[Antiphospholipid antibodies in Behcet's disease]. / Antifosfolipidnye antitela pri bolezni Bekhcheta.

35 patients with Behcet's disease (BD) were examined for antiphospholipid antibodies (aPL). Elevated levels of antibodies to cardiolipin (aCL) were registered in 20% of the patients (aCL IgG and IgM in 11.4 and 8.6%, respectively). Low positivity of these antibodies prevailed (33.2 GPL and 41.2 MPL). Lupus anticoagulant was present in 6 patients. No distinct correlation was found between positivity by aPL and vascular disorders. It is inferred that aPL do not seem to play a leading role in thrombotic diathesis in BD. This diathesis is brought by a much more complicated and multifactor process.

Novel functional activities of anti-DNA autoantibodies from sera of patients with lymphoproliferative and autoimmune diseases.

DNA-hydrolyzing activity of IgG autoantibodies from sera of patients with various types of lymphoproliferative diseases was investigated. The association of DNA-hydrolyzing activity with the antibody (Ab) fraction has been proved by newly developed affinity-capture assay. Study of abzyme incidence in blood tumors and systemic lupus erythematosis (SLE) revealed linkage of anti-DNA Ab catalysts to mature B-cell tumors, and increased probability of DNA-abzymes formation on the background of autoimmune manifestations. These data suggest possible similarity between mechanisms of abzyme formation in SLE and B-cell lymphomas. A new mechanism of formation of DNA-specific catalytic Abs has been proposed based on the increased crossreactivity of polyclonal DNA-abzymes to DNA-depleted nuclear matrix proteins. The possibility of the abzyme production as Ab to the energetically destabilized ground state of the antigen has been discussed. Preliminary results were obtained that indicate the complement-independent cytotoxicity of anti-DNA autoantibodies isolated from blood of patients with SLE and chronic lymphocytic leukemia.

[Does the basic therapy affect the development of secondary amyloidosis in rheumatoid arthritis?]. / Vliiaet li terapiia bazisnogo riada na razvitie vtorichnogo amiloidoza pri revmatoidnom artrite?

Anti-rheumatic drug treatments were studied in 260 patients from Finland and Russia suffering from rheumatoid arthritis (RA) with or without biopsy-proven secondary amyloidosis (RSA). Chloroquine was used for longer period in RSA group in Russia (p = 0.003) and in Finland (p = 0.06). In Finland chloroquine was used more often in the RSA group (p = 0.02), and sulphasalazine (p = 0.02), D-penicillamine (p = 0.03) and cytotoxics (p = 0.04) in the control group. The role of therapy in the prevention of RSA in chronic inflammation is discussed.

[Serum neopterin in Behçet's disease]. / Syvorotchnyi neopterin pri bolezni Bekhcheta.

Neopterin radioimmunoassay measurements (Henning, Berlin) were conducted in 26 male and 12 female patients (mean age 32 +/- 8.01) with Behcet's disease (BD) and healthy controls. In BD patients mean serum neopterin concentrations were significantly higher than in the controls (8.7 +/- 4.1 nmol/l against 5.0 +/- 1.9 nmol/l, respectively). Neopterin levels were higher in patients with positive pathergy test than in negative subjects (p<0.05). There was a significant correlation between neopterin and CRP (rs=0.42. p<0.02). The findings indicate that cellular immunity in BD patients is activated.

[The sex- and age-related characteristics of the x-ray changes in rheumatoid arthritis]. / Polovye i vozrastnye osobennosti rentgenologicheskikh izmenenii pri revmatoidnom artrite.

To investigate sex- and age-specific features of radiographic abnormalities in rheumatoid arthritis (RA) patients, radiographic signs in hands and feet were assessed using Steinbroker criteria. A score system from 0 to 3 was also introduced to evaluate every radiographic feature: osteoporosis, cysts, joint space narrowing and erosions. Radiographic indices of every joint group, whole hand and metatarsophalangeal joints were calculated. Using the regression analysis, the implication of 3 factors (age at the disease onset, disease duration and sex) in joint involvement was estimated in 56 males and 50 females with RA. Age subgroups entered patients who at the disease onset were under 50 (38 males and 27 females), over 50 (18 males and 23 females). Neither sex nor age at the disease onset affected Steinbroker stage in hands, whereas the influence of the male sex on radiographic stage in feet was essential. Radiographic indices for joints of the hand were different in sex and age subgroups. A multiple regression analysis revealed a significant effect of age at the disease onset on the involvement of metacarpophalangeal and wrist joints and hand on the whole. Wrist involvement was related to the female sex. Radiographic feet indices were more significant in young males.

Endocarditis with left atrial thrombus formation in Behçet's disease mimicking myxoma.

A 51-year-old male patient with Behçet's disease had a large echogenic mass in the left atrium mimicking myxoma, documented by echocardiography. Postoperative pathological examination revealed left atrial thrombus, deep ulcerations of mitral valve leaflets with signs of active endocarditis. Cardiac evaluation with echocardiography should be considered in patients with Behçet's disease.

[Isolation and characteristics of catalytic antibodies to DNA in systemic lupus erythematosis]. / Vydelenie i kharakteristika kataliticheskikh antitel k DNK pri sistemnoi krasnoi volchanke.

