665 research outputs found
ΠΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½Π°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ-2019 (COVID-19): Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠΎΠ² IL-6
The coronavirus disease 2019 (COVID-19) pandemic has drawn attention to new clinical and fundamental issues in the immunopathology of human diseases. Since in COVID-19 it is the ββhyperimmuneββ response, called cytokine storm syndrome, which forms the basis of the pathogenesis of acute respiratory distress syndrome (ARDS) and multiorgan dysfunction in COVID-19, special attention is drawn to the possibility of βrepurposingβ (drug repurposing) of some widely used for treatment immune-mediated inflammatory rheumatic diseases (IMIRDs) anti-inflammatory drugs, including glucocorticoids (GC), disease-modified anti-rheumatic drugs (DMARDs), biologic agents and ββtargetedββ DMARDs. In the spectrum of cytokines involved in the pathogenesis of cytokine storm syndrome in IMIRDs and COVID-19, great importance is attached to the pro-inflammatory cytokine, interleukin IL-6. The development and introduction into clinical practice of monoclonal antibodies (mAbs) that inhibit the activity of IL-6 are among the major advances in the treatment of IMIRDs, and in recent years, critical conditions within the framework of the cytokine storm syndrome, including in COVID-19. The review discusses the materials of numerous studies devoted to the problems of the efficacy and safety of mAbs to the IL-6 receptor (tocilizumab) and other mAbs that inhibit the activity of this cytokine in COVID-19. Despite the effectiveness of inhibiting IL-6 in patients with severe COVID-19, many theoretical and clinical problems of immunopathology and pharmacotherapy of this disease require further study.ΠΠ°Π½Π΄Π΅ΠΌΠΈΡ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ-2019 (COVID-19) ΠΏΡΠΈΠ²Π»Π΅ΠΊΠ»Π° Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΠΊ Π½ΠΎΠ²ΡΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΈ ΡΡΠ½Π΄Π°ΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠΌ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌ ΠΈΠΌΠΌΡΠ½ΠΎΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. ΠΠΎΡΠΊΠΎΠ»ΡΠΊΡ ΠΏΡΠΈ COVID-19 ΠΈΠΌΠ΅Π½Π½ΠΎ Π³ΠΈΠΏΠ΅ΡΠΈΠΌΠΌΡΠ½Π½ΡΠΉ ΠΎΡΠ²Π΅Ρ, ΠΏΠΎΠ»ΡΡΠΈΠ²ΡΠΈΠΉ Π½Π°ΠΈΠΌΠ΅Π½ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΈΠ½Π΄ΡΠΎΠΌ Β«ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠΎΡΠΌΠ°Β», ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ ΠΎΡΠ½ΠΎΠ²Ρ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π° ΠΎΡΡΡΠΎΠ³ΠΎ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΡΡΡΠ΅ΡΡ-ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΈ ΠΌΡΠ»ΡΡΠΈΠΎΡΠ³Π°Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΡΠΈ COVID-19. ΠΡΠΈ ΡΡΠΎΠΌ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ ΠΏΡΠΈΠ²Π»Π΅ΠΊΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΠ΅ΠΏΠΎΠ·ΠΈΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ (drug repurposing) Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
ΡΠΈΡΠΎΠΊΠΎΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΠΌΡΡ
Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ (ΠΠΠ Π) ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², Π²ΠΊΠ»ΡΡΠ°Ρ Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄Ρ, Π±Π°Π·ΠΈΡΠ½ΡΠ΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ, Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΠ΅ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ ΠΈ ΡΠ°ΡΠ³Π΅ΡΠ½ΡΠ΅ Π±Π°Π·ΠΈΡΠ½ΡΠ΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ. Π ΡΠΏΠ΅ΠΊΡΡΠ΅ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ², ΠΏΡΠΈΠ½ΠΈΠΌΠ°ΡΡΠΈΡ
