Волкова М.В.*, Кундер Е.В.**
Ранний артрит: актуальность, иммунопатология, диагностика
УО «Витебский государственный ордена Дружбы народов медицинский университет»*
ГУО «Белорусская медицинская академия последипломного образования»**
Резюме. В обзоре обобщены современные знания об иммунопатогенезе ранних артритов в контексте обнаружения специфических иммунологических изменений при раннем ревматоидном артрите. Проанализированы актуальные тенденции диагностики и дифференциальной диагностики ранних стадий воспалительного процесса в суставах, возможность использования и аналитические характеристики классификационных критериев ревматоидного артрита для ранних стадиях заболевания. Суммированы сведения о чувствительности и специфичности лабораторных маркеров при раннем ревматоидном артрите.
Ключевые слова: ранний артрит, ранний ревматоидный артрит, патогенез, иммуноглобулины, ферментативные свойства.
Литература
1. Здравоохранение в Республике Беларусь: офиц. стат. сб. за 2011 г. – Минск: ГУ РНМБ, 2012. – 304 с.
2. Каратеев, Д.Е. Основные тенденции и вариабельность эволюции ревматоидного артрита: результаты многолетнего наблюдения / Д.Е. Каратеев // Научно–практическая ревматология. – 2004. – №1. – С. 8–14.
3. Каратеев, Д.Е. Современные принципы ведения больных ранним артритом // Д.Е. Каратеев, Е.Л. Лучихина, Г. Тогизбаев // Русский медицинский журнал – 2008. - Т.16 - №24 – С. 1610-1615.
4. Насонов, Е.Л. Ревматоидный артрит: терапевтические проблемы / Е.Л. Насонов, Н.В. Чичасова // Врач. – 1999. – № 5. – С. 7–10.
5. Насонова, В.А. Ревматические болезни в России в начале XXI века. / В.А. Насонова, О.М. Фоломеева, Ш.Ф. Эрдес // Научно-практическая ревматология – 2003. – № 1. – С. 6–10.
6. Пфлюгер, Б. Оценка глобального бремени костно-мышечных заболеваний / Б. Пфлюгер // Научно–практическая ревматология. – 2001. - №4. – С. 4–9.
7. Ранняя диагностика ревматоидного артрита в клинической практике на современном этапе (результаты наблюдений за московской когортой больных ранним артритом в рамках программы РАДИКАЛ) / Д.Е. Каратеев [и др.] // Тер. Архив. – 2008. – №5. – С. 8–13.
8. Распространенность ревматоидного артрита в России (по данным эпидемиологического исследования) / Е.А. Галушко [и др.] // Тер. Архив. – 2010. - №5. – С. 9–14.
9. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative / D. Aletaha [et al.] // Arthritis Rheum. - 2010. – Vol. 62. – P. 2569–2581.
10. Alterations on peripheral blood B-cell subpopulations in very early arthritis patients / R.A. Moura [et al.] // Rheumatology. – 2010. – Vol. 49. – P. 1082–1092.
11. Analysis of the synovial cell infiltrate in early rheumatoid synovial tissue in relation to local disease activity / P.P. Tak [et al.] // Arthritis Rheum. – 1997. – Vol. 40. – P. 217–225.
12. Antibodies to citrullinated human fibrinogen (ACF) have diagnostic and prognostic value in early arthritis / M.M. Nielen [et al.] // Ann. Rheum. Dis. – 2005. – Vol. 64. – P. 1199–1204.
13. Anti-citrullinated peptide antibodies in the serum of heavy smokers without rheumatoid arthritis.A differential effect of chronic obstructive pulmonary disease? / V. Ruiz-Esquide [et al.] // Clin. Rheumatol. – 2012. – Vol. 31. – P. 1047–1050.
14. Antiperinuclear factor, a marker autoantibody for rheumatoid arthritis: colocalisation of the perinuclear factor and profilaggrin / R.M. Hoet [et al.] // Ann. Rheum. Dis. – 1991. – Vol. 50. – P. 611–618.
15. Associations of disease activity and treatment with mortality in men with rheumatoid arthritis: results from the VARA registry / T.R. Mikuls [et al.] / Rheumatology (Oxford). – 2011. – Vol. 50. – P. 101–109.
16. Auto-antibodies and autoreactive T-cells in rheumatoid arthritis: pathogenetic players and diagnostic tools / G. Steiner [et al.] // Clinical Reviews in Allergy and Immunology. – 2007. – Vol. 32. – P. 23–35.
