocaine, possible results of its interaction with other substances and medicines, various aspects of cocaine effect on the cardiovascular system. The mechanisms of cocaine action underlying the development of the main widespread pathological processes in the heart and blood vessels, are considered in detail. The data of a large number of published studies on the cocaine influence on the development of various disorders of conduction and heart rhythm, arterial hypertension, endothelial dysfunction, and dissection of large arteries and aorta are analyzed. The particulars of action with the duration of cocaine use as well as in different groups of patients are discussed. Recommendations are given for the diagnostics and choice of therapy for a number of pathological conditions associated with cocaine use. Particular attention is paid to controversial issues of treatment and effect of cocaine on the heart and blood vessels, the diagnostic capabilities of various diagnostic methods.

Background:Systemic lupus erythematosus (SLE) has a significant genetic predisposition. Many genetic variants of susceptibility to SLE have been published and analyzed, but the clinical and functional significance of the various genotypes has not yet been clearly defined [1].Objectives:To estimate the association between some of non-HLA gene polymorphisms such as STAT4 rs7574865, RUNX1 rs9979383, IL6 rs1800795, IL6R rs2228145, IL6R rs4845618 and susceptibility to SLE in Belarusian population as well as some disease manifestations.Methods:We examined 383 healthy blood donors and 54 SLE patients (18-72 years old, median age 35) classified according to the 1997 American College of Rheumatology (ACR) revised classification criteria [2]. Deoxyribonucleic acid was extracted from peripheral blood samples by phenol-chloroform method. Genotyping was performed by real-time PCR with fluorescent probes. Differences of distribution of all the single nucleotide polymorphism (SNP) genotypes and their associations with secondary antiphospholipid syndrom (APS) and lupus arthritis were analyzed using Pearson χ2 (χ2) and two-way Fisher exact test (F, p2-t). Diagnostic odds ratio (dOR), likelihood ratio of positive (LR +) and negative (LR –) tests and corresponding 95% confidence intervals (CI) were also calculated.Results:We revealed significant difference in STAT4 rs7574865 genotypes in SLE patients and healthy donors (χ2=8,27, р=0,016) with significant increase of ТТ genotype frequency in SLE patients vs healthy donors (χ2=6.83 p=0.009; p2-t =0.020; dOR=3.78 (CI95% 1.36-10.55); LR+ =3.44 (CI95% 1.35-8.71); LR– =0.91 (CI95% 0.83-0.98)). Lupus arthritis was more common in risk TT-genotype SLE carriers than in other SLE patients (χ2=5.902 p=0.015; p2-t =0.027).We revealed significant increase of СТ genotype (RUNX1 rs9979383) in healthy donors vs SLE patients (χ2=4.14; p=0.042; dOR=0.53 (CI95% 0.29-0.98); LR+ =0.69 (CI95% 0.45-0.99); LR– =1.3 (CI95% 1.01-1,56)). Lupus arthritis was more common in SLE СТ-genotype carriers than in other SLE patients (χ2=4.66 p=0.031; p2-t =0.058).Significant differences in IL6 rs1800795, IL6R rs2228145 and IL6R rs4845618 genotypes distribution between studied groups were not found (χ2, p=0.427, p=0.559 and p=0.407, correspondingly) but GG-genotype (IL6 rs1800795) carriership in SLE patients was associated with increased APS frequency (χ2=4.45, p=0.035; dOR=0.19 (CI95% 0.04-0.9); LR+ =0.28 (CI95% 0.07-0.93); LR– =1.41 (CI95% 1.03-1.64).Conclusion:Our data suggest the susceptibility to SLE in ТТ genotype of STAT4 rs7574865 polymorphism, protective role of СТ genotype of RUNX1 rs9979383 for SLE and association between GG-genotype of IL6 rs1800795 and APS in SLE patients in Belarusian population. Lupus arthritis was associated with ТТ genotype of STAT4 rs7574865 and СТ genotype of RUNX1 rs9979383.References:[1]Chen L, Morris DL, Vyse TJ. Genetic advances in systemic lupus erythematosus: an update. Curr Opin Rheumatol 2017;29:423–33.[2]Hochberg MC. Updating the American College of Rheumatology Revised Criteria for the classification of Systemic Lupus Erythematosus. Arthritis Rheum 1997;40:1725.Disclosure of Interests:None declared