ΡΡΠ°ΡΡΠΈΠ΅ Π² ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Β«ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠΎΡΠΌΠ°Β» ΠΏΡΠΈ ΠΠΠ Π ΠΈ COVID-19, Π±ΠΎΠ»ΡΡΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΈΠ΄Π°Π΅ΡΡΡ ΠΏΡΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌΡ ΡΠΈΡΠΎΠΊΠΈΠ½Ρ ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΠΉΠΊΠΈΠ½Ρ (IL)-6. Π Π°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΠΈ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΠΏΡΠ°ΠΊΡΠΈΠΊΡ ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡΠ½ΡΡ
Π°Π½ΡΠΈΡΠ΅Π» (ΠΌΠΠ’), ΠΈΠ½Π³ΠΈΠ±ΠΈΡΡΡΡΠΈΡ
Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ IL-6, ΠΎΡΠ½ΠΎΡΠΈΡΡΡ ΠΊ ΡΠΈΡΠ»Ρ ΠΊΡΡΠΏΠ½ΡΡ
Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠΉ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΠΠ Π, Π° Π² ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π³ΠΎΠ΄Ρ β ΠΊΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Β«ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠΎΡΠΌΠ°Β», Π² Ρ. Ρ. ΠΏΡΠΈ COVID-19. Π ΠΎΠ±Π·ΠΎΡΠ΅ ΠΎΠ±ΡΡΠΆΠ΄Π°ΡΡΡΡ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΌΠ½ΠΎΠ³ΠΎΡΠΈΡΠ»Π΅Π½Π½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π½ΡΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΌΠΠ’ ΠΊ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΡ IL-6 (ΡΠΎΡΠΈΠ»ΠΈΠ·ΡΠΌΠ°Π±) ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΌΠΠ’, ΠΈΠ½Π³ΠΈΠ±ΠΈΡΡΡΡΠΈΡ
Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΡΠΎΠ³ΠΎ ΡΠΈΡΠΎΠΊΠΈΠ½Π° ΠΏΡΠΈ COVID-19. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΠ²Π°Π½ΠΈΡ IL-6 Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ COVID-19, ΡΡΠ΅Π±ΡΠ΅ΡΡΡ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅Π΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΡΠ΅ΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΠΈΠΌΠΌΡΠ½ΠΎΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΡΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ
NEW GUIDELINES FOR THE MANAGEMENT OF RHEUMATOID ARTHRITIS (EULAR, 2013): THE PLACE OF GLUCOCORTICOIDS
Despite major advances in the management of rheumatoid arthritis (RA), whicare associated with the development ofΒ new methods for its early diagnosis, the clinical introduction of a wide range of innovative medications and particularlyΒ the improvement of a strategy for their use, glucocorticoids (GC) still remain the most important component ofΒ pharmacotherapy for this disease in real clinical practice. This publication that is a continuation of a series of papersΒ devoted to the discussion of the main points of the 2013 European League against Rheumatism (EULAR) guidelinesΒ for the treatment of early RA, deals with the place of GC. An analysis of available data suggests that GC should beΒ reserved for patients showing a high activity of the inflammatory process and having factors associated with a poorΒ prognosis, but also, in the absence of risk factors for adverse events (AE), of course, contraindications to GC therapy.Β Throughout the use of GC, their AE should be meticulously monitored in compliance with the EULAR guidelines. Itis anticipated that the wider use of combined therapy with methotrexate and a GC in earlyRA will be able to improveΒ its prognosis in at least some patients and to cause a substantial decrease in the burden of disease, by reducing the riskΒ of disability and the needs for expensive biological agents and joint replacement. All this confirms that it is relevant toΒ include the proposition for using GC into the 2014 Guidelines for the management of rheumatoid arthritis of the All-Russian public organization βAssociation of Rheumatologists of Russiaβ
Electromagnetically induced switching of ferroelectric thin films
We analyze the interaction of an electromagnetic spike (one cycle) with a
thin layer of ferroelectric medium with two equilibrium states. The model is
the set of Maxwell equations coupled to the undamped Landau-Khalatnikov
equation, where we do not assume slowly varying envelopes. From linear
scattering theory, we show that low amplitude pulses can be completely
reflected by the medium. Large amplitude pulses can switch the ferroelectric.