17. Cannella, A.C. Early rheumatoid arthritis: pitfalls in diagnosis and review of recent clinical trials / A.C. Cannella, J.R. O'Del // Drugs. – 2006. – Vol. 66. – P. 1319–1337.
18. Chromatin-IgG complexes activate B cells by dual engagement of IgM and Toll-like receptors / E.A. Leadbetter [et al.] // Nature. – 2002. – Vol. 416. – P. 603–607.
19. Citrullinated vimentin stimulates proliferation, pro-inflammatory cytokine secretion, and PADI4 and RANKL expression of fibroblast-like synoviocytes in rheumatoid arthritis / L. Fan [et al.] // Scand. J. Rheumatol. – 2012. – Vol. 41. – P. – 354–358.
20. Citrullination of fibronectin in rheumatoid arthritis synovial tissue / X. Chang [et al.] // Rheumatology. – 2005. – Vol. 44 (11). – P. 1374–1382.
21. Comparison of long term outcome of patients with rheumatoid arthritis presenting with undifferentiated arthritis or with rheumatoid arthritis: an observational cohort study / J. Van Aken [et al.] // Ann. Rheum. Dis. – 2006. – Vol. 65. – P. 20–25.
22. Concepts and epidemiology of spondyloarthro-pathies / J. Sieper [et al.] // Best Pract. Res. Clin. Rheumatol. – 2006. – Vol. 20. – P. 401–407.
23. Cost effectiveness analysis of disease-modifying antirheumatic drugs in rheumatoid arthritis. A sustemic review literature / M. Benucci [et al.] // Int. J. Rheumatol. – 2011. – Vol. 22. – P. 845–849.
24. Cytokine pattern in very early rheumatoid arthritis favours B-cell activation and survival / R.A. Moura [et al.] // Rheumatolog. – 2011. – Vol. 50. – P. 278–282.
25. Diagnosing reactive arthritis: role of clinical setting in the value of serologic and microbiologic assays / J. Sieper [et al.] // Arthritis Rheum. – 2002. – Vol. 46. – P. 319–327.
26. Diagnostic accuracy of ACR/EULAR 2010 criteria for rheumatoid arthritis in a 2-year cohort // S.Varache [et al.] // J. Rheumatol. – 2011. – Vol. 38. – P. 1250–1257.
27. Diagnostic accuracy of the anti-citrulline antibody assay for rheumatoid arthritis / N. Bizzaro [et al.] // Clin. Chem. – 2001. – Vol. 47. – P. 1089–1093.
28. Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH) / C. Alves [et al.] // Ann. Rheum. Dis. – 2011. – Vol. 70. – P. 1645–1647.
29. Diagnostic value of anti-mutated citrullinatedvimentin in comparison to anti-cyclic citrullinated peptide and anti-viral citrullinated peptide 2 antibodies in rheumatoid arthritis: An Italian multicentric study and review of the literature / E. Bartoloni [et al.] // Autoimmun Rev. – 2012. – Vol. 11. – P. 815–820.
30. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide / P. Emery [et al.] // Ann. Rheum. Dis. – 2002. – Vol. 61. – P. 290–297.
31. Early rheumatoid arthritis: concept / L.M. Mota [et al.] // Rev. Assoc. Med. Bras. – 2010. – Vol. 56. – P. 227–229.
32. Early treatment in early undifferentiated arthritis / I. Olivieri [et al.] // Autoimmun. Rev. – 2012. – Vol. 11. – P.589–592.
33. Ectopic lymphoid structures support on going production of class switched autoantibodies in rheumatoid synovium / F. Humby [et al.] // PLoSMed. – 2009. – Vol. 6. – P. 229–237.
34. Effect of adherence to European treatment recommendations on early arthritis outcomes: data from the ESPOIR cohort / C. Escalas [et al.] // Ann. Rheum. Dis. – 2012. – Vol. 71. – P. 1803–1808.
35. EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) / B. Combe [et al.] // Ann. Rheum. Dis. – 2007. – Vol. 66. – P. 34–45.
36. Expression and activity of citrullinating peptidylarginine deiminase enzymes in monocytes and macrophages / E.R. Vossenaar [et al.] // Ann. Rheum. Dis. – 2004. – Vol. 63. – P. 373–381.