A method for purifying DNA-specific catalytic antibodies based on affinity chromatography on protein A Sepharose and on both modified and non-modified DNA-cellulose as well as HPLC has been developed. The elution conditions with high yields of DNA-hydrolyzing activity of antibodies have been optimized. The biochemical and immunological properties of catalytic antibodies have been examined. The kinetic parameters of the enzyme interaction with an oligonucleotide substrate have been determined. The influence of effectors on DNA hydrolysis by antibodies has been investigated.

[The HLA-B5 immunogenetic marker in Behçet's disease]. / HLA-B5-immunogeneticheskii marker bolezni Bekcheta.

Twenty-three patients with Behçet's disease (BD) meeting the criteria of the international group for classification and diagnosis of BD (17 men and 6 women) were typed for HLA antigens class 1. The patients group was multinational, of them 19 were Caucasoids and 4 Mongoloids. It was shown that HLA B5 in Caucasoids occurred more frequently vs normal controls (73.7% and 15.5%, respectively). Under the correction of the antigens number up to 21, the differences continued to be statistically high. Characteristic for B5 antigen was a high relative risk and close association with the disease. In antigen group B5 + B35 the relative risk and association power grew still higher. The B5 positive group statistically more frequently had superficial thrombophlebitis and less frequently gastrointestinal involvement. It is concluded that class 1 HLA antigens, B5 in particular, are closely associated with BD in CIS countries.

DNA-specific antiidiotypic antibodies in the sera of patients with autoimmune diseases.

Blood sera of patients with autoimmune diseases scleroderma (Scl), systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) have been shown to yield a specific immune response to topoisomerase I, the product of expression of a cDNA fragment cloned into lambda gt11 and monoclonal antibodies (MAB) to the enzyme. The 'topoisomerase test' is not absolutely specific for Scl. The stable positive response of autoimmune sera to anti-topoisomerase monoclonal antibodies has a specific character and is associated with the interaction of the Fab fragment of MAB with the IgG fraction of autoimmune serum. The response observed indicates the induction of anti-idiotypic antibodies against topoisomerase. The anti-idiotype, isolated by HPLC and affinity chromatography demonstrated the following functional activities: (i) the immunological reaction against DNA; (ii) high-affinity DNA-binding with topoisomerase-specific consensus; (iii) ability to compete with the native enzyme for binding with DNA and MAB to topoisomerase; (iv) immunological reaction against MAB to topoisomerase.

[Clinical characteristics of disorders of sexual functions in patients with rheumatoid arthritis]. / Klinicheskaia kharakteristika narushenii seksual'noi funktsii u bol'nykh revmatoidnym artritom.

The method of structural analysis was used to study the presence of sexual disorders in 26 male patients with rheumatoid arthritis (RA). The incidence of sexual disorders was 42.3 per cent (11 patients). In this case the ejaculatory and neurohumoral components of the copulative cycle were mostly disturbed. Sexual dysfunction developed during the disease and was often associated with exacerbation of RA. Disorders in pubertal development were revealed in none of the patients. But patients with a disturbed sexual function exhibited a significant decrease in the total cumulative index in the male sexual formula, in the level of total and free testosterone, a rise in the content of prolactin. Possible causes and mechanisms of sexual disorders in male patients with RA are discussed.

[Interactions of sera from patients with autoimmune diseases with cDNA expressed fragment of topoisomerase I and monoclonal antibodies against enzyme]. / Vzaimodeistvie syvorotok krovi bol'nykh autoimmunnymi zabolevaniiami s ékspressirovannym fragmentom kDNK topoizomerazy I i monoklonal'nymi antitelami k fermentu.

The interaction of sera from 34 patients with different autoimmune diseases with the expressed fusion protein cloned in lambda gt11 vector (topoisomerase I--beta galactosidase) and monoclonal antibodies against enzyme was studied. It was demonstrated that 100% of Scl cases possessed positive activity against fusion protein. It was shown that this test is not absolutely specific for Scl, i. e. 57.1% of Sle and 84.6% of RA demonstrated positive activity against "topoisomerase test". Autoimmune sera had the positive activity against monoclonal antibodies for topoisomerase I. This activity was shown to be due to the presence of antiidiotypic antibodies against topoisomerase in the autoimmune sera.

[Secondary amyloidosis in elderly patients with rheumatoid arthritis]. / Vtorichnyi amiloidoz u bol'nykh revmatoidnym artritom pozhilogo vozrasta.

Examination of rheumatoid arthritis (RA) patients (52 males and 35 females) revealed secondary amyloidosis (SA) in 44.2% and 48.6% of patients, respectively. The disease was confirmed by amyloid deposits in biopsy specimens of gingival mucosa. As far as age-specific SA incidence is concerned, SA was more prevalent in elderly age-groups: 29.7% and 80% in males under and over 50, respectively; 15.4% and 68.2% in relevant women. The disease history in old patients was not long: 4.6 +/- 1.0 yr and 3.3 +/- 0.7 yr for males and females, respectively. Not a single case of amyloid deposit occurred in patients with systemic lupus erythematosus at the age over 60. The contribution of sex hormones and other factors to SA onset in RA is under discussion. An old age of RA patients and associated infection, especially urogenic, can predispose to SA development.