Using numerical simulations and analysis, we study this switching for long and
short pulses, estimate the switching times and provide useful information for
experiments
Program for experimental investigations of the mechanisms for the emission of coherent radiation by relativistic electrons with energies of 10-500 MeV in oriented crystals
A program of experimental investigations of the mechanisms for the emission of coherent radiation by electrons in periodic structures is proposed. The program is aimed at developing sources of energy-tunable quasimonochromatic x radiation and y radiationyesBelgorod State Universit
ΠΠΎΠ²ΡΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΠΊΡΠ°ΡΠ½ΠΎΠΉ Π²ΠΎΠ»ΡΠ°Π½ΠΊΠΈ: ΠΌΠ΅ΡΡΠΎ Π±Π΅Π»ΠΈΠΌΡΠΌΠ°Π±Π°
Systemic lupus erythematosus (SLE) is a multifactorial disease caused by complex interactions between the genetic and environmental factorsΒ underlying various innate and adaptive immunity disorders, including cytokine hyperproduction, abnormal B cell activation, impaired intracellular T-cell signaling, and defective apoptotic and necrotic cell clearance. A broad spectrum of genetic disorders associated with susceptibility to the disease and/or its definite variants has been identified. Our knowledge concerning the mechanisms of polyclonal B cell activation in SLE has advanced substantially. Various defects in the T cells regulating a B cell immune response have been detected. The development of genetic, epigenomic, transcriptomic, and proteomic technologies could identify a group of pathogenetically relevant cytokines, including BLyS (the B-lymphocyte stimulator is the most important component of cytokine-mediated regulation of B cell function, proliferation, and differentiation), interleukin (IL) 6, 17, 18, type 1 interferon, and tumor necrosis factor-Ξ±, which are involved in the development of visceral inflammation and damage.Large-scale clinical trials of different medications, primarily biological agents (BA), were conducted in patients with SLE. Rituximab (RTM) is the first BA to be used to treat this disease. Despite its official registration for the therapy of SLE, RTM is included in the EULAR, ACR, and Russia's Association of Rheumatologists guidelines for its treatment. Belimumab, a fully human recombinant IgG1Ξ»monoclonal antibody, specially designed to treat SLE, prevents the interaction of pBLyS with the receptors of autoreactive transitional and naive B cells, giving rise to the suppression of B cell hyperresponsiveness, autoantibody synthesis in particular. In addition, BLyS block may cause decreased survival of B cells in the germinal centers of lymphoid organs, differentiation of memory B cells into autoantibody-producing cells, and synthesis of proinflammatory cytokines (IL-21, IL-17, and others) that play an important role in the immunopathogenesis of SLE. Despite its moderate efficacy, belimumab will be able to improve pharmacotherapy for this disease.Π‘ΠΈΡΡΠ΅ΠΌΠ½Π°Ρ ΠΊΡΠ°ΡΠ½Π°Ρ Π²ΠΎΠ»ΡΠ°Π½ΠΊΠ° (Π‘ΠΠ) β ΠΌΡΠ»ΡΡΠΈΡΠ°ΠΊΡΠΎΡΠ½ΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΠΎΠ΅ ΡΠ»ΠΎΠΆΠ½ΡΠΌ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ΠΌ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ Π²Π½Π΅ΡΠ½Π΅ΡΡΠ΅Π΄ΠΎΠ²ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ², Π»Π΅ΠΆΠ°ΡΠΈΡ