37. Expression of interferon-gamma(IFN-gamma), IL-10, IL-12 and transforming growth factor-beta (TGF-beta) mRNA in synovial fluid cells from patients in the early and late phases of rheumatoid arthritis / A. Bucht [et al.] // Clin. Exp. Immunol. – 1996. – Vol. 103. – P. 357–367.
38. Fisher, B.A. Inhibiting citrullination in rheumatoid arthritis: taking fuel from the fire / B.A. Fisher, P.J. Venables // Arthritis Res. Ther. – 2012. – Vol. 14. – P. 108.
39. Gottenberg J.E., Migot S., Nicaise-Rolland P. et al. Prevalence of anti-cyclic citrullinated peptide and anti-keratin antibodies in patients with primary Sjogrens syndrome / J.E. Gottenberg [et al.] // Ann. Rheum. Dis. – 2004. – Vol. 34. – P. 456–458.
40. Haga, H. G. Prevalence of IgA class antibodies to cyclic citrullinated peptide in patients with inflammatory bowel disease (IBD) / H .J. Haga, O. Palm, E. Peen // Clin. Rheumatol. – 2011. – Vol. 30. – P.955–957.
41. Hazes, J.M. The epidemiology of early inflammatory arthritis // J.M. Hazes, J.J. Luime // Nat. Rev. Rheumatol. – 2011. – Vol. 7. – P. 381–390.
42. Hoffmann I.E.A., Peene I., Cebecauer L., et al. Presence of rheumatoid factor and antibodies to citrullinated peptides in systemic lupus erythematosus / I.E. Hoffmann [et al.] // Ann. Rheum. Dis. – 2005. – Vol. 64. – P. 330–332.
43. Kwiatkowska, B. Reactive arthritis / B. Kwiatkowska, A. Filipowicz-Sosnowska // Polskie Archiwum Medycyny Wewnetrznej. – 2009. – Vol. 119. – P. 60–65.
44. Lima, I. Antibodies against cyclic citrullinated peptides in infectious diseases--a systematic review / I. Lima, M. Santiago // Clin. Rheumatol. – 2010. – Vol. 29. – P. 1345–1351.
45. nti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis / B. Vander Cruyssen [et al.] // Ann. Rheum. Dis. – 2005. – Vol. 64. – P. 1145–1149.
46. Presence of lymphocytes aggregates in the synobium of the patients with early arthritis in relationship to diagnosis and outcome: is it a constant feature over time? / M.G. van de Sande [et al.] // Ann. Rheum. Dis. – 2011. – Vol. 70. – P. 700–703.
47. Reneses, S. Comparison of the 1987 ACR criteria and the 2010 ACR/EULAR criteria in an inception cohort of patients with recent-onset inflammatory polyarthritis / S. Reneses, L. Pestana, A. Garcia // Clin. Exp. Rheumatol. - 2012. – Vol. 30. – P. 417–420.
48. Rheumatoid arthritis / L. Carmona [et al.] / Best. Pract. Res. Clin. Rheumatol. – 2010. – Vol. 24. – P. 733–745.
49. Synovial fluid leukocyte apoptosis is inhibited in patients with very early rheumatoid arthritis / K. Raza [et al.] // Arthritis Res. Ther. – 2006. – Vol. 8. – P. R120.
50. Takeda, K. Toll-like receptors / K. Takeda, T. Kaisho, S. Akira // Ann. Rev. Immunol. – 2003. – Vol. 21. – P. 335–376.
51. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis / F.C. Arnett [et al.] // Arthritis Rheum. - 1988. – Vol. 31. – P. 315-324.
52. The course of radiologic damage during the first six years of rheumatoid arthritis / H.M. Hulsmans [et al.] // Arthritis Rheum. – 2000. – Vol. 43. – P. 1927–1940.
53. The differential expressions of 78-kDa glucose-regulated protein of infiltrating plasma cells in peripheral jointswith the histopathological variants of rheumatoid synovitis / W. Dong [et al.] // Arthritis Res. Ther. – 2009. – Vol. 11. – P. R4.
54. The periodontium of periodontitis patients contains citrullinated proteins which may play a role in ACPA (anti-citrullinated protein antibody) formation / W. Nesse [et al.] // J. Clin. Periodontol. – 2012. – Vol.39 – P. 599-607.
55. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis / E.J. Kroot [et al.] // Arthritis Rheum. – 2000. – Vol. 43. – P. 1831–1835.
