Shmanko O. Improving the early diagnosis of rheumatoid arthritis and predicting its course based on the clinical and immunological criteria.

The thesis is dedicated to improving the early diagnosis of rheumatoid arthritis (RA) based on the comprehensive clinical, laboratory and instrumental examination of patients. Low informativeness of ACR criteria, EULAR recommendations was demonstrated in the diagnosis of early RA. Determined high diagnostic value of antibodies to citrullinated peptides (anti-CCP, anti-MCV) in the detection of early RA and prognosis of its course. Measured the levels of interleukin-17 (IL-17), and identified that high levels of IL-17 in patients with RA are accompanied by significantly higher clinical and laboratory indicators, disease activity score DAS28, and indicators of immune status. Its high diagnostic value as a prognostic marker of disease activity in patients with RA was proved, indicating the feasibility of its inclusion in the list of standard laboratory markers that reflect the activity of the inflammatory process. Determined that the level of vascular endothelial growth factor (VEGF) in patients with early RA with high disease activity is a potential marker of joint destruction, as evidenced by ultrasound examination of the joints