Π² ΠΎΡΠ½ΠΎΠ²Π΅ ΠΌΠ½ΠΎΠ³ΠΎΠΎΠ±ΡΠ°Π·Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠ³ΠΎ ΠΈ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ°, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π³ΠΈΠΏΠ΅ΡΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠΈ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ², ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°ΠΊΡΠΈΠ²Π°ΡΠΈΠΈ Π-ΠΊΠ»Π΅ΡΠΎΠΊ, Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π²Π½ΡΡΡΠΈΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ ΡΠΈΠ³Π½Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π’-ΠΊΠ»Π΅ΡΠΎΠΊ, Π΄Π΅ΡΠ΅ΠΊΡΠΎΠ² ΠΊΠ»ΠΈΡΠ΅Π½ΡΠ° ΠΊΠ»Π΅ΡΠΎΠΊ, ΠΏΠΎΠ΄Π²Π΅ΡΠ½ΡΡΡΡ
Π°ΠΏΠΎΠΏΡΠΎΠ·Ρ ΠΈ Π½Π΅ΡΠΎΠ·Ρ. ΠΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½ ΡΠΈΡΠΎΠΊΠΈΠΉ ΡΠΏΠ΅ΠΊΡΡ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ, Π°ΡΡΠΎΡΠΈΠΈΡΡΡΡΠΈΡ
ΡΡ Ρ Β«ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡΒ» ΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ/ΠΈΠ»ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠΌΠΈ Π²Π°ΡΠΈΠ°Π½ΡΠ°ΠΌΠΈ Π΅Π³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ. Π‘ΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠ°ΡΡΠΈΠ»ΠΈΡΡ Π·Π½Π°Π½ΠΈΡ ΠΎ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ°Ρ
ΠΏΠΎΠ»ΠΈΠΊΠ»ΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π-ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π°ΠΊΡΠΈΠ²Π°ΡΠΈΠΈ ΠΏΡΠΈ Π‘ΠΠ. ΠΡΡΠ²Π»Π΅Π½Ρ ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΡ Π’-ΠΊΠ»Π΅ΡΠΎΠΊ, ΡΠ΅Π³ΡΠ»ΠΈΡΡΡΡΠΈΡ
Π-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΉ ΠΈΠΌΠΌΡΠ½Π½ΡΠΉ ΠΎΡΠ²Π΅Ρ.Π Π°Π·ΡΠ°Π±ΠΎΡΠΊΠ° Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
, ΡΠΏΠΈΠ³Π΅Π½ΠΎΠΌΠ½ΡΡ
, ΡΡΠ°Π½ΡΠΊΡΠΈΠΏΡΠΎΠΌΠ½ΡΡ
ΠΈ ΠΏΡΠΎΡΠ΅ΠΎΠΌΠ½ΡΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ Π³ΡΡΠΏΠΏΡ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΡ
ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ², Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ BLyS (B-lymphocyte stimulator β Π²Π°ΠΆΠ½Π΅ΠΉΡΠΈΠΉ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΠΎΠΉ ΡΠ΅Π³ΡΠ»ΡΡΠΈΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ, ΠΏΡΠΎΠ»ΠΈΡΠ΅ΡΠ°ΡΠΈΠΈ ΠΈ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΠΈ Π-ΠΊΠ»Π΅ΡΠΎΠΊ), ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΠΉΠΊΠΈΠ½ (ΠΠ) 6, 17, 18, ΠΈΠ½ΡΠ΅ΡΡΠ΅ΡΠΎΠ½ ΡΠΈΠΏΠ° 1, ΡΠ°ΠΊΡΠΎΡ Π½Π΅ΠΊΡΠΎΠ·Π° ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ (Π€ΠΠ) Ξ±, ΠΊΠΎΡΠΎΡΡΠ΅ ΡΡΠ°ΡΡΠ²ΡΡΡ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠΈ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ ΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΡ
ΠΎΡΠ³Π°Π½ΠΎΠ².ΠΡΠΎΠ²Π΅Π΄Π΅Π½Ρ ΡΠΈΡΠΎΠΊΠΎΠΌΠ°ΡΡΡΠ°Π±Π½ΡΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ², Π² ΠΏΠ΅ΡΠ²ΡΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΡ
Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² (ΠΠΠΠ) Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘ΠΠ. ΠΠ΅ΡΠ²ΡΠΌ ΠΠΠΠ, ΠΊΠΎΡΠΎΡΡΠΉ Π½Π°ΡΠ°Π»ΠΈ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Π‘ΠΠ, Π±ΡΠ» ΡΠΈΡΡΠΊΡΠΈΠΌΠ°Π± (Π Π’Π). ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΎΡΠΈΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π³ΠΈΡΡΡΠ°ΡΠΈΠΈ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Π‘ΠΠ, Π Π’Π Π²ΠΊΠ»ΡΡΠ΅Π½ Π² ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ EULAR, ACR ΠΈ ΠΡΡΠΎΡΠΈΠ°ΡΠΈΠΈ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ² Π ΠΎΡΡΠΈΠΈ ΠΏΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π‘ΠΠ. Π‘ΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΠΉ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Π‘ΠΠ Π±Π΅Π»ΠΈΠΌΡΠΌΠ°Π± β ΠΏΠΎΠ»Π½ΠΎΡΡΡΡ ΡΠ΅Π»ΠΎΠ²Π΅ΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ±ΠΈΠ½Π°Π½ΡΠ½ΡΠ΅ ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ Π°Π½ΡΠΈΡΠ΅Π»Π° (IgG1 Ξ») β ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ°Π΅Ρ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ ΡBLyS Ρ ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌΠΈ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠ°ΠΌΠΈ Π°ΡΡΠΎΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΡΡ
Β«ΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ΄Π½ΡΡ
Β» (transitional) ΠΈ Π½Π°ΠΈΠ²Π½ΡΡ
Π-ΠΊΠ»Π΅ΡΠΎΠΊ, ΡΡΠΎ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΠΏΠΎΠ΄Π°Π²Π»Π΅Π½ΠΈΡ Π-ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠ΅Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ ΡΠΈΠ½ΡΠ΅Π·Π° Π°ΡΡΠΎΠ°Π½ΡΠΈΡΠ΅Π». ΠΡΠΎΠΌΠ΅ ΡΠΎΠ³ΠΎ, Π±Π»ΠΎΠΊΠ°Π΄Π° BLyS ΠΌΠΎΠΆΠ΅Ρ Π²ΡΠ·ΡΠ²Π°ΡΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π-ΠΊΠ»Π΅ΡΠΎΠΊ Π² ΡΠΎΡΡΠΊΠΎΠ²ΡΡ
ΡΠ΅Π½ΡΡΠ°Ρ
Π»ΠΈΠΌΡΠΎΠΈΠ΄Π½ΡΡ
ΠΎΡΠ³Π°Π½ΠΎΠ², Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΡ Π-ΠΊΠ»Π΅ΡΠΎΠΊ ΠΏΠ°ΠΌΡΡΠΈ Π² Π°ΡΡΠΎΠ°Π½ΡΠΈΡΠ΅Π»ΠΎ-ΠΏΡΠΎΠ΄ΡΡΠΈΡΡΡΡΠΈΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ ΠΈ ΡΠΈΠ½ΡΠ΅Π· Β«ΠΏΡΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
Β» ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ² (ΠΠ21, ΠΠ17 ΠΈ Π΄Ρ.), ΠΊΠΎΡΠΎΡΡΠ΅ ΠΈΠ³ΡΠ°ΡΡ Π²Π°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ Π² ΠΈΠΌΠΌΡΠ½ΠΎΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅ Π‘ΠΠ. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΡΠΌΠ΅ΡΠ΅Π½Π½ΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π±Π΅Π»ΠΈΠΌΡΠΌΠ°Π±Π° ΠΏΡΠΈ Π‘ΠΠ, ΠΏΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°ΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ ΡΡΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ
ΠΡΠΎΠ³ΡΠ΅ΡΡ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π² Π½Π°ΡΠ°Π»Π΅ XXI Π²Π΅ΠΊΠ°
Rheumatoid arthritis (RA), juvenile arthritis, spondyloarthritis, including psoriatic arthritis, systemic lupus erythematosus (SLE), and otherΒ systemic connective tissue diseases, are the most severe chronic immunoinflammatory rheumatic diseases (IIRDs) that affect as high as 10% ofΒ the population. Substantial progress has been made in the treatment of IIRDs in the 21st century. The current Treat to Target (T2T) strategy forΒ RA is to achieve remission as soon as possible. The main treatment goal is to improve quality of life, by controlling the symptoms of the disease,Β by preventing joint destruction and dysfunction, and by maintaining social possibilities. The most important way to achieve this goal is to inhibitΒ inflammation and to evaluate the efficiency of treatment, by using the standardized activity indices and by choosing the appropriate treatmentΒ option. The widespread use of biological agents in combination with standard disease-modifying antirheumatic drugs could substantiallyΒ enhance therapeutic effectiveness. A new class of medicaments (chemically synthesized small molecular weight agents) to treat RA hasΒ appeared. The point of their application is tyrosine kinases, primarily Janus kinase (JAK). The new era in the treatment of SLE and otherΒ IIRDs is associated with the design of the new class of drugs Π BLyS inhibitors.