Сведения об авторах:
Волкова М.В. – ассистент кафедры госпитальной терапии УО «Витебский государственный ордена Дружбы народов медицинский университет»;
Кундер Е.В. – д.м.н., доцент, профессор кафедры кардиологии и ревматологии ГУО «Белорусская медицинская академия последипломного образования».
Адрес для корреспонденции: 210023, г.Витебск, пр-т Фрунзе, 27, УО «Витебский государственный ордена Дружбы народов медицинский университет», кафедра госпитальной терапии. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Волкова Маргарита Васильевна.
Литература
1. Здравоохранение в Республике Беларусь: офиц. стат. сб. за 2011 г. – Минск: ГУ РНМБ, 2012. – 304 с.
2. Каратеев, Д.Е. Основные тенденции и вариабельность эволюции ревматоидного артрита: результаты многолетнего наблюдения / Д.Е. Каратеев // Научно–практическая ревматология. – 2004. – №1. – С. 8–14.
3. Каратеев, Д.Е. Современные принципы ведения больных ранним артритом // Д.Е. Каратеев, Е.Л. Лучихина, Г. Тогизбаев // Русский медицинский журнал – 2008. - Т.16 - №24 – С. 1610-1615.
4. Насонов, Е.Л. Ревматоидный артрит: терапевтические проблемы / Е.Л. Насонов, Н.В. Чичасова // Врач. – 1999. – № 5. – С. 7–10.
5. Насонова, В.А. Ревматические болезни в России в начале XXI века. / В.А. Насонова, О.М. Фоломеева, Ш.Ф. Эрдес // Научно-практическая ревматология – 2003. – № 1. – С. 6–10.
6. Пфлюгер, Б. Оценка глобального бремени костно-мышечных заболеваний / Б. Пфлюгер // Научно–практическая ревматология. – 2001. - №4. – С. 4–9.
7. Ранняя диагностика ревматоидного артрита в клинической практике на современном этапе (результаты наблюдений за московской когортой больных ранним артритом в рамках программы РАДИКАЛ) / Д.Е. Каратеев [и др.] // Тер. Архив. – 2008. – №5. – С. 8–13.
8. Распространенность ревматоидного артрита в России (по данным эпидемиологического исследования) / Е.А. Галушко [и др.] // Тер. Архив. – 2010. - №5. – С. 9–14.
9. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative / D. Aletaha [et al.] // Arthritis Rheum. - 2010. – Vol. 62. – P. 2569–2581.
10. Alterations on peripheral blood B-cell subpopulations in very early arthritis patients / R.A. Moura [et al.] // Rheumatology. – 2010. – Vol. 49. – P. 1082–1092.
11. Analysis of the synovial cell infiltrate in early rheumatoid synovial tissue in relation to local disease activity / P.P. Tak [et al.] // Arthritis Rheum. – 1997. – Vol. 40. – P. 217–225.
12. Antibodies to citrullinated human fibrinogen (ACF) have diagnostic and prognostic value in early arthritis / M.M. Nielen [et al.] // Ann. Rheum. Dis. – 2005. – Vol. 64. – P. 1199–1204.
13. Anti-citrullinated peptide antibodies in the serum of heavy smokers without rheumatoid arthritis.A differential effect of chronic obstructive pulmonary disease? / V. Ruiz-Esquide [et al.] // Clin. Rheumatol. – 2012. – Vol. 31. – P. 1047–1050.
14. Antiperinuclear factor, a marker autoantibody for rheumatoid arthritis: colocalisation of the perinuclear factor and profilaggrin / R.M. Hoet [et al.] // Ann. Rheum. Dis. – 1991. – Vol. 50. – P. 611–618.
15. Associations of disease activity and treatment with mortality in men with rheumatoid arthritis: results from the VARA registry / T.R. Mikuls [et al.] / Rheumatology (Oxford). – 2011. – Vol. 50. – P. 101–109.
16. Auto-antibodies and autoreactive T-cells in rheumatoid arthritis: pathogenetic players and diagnostic tools / G. Steiner [et al.] // Clinical Reviews in Allergy and Immunology. – 2007. – Vol. 32. – P. 23–35.
17. Cannella, A.C. Early rheumatoid arthritis: pitfalls in diagnosis and review of recent clinical trials / A.C. Cannella, J.R. O'Del // Drugs. – 2006. – Vol. 66. – P. 1319–1337.
18. Chromatin-IgG complexes activate B cells by dual engagement of IgM and Toll-like receptors / E.A. Leadbetter [et al.] // Nature. – 2002. – Vol. 416. – P. 603–607.
