Yakimenko D. O.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The features of the clinical picture, the state of the tooth-jaw system and the oral mucosal mucosa in 60 patients with rheumatoid arthritis, 11 men (18%) and 49 women (82%), mean age 49.7 + 0.43 years were studied. It was found that in patients with RA there is a decrease in salivation, which leads to the defeat of the oral mucosa. In all patients with RA, the rate of spontaneous salivation is significantly lower than in the control group (0.25 + 0.005 ml/min in the 1st, 0.14 + 0.04 ml/min in the 2nd and 0.39 + 0, 01 ml/min in the control group, respectively). The lowest salivation rate is in patients with RA and MS (a decrease of 64% compared with the control group). They also have the highest hygienic index of Green-Vermillion (an increase of 17% compared with patients with RA without MS), which indicates a pronounced defeat of the oral cavity. Reducing the amount of saliva in patients with RA is accompanied by a change in its qualitative characteristics – a decrease in the content of lysozyme (by 45%) and leukocytes (by 54% compared to control), which leads to a decrease in antimicrobial properties, activation of saprophytic microflora and deterioration of the hygienic state of the oral cavity, as evidenced by the growth of the hygienic index of Green-Vermillion. The presence of RA and CSH is accompanied by a deterioration in the quality of life: all patients experienced an increase in the EuroQol-5D index, indicating a decrease in the quality of life due to the disease, with patients with RA with the US, the decline in the quality of life was significantly more pronounced than in patients without RA The secondary school (4.9 + 0.2 versus 5.7 + 0.4, the difference is significant, p <0.01). In patients with RA with CS, the lowest spontaneous salivation rate is accompanied by high activity of the inflammatory process: the highest ESR (an increase of 46.7% compared to control) and the content of inflammatory markers – C-reactive protein (an increase of 115% compared to control), IL-1 (increase by 52.7%), CIC (increase by 69.7%). They have the highest content of RF, antibodies to the SSR and ANA of different types. The presence of a wide range of autoantibodies, characteristic of RA, is associated with a decrease in the rate of spontaneous salivation, and most often they are detected in patients with MS. Patients with RA from the U.S. have a higher activity in the inflammatory process than patients without CSF with a significantly shorter duration of the disease (2.9 + 0.7 vs. 4.8 + 0.5 years, the difference is significant, p <0.05%). The rate of spontaneous salivation in patients with RA decreases with the increase in the activity of the inflammatory autoimmune process, which may be explained by the presence in the vast majority (80%) of patients with RA of varying degrees of sialoadenitis, reaching the maximum severity with high activity of the rheumatic process. The disruption of immunological tolerance observed in RA is accompanied by the emergence of various autoantibodies, organoleptic and organ-specific, an increase in the rate of synthesis of proinflammatory cytokines and the damage of many organs and systems (exocrine glands of the gastrointestinal tract, vascular system). The presence of Sjogren’s syndrome in rheumatoid arthritis is associated with significant deterioration of oral hygiene, decreased number and degradation of saliva, high activity of the inflammatory process and the concentration of inflammatory markers, the presence of a wide range of autoantibodies in high titres (rheumatoid factor, antibodies to SSR, antinuclear antibodies, SSA antibodies / Ro and SSB / La), increased content of C-reactive protein, circulating immune complexes, interleukin -1). Reduced saliva production is accompanied by a deterioration of its antimicrobial properties (lowering the content of lysozyme and leukocytes) and progressive loss of teeth.

rheumatoid arthritis, Sjogren’s syndrome, quality of life, markers of inflammation, autoantibodies

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«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 203-206 pages, index UDK 616.72-002.77-06:616.316-008.811.4

10.29254/2077-4214-2018-3-1-145-203-206