Взаимосвязь эндотелиальных факторов вазорегуляции и состояния антиоксидантной системы с клиническими проявлениями ревматоидного артрита

The aim of the work was to identify the relationship of vasomotor and angiogenic factors of the endothelium, as well as the state of the antioxidant system in rheumatoid arthritis (RA). Materials and methods included 50 patients with RA and 42 healthy people of appropriate age and gender, who analyzed the main clinical indicators. In erythrocytes, the activity of superoxide dismutase (SOD), glutathione peroxidase (GPO), glutathione reductase (GR) and the concentration of reduced glutathione (GSH) were investigated. The concentration of higher nitrogen oxides (NOx), endothelin-1 (ET-1) and vascular endothelial growth factor VEGF-A was determined in plasma. Results . In the general group of patients with RA, signs of oxidative stress (OS) were observed, expressed in a decrease in the activity of GPO, GR and SOD when compared with the control, and a positive correlation of ET-1 with VEGF-A (R=0.547, p=0.028) and ET-1 with RF ( R=0.578; p=0.024). ET-1 (R=0.622; p=0.031) and VEGF-A (R=0.627; p=0.016) correlated with the presence of joint erosion. Among patients with joint erosion, the level of VEGF-A correlated with the activity of the process (R=0.756; p=0.030), the level of plasma NOx (R=0.545; p=0.036) and the activity of GR (R=0.579; p=0.03). The ET-1 level in the blood plasma of patients with RA with joint erosion was 10.0 (4.4–10.0) ng / l and was higher than in patients without erosion (4.2 (2.3–17) ng/l). The level of plasma VEGF-A in patients with RA with joint erosion (62.8 (31.0–100.0) ng /l) was higher than in patients without erosion (20.4 (10.0–25.3) ng/l). Conclusions . A decrease in the concentration of GSH and the activity of GPO, GR and SOD indicate the presence of OS in patients with RA, regardless of the duration and activity of the disease. ET-1 and VEGF-A may be prognostic criteria for erosive RA.