19. Citrullinated vimentin stimulates proliferation, pro-inflammatory cytokine secretion, and PADI4 and RANKL expression of fibroblast-like synoviocytes in rheumatoid arthritis / L. Fan [et al.] // Scand. J. Rheumatol. – 2012. – Vol. 41. – P. – 354–358.
20. Citrullination of fibronectin in rheumatoid arthritis synovial tissue / X. Chang [et al.] // Rheumatology. – 2005. – Vol. 44 (11). – P. 1374–1382.
21. Comparison of long term outcome of patients with rheumatoid arthritis presenting with undifferentiated arthritis or with rheumatoid arthritis: an observational cohort study / J. Van Aken [et al.] // Ann. Rheum. Dis. – 2006. – Vol. 65. – P. 20–25.
22. Concepts and epidemiology of spondyloarthro-pathies / J. Sieper [et al.] // Best Pract. Res. Clin. Rheumatol. – 2006. – Vol. 20. – P. 401–407.
23. Cost effectiveness analysis of disease-modifying antirheumatic drugs in rheumatoid arthritis. A sustemic review literature / M. Benucci [et al.] // Int. J. Rheumatol. – 2011. – Vol. 22. – P. 845–849.
24. Cytokine pattern in very early rheumatoid arthritis favours B-cell activation and survival / R.A. Moura [et al.] // Rheumatolog. – 2011. – Vol. 50. – P. 278–282.
25. Diagnosing reactive arthritis: role of clinical setting in the value of serologic and microbiologic assays / J. Sieper [et al.] // Arthritis Rheum. – 2002. – Vol. 46. – P. 319–327.
26. Diagnostic accuracy of ACR/EULAR 2010 criteria for rheumatoid arthritis in a 2-year cohort // S.Varache [et al.] // J. Rheumatol. – 2011. – Vol. 38. – P. 1250–1257.
27. Diagnostic accuracy of the anti-citrulline antibody assay for rheumatoid arthritis / N. Bizzaro [et al.] // Clin. Chem. – 2001. – Vol. 47. – P. 1089–1093.
28. Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH) / C. Alves [et al.] // Ann. Rheum. Dis. – 2011. – Vol. 70. – P. 1645–1647.
29. Diagnostic value of anti-mutated citrullinatedvimentin in comparison to anti-cyclic citrullinated peptide and anti-viral citrullinated peptide 2 antibodies in rheumatoid arthritis: An Italian multicentric study and review of the literature / E. Bartoloni [et al.] // Autoimmun Rev. – 2012. – Vol. 11. – P. 815–820.
30. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide / P. Emery [et al.] // Ann. Rheum. Dis. – 2002. – Vol. 61. – P. 290–297.
31. Early rheumatoid arthritis: concept / L.M. Mota [et al.] // Rev. Assoc. Med. Bras. – 2010. – Vol. 56. – P. 227–229.
32. Early treatment in early undifferentiated arthritis / I. Olivieri [et al.] // Autoimmun. Rev. – 2012. – Vol. 11. – P.589–592.
33. Ectopic lymphoid structures support on going production of class switched autoantibodies in rheumatoid synovium / F. Humby [et al.] // PLoSMed. – 2009. – Vol. 6. – P. 229–237.
34. Effect of adherence to European treatment recommendations on early arthritis outcomes: data from the ESPOIR cohort / C. Escalas [et al.] // Ann. Rheum. Dis. – 2012. – Vol. 71. – P. 1803–1808.
35. EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) / B. Combe [et al.] // Ann. Rheum. Dis. – 2007. – Vol. 66. – P. 34–45.
36. Expression and activity of citrullinating peptidylarginine deiminase enzymes in monocytes and macrophages / E.R. Vossenaar [et al.] // Ann. Rheum. Dis. – 2004. – Vol. 63. – P. 373–381.
37. Expression of interferon-gamma(IFN-gamma), IL-10, IL-12 and transforming growth factor-beta (TGF-beta) mRNA in synovial fluid cells from patients in the early and late phases of rheumatoid arthritis / A. Bucht [et al.] // Clin. Exp. Immunol. – 1996. – Vol. 103. – P. 357–367.
38. Fisher, B.A. Inhibiting citrullination in rheumatoid arthritis: taking fuel from the fire / B.A. Fisher, P.J. Venables // Arthritis Res. Ther. – 2012. – Vol. 14. – P. 108.
