Middle molecules of different fractions and middle-molecular osteoassociated hormones in gouty arthritis
Background. Gouty arthritis is the most common inflammatory disease of joints in men. In addition to disorders of purine metabolism, proinflammatory cytokines, matrix metalloproteinases and eicosanoids, various middlemolecular compounds (hormones, peptides, lipids) may participate in the pathogenesis of the disease, but their significance remains to be explored. The purpose of the study was to evaluate the clinical and pathogenetic significance of middle molecules (MM) of different fractions and middlemolecular osteoassociated hormones in gouty arthritis. Materials and methods. 105 patients with primary gout were examined, 92 % of men and 8 % of women aged 26 to 76 years (51 years on average), and women were 8 years older. The average duration of the disease was 12 years. The first sign of gout among 91 % of the patients was the joint crisis, and in the remaining cases — renal colic. The ratio of the frequency of intermittent and chronic forms of arthritis was 2 : 1, the latent type of nephropathy occurred in 66 % of cases, urolithiasis — in 34 %, and the ratio of stages I, II, III and IV of chronic kidney disease was 4 : 2 : 1 : 1 The content of the aminopeptide (AF), peptide (PF), nucleotide (NF), chromatophoric fractions (CF) and integral middlemolecular index (MMI) was investigated, as well as middlemolecular osteoassociated hormones (insulin (Ins), calcitonin (CT), osteocalcin (OC)). A spectrophotometer SF46 (Russia), OlympusAU640 bioanalyzer (Japan), MPT2Lauda computer tensiometer (Germany), and PR2100Sanofi Diagnostic Pasteur reader (France) were used. Only patients without exacerbation of arthritis were examined. Results. Primary gout occurs with disturbances in the metabolism of uric acid, oxypurinol, purine bases, purine metabolism enzymes and purineassociated microelements, the integral changes of which depend on the type of the joint syndrome, the presence of peripheral and bone tofi, determine bonedestructive articular lesions, while prognostic factor for the severity of arthropathy is the high blood level of purine bases. In cases of gout, serum AF concentrations increase by 15 %, PF — by 16 %, NF — by 31 %, CF — by 15 %, average fraction — by 17 % and MMI — by 10 %, which is observed in 67, 53, 64, 25, 62 and 31 % of patients, respectively. Meanwhile, the AF content is closely related to the severity of the joint syndrome, it determines the degree of joint space narrowing and subchondral sclerosis, the development of bone erosions and meniscus changes, and the MM of different fractions have correlation links with the parameters of purine metabolism (uric acid, adenine, guanine, xanthine, xanthine deaminase, adenosine deaminase, molybdenum and lead). Patients with gout were characterized by the significant increase in the concentration of Ins in the blood by 92 % and OC by 3 times combined with the decrease in the CT content by 51 %, which is respectively found in 53, 99 and 83 % of examined patients. It correlated with severity of the joint syndrome, the presence of peripheral and bone tofi. And in cases of the chronicity of arthritis, OC indicators increase, and there are close relationships of middlemolecular osteoassociated hormones with bonedestructive articular changes, parameters of purine metabolism and integral level of MM of different fractions. The indicators of Ins are of practical importance. Conclusions. The studied middlemolecular compounds are involved in clinical and pathogenetic formation of gouty arthritis and have prognostic significance.
Full Text:PDF (Русский)
Gonzalez-Rozas M., Prieto de Paula J.M., Franco Hidalgo S., Lopez Pedreira M.R. Chronic tophaceous gout // Semergen. — 2013. — 39(6). — Р. 29-34.
Martillo M.A., Nazzal L., Crittenden D.B. The crystallization of monosodium urate // Curr. Rheumatol. Rep. — 2018. — 16(2). — Р. 400-5. doi: 10.1136/jim-2018-000728.
Steiger S., Harper J.L. Mechanisms of spontaneous resolution of acute gouty inflammation // Curr. Rheumatol. Rep. — 2017. — 16(1). — Р. 392-6. doi: 10.1038/nrrheum.2017.155.
Bolzetta F., Veronese N., Manzato E., Sergi G. Chronic gout in the elderly // Aging. Clin. Exp. Res. — 2013. — 25(2). — Р. 129-37.
Manara M., Bortoluzzi A., Favero M., Prevete I., Scire C.A., Bianchi G. et al. Italian society of rheumatology recommendations for the management of gout // Reumatismo. — 2018. — 65(1). — Р. 4-21. doi: 10.1074/jbc.M115.649855.
Manger B. Gout and other crystal-induced arthritides // Dtsch. Med. Wochenschr. — 2012. — 137(31–32). — Р. 1579-81.
Hayward R.A., Rathod T., Roddy E., Muller S., Hider S.L., Mallen C.D. The association of gout with socioeconomic status in primary care: a cross-sectional observational study // Rheumatology. — 2013. — 52(11). — Р. 2004-8.
Kuo C.F., Grainge M.J., See L.C., Yu K.H., Luo S.F., Zhang W., Doherty M. Epidemiology and management of gout in Taiwan: a nationwide population study // Arthritis Res. Ther. — 2016. — 23(17). — Р. 13-9. doi: 10.1186/s13075-015-0522-8.
Crişan T.O., Cleophas M.C.P., Novakovic B., Erler K., van de Veerdonk F.L., Stunnenberg H.G. et al. Uric acid priming in human monocytes is driven by the AKT-PRAS40 autophagy pathway // Proc. Natl. Acad. Sci. USA. — 2017. — 114(21). — Р. 5485-90. doi: 10.1073/pnas.1620910114.
Lee J.H., Yang J.A., Shin K., Lee G.H., Lee W.W., Lee E.Y. et al. Elderly patients exhibit stronger inflammatory responses during gout attacks // J. Korean Med. Sci. — 2017. — 32(12). — Р. 1967-73. doi: 10.3346/jkms.2017.32.12.1967.
Tao J.H., Cheng M., Tang J.P., Dai X.J., Zhang Y., Li X.P. et al. Single nucleotide polymorphisms associated with P2X7R function regulate the onset of gouty arthritis // PLoS One. — 2017. — 12(8). — 0181685. doi: 10.1371/journal.pone.0181685.
Vanheule V., Boff D., Mortier A., Janssens R., Petri B., Kolaczkowska E. et al. CXCL9-derived peptides differentially inhibit neutrophil migration in vivo through interference with glycosaminoglycan interactions // Front. Immunol. — 2017. — 7(8). — 00530. doi: 10.3389/fimmu.2017.00530.
Carneiro L., Geller S., Hébert A., Repond C., Fioramonti X., Leloup C. et al. Hypothalamic sensing of ketone bo-dies after prolonged cerebral exposure leads to metabolic control dysregulation // Sci. Rep. — 2016. — 6(6). — Р. 34909. doi: 10.1038/srep34909.
Copyright (c) 2018 TRAUMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020