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Information × Registration Number 0218U002427, 0115U002152 , R & D reports Title Optimization of diagnosis and improvement of treatment of juvenile arthritis popup.stage_title Head Berezhnyi V. V., Registration Date 06-03-2018 Organization National Medical Academy of Post-Graduate Education named after P.L.Shupyk popup.description2 In early stages, in addition to the symptoms of effusion, only 15% of paediatric patients with reactive arthritis develop hypertrophy of the synovial membrane, there is seen no proliferation, hypervascularization of the synovial membrane, the articular cartilage damage or bone erosion at all. These findings can significantly contribute to timely diagnosis and adequate therapy. Apart from a targeted autoimmune reaction to the synovial membrane, most cases of paediatric juvenile rheumatoid arthritis (JUA) show autoantibodies against the organ myocardial antigens (36.8%) in articular and visceral lesions when the involvement of organs in the autoimmune process manifests clinically. Determination of levels of TNF, IL-6, anti-inflammatory cytokine IL-10 is essential for a comprehensive evaluation of immunopathological reactions in JUA paediatric patients. During the acute exacerbation, significantly increased serum levels of IL-6 (8.6 ± 1.4 pg / ml) and TNF- (40.38 2.26 pg / ml) are found. The level of anti-inflammatory cytokine IL-10 is not significantly increased, which is indicative of some imbalance of cytokines in the acute period of the disease and can be used to evaluate the activity of the inflammatory process. The levels of TNF, IL-6, proinflammatory cytokine IL-10 values in serum in the exacerbation of the inflammatory process do not correlate with the form of the disease. In the exacerbation period, the content of cytokines in synovial fluid in JUA patients is 3-15 times higher (p 0.001) than in serum, indicating that the local immune-inflammatory process is more intensive than the systemic immune response. The number of patients who experienced the exacerbation of the pathological process within one year of observation was significantly fewer in the combined therapy group (tumour necrosis factor blocker and methotrexate) as compared with the group receiving methotrexate monotherapy (p = 0.001). The obtained data allowed improving the early diagnosis of the disease, predicting the course and developing an algorithm of treatment to prevent the progression and exacerbation of the pathological process. The data received show a decrease in terms to reach the remission, reduced length of hospital stay. Product Description popup.authors Герман О. Б. Глядєлова Н. П. Козачук В. Г. Корнєва В. В. Маменко М. Є. Марушко Т. В. Романкевич І. В. Тараненко Т. В. popup.nrat_date 2020-04-02 Close