39. Gottenberg J.E., Migot S., Nicaise-Rolland P. et al. Prevalence of anti-cyclic citrullinated peptide and anti-keratin antibodies in patients with primary Sjogrens syndrome / J.E. Gottenberg [et al.] // Ann. Rheum. Dis. – 2004. – Vol. 34. – P. 456–458.
40. Haga, H. G. Prevalence of IgA class antibodies to cyclic citrullinated peptide in patients with inflammatory bowel disease (IBD) / H .J. Haga, O. Palm, E. Peen // Clin. Rheumatol. – 2011. – Vol. 30. – P.955–957.
41. Hazes, J.M. The epidemiology of early inflammatory arthritis // J.M. Hazes, J.J. Luime // Nat. Rev. Rheumatol. – 2011. – Vol. 7. – P. 381–390.
42. Hoffmann I.E.A., Peene I., Cebecauer L., et al. Presence of rheumatoid factor and antibodies to citrullinated peptides in systemic lupus erythematosus / I.E. Hoffmann [et al.] // Ann. Rheum. Dis. – 2005. – Vol. 64. – P. 330–332.
43. Kwiatkowska, B. Reactive arthritis / B. Kwiatkowska, A. Filipowicz-Sosnowska // Polskie Archiwum Medycyny Wewnetrznej. – 2009. – Vol. 119. – P. 60–65.
44. Lima, I. Antibodies against cyclic citrullinated peptides in infectious diseases--a systematic review / I. Lima, M. Santiago // Clin. Rheumatol. – 2010. – Vol. 29. – P. 1345–1351.
45. nti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis / B. Vander Cruyssen [et al.] // Ann. Rheum. Dis. – 2005. – Vol. 64. – P. 1145–1149.
46. Presence of lymphocytes aggregates in the synobium of the patients with early arthritis in relationship to diagnosis and outcome: is it a constant feature over time? / M.G. van de Sande [et al.] // Ann. Rheum. Dis. – 2011. – Vol. 70. – P. 700–703.
47. Reneses, S. Comparison of the 1987 ACR criteria and the 2010 ACR/EULAR criteria in an inception cohort of patients with recent-onset inflammatory polyarthritis / S. Reneses, L. Pestana, A. Garcia // Clin. Exp. Rheumatol. - 2012. – Vol. 30. – P. 417–420.
48. Rheumatoid arthritis / L. Carmona [et al.] / Best. Pract. Res. Clin. Rheumatol. – 2010. – Vol. 24. – P. 733–745.
49. Synovial fluid leukocyte apoptosis is inhibited in patients with very early rheumatoid arthritis / K. Raza [et al.] // Arthritis Res. Ther. – 2006. – Vol. 8. – P. R120.
50. Takeda, K. Toll-like receptors / K. Takeda, T. Kaisho, S. Akira // Ann. Rev. Immunol. – 2003. – Vol. 21. – P. 335–376.
51. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis / F.C. Arnett [et al.] // Arthritis Rheum. - 1988. – Vol. 31. – P. 315-324.
52. The course of radiologic damage during the first six years of rheumatoid arthritis / H.M. Hulsmans [et al.] // Arthritis Rheum. – 2000. – Vol. 43. – P. 1927–1940.
53. The differential expressions of 78-kDa glucose-regulated protein of infiltrating plasma cells in peripheral jointswith the histopathological variants of rheumatoid synovitis / W. Dong [et al.] // Arthritis Res. Ther. – 2009. – Vol. 11. – P. R4.
54. The periodontium of periodontitis patients contains citrullinated proteins which may play a role in ACPA (anti-citrullinated protein antibody) formation / W. Nesse [et al.] // J. Clin. Periodontol. – 2012. – Vol.39 – P. 599-607.
55. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis / E.J. Kroot [et al.] // Arthritis Rheum. – 2000. – Vol. 43. – P. 1831–1835.
Сведения об авторах:
Волкова М.В. – ассистент кафедры госпитальной терапии УО «ВГМУ»;
Кундер Е.В. – д.м.н., доцент, профессор кафедры кардиологии и ревматологии ГУО «БелМАПО».
Адрес для корреспонденции: 210023, г.Витебск, пр-т Фрунзе, 27, УО «Витебский государственный ордена Дружбы народов медицинский университет», кафедра госпитальной терапии. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Волкова Маргарита Васильевна.
