Zaitseva E. Prediction of the flow of articular form of juvenile rheumatoid arthritis

The thesis work contains a new solution to improve the prediction of the evolution and consequences of JRA on the basis of studying clinical polymorphism, genetic factors, disorders in immune homeostasis and metabolism of connective tissue structures at the stages of the development of the pathological process. The results of the study of clinical and laboratory manifestations of JRA compared with JNA aged from 2 to 18 years at the stages of clinical evolution are presented according to the classification of the International League of the Association of Rheumatology ILAR (Durban, 1997; Edmonton, 2001). Disorders in various parts of the immune system (cellular, humoral, phagocytosis, cytokine status) in JRA, which are similar in tendency to JNA, are analyzed, but persist for a long time despite treatment. An important sign for JRA is a significant increase in IL-6 indices over a long period of the disease, especially expressed in the first five years of the pathological process. These disorders in the CT metabolism in JRA, especially PG, which were manifested by changes in the quantitative composition of GAG, are determined. JRA is characterized by disorders in the metabolism of collagen, which was confirmed by increased excretion of oxyproline and blood collagenolytic activity, which were more pronounced against the background of a high degree of activity of the pathological process and the formation of a more severe X-ray stage. The data indicates that hereditary burden of RD and family aggregation of some of them are characteristic of JRA, and their frequency decreases with a decrease in the degree of kinship of the patient. It was revealed that the inheritance of pathological signs among the generations most often occurred on the maternal line. Statistical differences in quantitative and qualitative signs of dermatoglyphic indicators areestablished between patients with JRA and JNA, which made it possible to predict the possibility of the development of each disease, to differentiate them in the early stages of formation. An algorithm has been created for predicting the early determination of an unfavorable course of JRA regarding the possible rapid development of stable joint insufficiency. A model has been developed for predicting the effects of JRA during its long course.