Β In the coming years, the main lines of researches by Russian rheumatologists will be to elaborate a strategy to prevent IIRDs; to introduce innovativeΒ methods for their early diagnosis and treatment (biological agents, JAK inhibitors, and other cell signaling molecules) and for the prediction of the outcomesΒ of the most severe forms of IIRD; to realize the concept of personified medicine (to investigate the prognostic biomarkers of the efficiency and safetyΒ of targeted therapy), to reduce the risk of infectious complications, cardiovascular diseases, cancer, osteoporotic fractures, and other comorbidities.Π Π΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π½ΡΠΉ Π°ΡΡΡΠΈΡ (Π Π), ΡΠ²Π΅Π½ΠΈΠ»ΡΠ½ΡΠ΅ Π°ΡΡΡΠΈΡΡ, ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ°ΡΡΡΠΈΡΡ, Π²ΠΊΠ»ΡΡΠ°Ρ ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°ΡΡΡΠΈΡ, ΡΠΈΡΡΠ΅ΠΌΠ½Π°Ρ ΠΊΡΠ°ΡΠ½Π°Ρ Π²ΠΎΠ»ΡΠ°Π½ΠΊΠ° (Π‘ΠΠ) ΠΈ Π΄ΡΡΠ³ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ, β Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΡΠ΅ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΠΌΠΌΡΠ½ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΡΠ΅Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ (ΠΠΠ Π), ΠΊΠΎΡΠΎΡΡΠΌΠΈ ΡΡΡΠ°Π΄Π°Π΅Ρ Π΄ΠΎ 10% ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ. Π XXI Π². Π΄ΠΎΡΡΠΈΠ³Π½ΡΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΏΡΠΎΠ³ΡΠ΅ΡΡ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈΒ ΠΠΠΠ . ΠΡΠ½ΠΎΠ²ΠΎΠΉ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π Π β Β«ΠΠ΅ΡΠ΅Π½ΠΈΠ΅ Π΄ΠΎ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΡ ΡΠ΅Π»ΠΈΒ» (Treat to Target β T2T) β ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎ Π±ΡΡΡΡΠΎΠ΅ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅ΠΌΠΈΡΡΠΈΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΡΠ½ΠΎΠ²Π½Π°Ρ Π·Π°Π΄Π°ΡΠ° Π»Π΅ΡΠ΅Π½ΠΈΡ β ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΡΠ΅ΠΌ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΒ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ΅Π½ΠΈΠ΅ Π΄Π΅ΡΡΡΡΠΊΡΠΈΠΈ ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΡΠ½ΠΊΡΠΈΠΈ ΡΡΡΡΠ°Π²ΠΎΠ², ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΡ
Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ. ΠΠ°ΠΆΠ½Π΅ΠΉΡΠΈΠΉ ΠΏΡΡΡ Π΄Π»Ρ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΠΎΠΉ ΡΠ΅Π»ΠΈ β ΠΏΠΎΠ΄Π°Π²Π»Π΅Π½ΠΈΠ΅ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ; ΠΎΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΡΠ°Π½Π΄Π°ΡΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΈΠ½Π΄Π΅ΠΊΡΠΎΠ² Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠ΅Π³ΠΎ ΠΏΠΎΠ΄Π±ΠΎΡΠ° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π¨ΠΈΡΠΎΠΊΠΎΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΈ Π Π Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΡ
Β Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² (ΠΠΠΠ) Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ ΡΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠΌΠΈ Π±Π°Π·ΠΈΡΠ½ΡΠΌΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ (ΠΠΠΠ) ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΠΏΠΎΠ²ΡΡΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠΎΡΠ²ΠΈΠ»ΡΡ Π½ΠΎΠ²ΡΠΉ ΠΊΠ»Π°ΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Π Π β Π½ΠΈΠ·ΠΊΠΎΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΠ΅Β Ρ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈ ΡΠΈΠ½ΡΠ΅Π·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ Π²Π΅ΡΠ΅ΡΡΠ²Π° (small molecules). ΠΡ
ΡΠΎΡΠΊΠ° ΠΏΡΠΈΠ»ΠΎΠΆΠ΅Π½ΠΈΡ β ΡΠΈΡΠΎΠ·ΠΈΠ½ΠΊΠΈΠ½Π°Π·Ρ, Π² ΠΏΠ΅ΡΠ²ΡΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ Π―Π½ΡΡ-ΠΊΠΈΠ½Π°Π·ΡΒ (JAK). ΠΡΠΎΠ³ΡΠ΅ΡΡ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π‘ΠΠ ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΠΠ Π ΡΠ²ΡΠ·Π°Π½ Ρ ΡΠΎΠ·Π΄Π°Π½ΠΈΠ΅ΠΌ Π½ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠ»Π°ΡΡΠ° Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² β ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠΎΠ² BLyS.Β ΠΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡΠΌΠΈ Π½Π°ΡΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π² Π±Π»ΠΈΠΆΠ°ΠΉΡΠΈΠ΅ Π³ΠΎΠ΄Ρ Π±ΡΠ΄ΡΡ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΠΠ Π; Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ ΠΈΠ½Π½ΠΎΠ²Π°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ (ΠΠΠΠ, ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΡ JAK-ΠΊΠΈΠ½Π°Π· ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΡΠΈΠ³Π½Π°Π»ΡΠ½ΡΡ
ΠΌΠΎΠ»Π΅ΠΊΡΠ»), Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΡΡ
ΡΠΎΡΠΌ ΠΠΠΠ ; ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΈΠΈ ΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Ρ (ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ Β«ΡΠ°ΡΠ³Π΅ΡΠ½ΠΎΠΉΒ» ΡΠ΅ΡΠ°ΠΏΠΈΠΈ), ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΠΊΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»ΡΡΠ½ΠΎΠΉ, ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΎΡΡΠ΅ΠΎΠΏΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ΅ΡΠ΅Π»ΠΎΠΌΠΎΠ² ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΊΠΎΠΌΠΎΡΠ±ΠΈΠ΄Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ
MODERN IDEA ON THE PATHOGENESIS OF SPONDYLOARTHRITIS: MOLECULAR MECHANISMS
As of now, impaired immune homeostasis of the intestinal mucosa in genetically predisposed individuals is consideredΒ to be one of the major components in the pathogenesis of spondyloarthritis (SpA), which leads to systemic chronicΒ inflammation. The results of recent studies may suggest that the interleukin-23/interleukin-17 (IL-23/IL-17) axisΒ plays a leading role in the development of these diseases. The multifactorial components of the pathogenesis of SpAΒ are characterized by not only the hyperproduction of IL-23, but also by the change in cell target susceptibility to thisΒ cytokine with aconcurrent increase in their number, resulting in the chronic autoinflammatory process that occurs viaΒ a wide spectrum of clinical manifestations of different types of Sp
Diagnostics of nanodisperse polycrystals based on the polarization bremsstrahlung of relativistic electrons
The spectra of polarization bremsstrahlung are measured in the backscattering geometry during the interaction of 7 MeV electrons with a polycrystalline Ni foil. Measurement is conducted under condi tions such that the size of the region of coherent Xray radiation scattering in a target is on the order of 10 nm. The obtained results make it possible to suggest that using polarization bremsstrahlung as a new method for the diagnostics of the atomic structures of nanodisperse polycrystals is effectiv
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