[The clinico-genetic characteristics of combined forms of seronegative spondylarthritis]. / Kliniko-geneticheskie osobennosti sochetannykh form seronegativnykh spondiloartritov.

The authors present the results of clinico-genetic investigations made in 124 patients with combined forms of seronegative spondylarthritis. The combined and isolated forms are compared clinically. HLA-typing results are analysed.

[Immunoglobulin E in ankylosing spondylarthritis]. / Immunoglobulin E pri ankiloziruiushchem spondiloartrite.

Ankylosing spondylarthritis (AS) patients (n-95) were examined for IgE concentrations using radioimmunoassay (commercial kits "Pharmacia"). Elevated IgE concentrations (greater than 100 Ku/l) were recorded in 16% out of 45 patients with central AS and in 40% out of 50 patients with peripheral AS (p less than 0.05). High IgE levels showed frequent association with a CIC rise and extraarticular manifestations (uveitis, focal nephritis). It is suggested that AS extraarticular signs arise in response to vascular affection due to IgE overproduction and formation of IgE-containing immune complexes.

[The peripheral joint syndrome in ankylosing spondylitis--one of the variants of reactive arthritis]. / Perifericheskii sustavnoi sindrom pri ankiloziruiushchem spondiloartrite--odin iz variantov reaktivnogo artrita.

In 75 patients with central (n = 37) and peripheral (n = 38) ankylosing spondylarthritis, EIA was used to detect serum antibodies to Klebsiella (IgG and IgA) and to the common enterobacterial antigen (CEBA) as compared to the level of the ESR, C-reactive protein and circulating immune complexes. Out of the 75 patients, 53 were examined for the intestinal microflora. Serum antibodies to Klebsiella were demonstrated more frequently in the peripheral form than in the central one, particularly in demonstrating Klebsiella coproculture. The presence of serum antibodies correlated with the disease activity. In the central form, enterobacteria without Klebsiella prevailed in the intestine. In both forms, antibodies to CEBA were demonstrated not so frequently (in 1/4 of the patients). In both forms, a large number of cases (74-80%) showed intestinal dysbacteriosis; in the peripheral form, however, it reached a greater degree. As to the central form, the etiological role of Klebsiella is not absolutely clear. It is more remarkable in the peripheral articular syndrome (reactive arthritis towards Klebsiella?) associated with ankylosing spondylarthritis.

[Evaluation of the activity of the inflammatory process in ankylosing spondyloarthritis]. / K otsenke aktivnosti vospalitel'nogo protsessa pri ankiloziru- iushchem spondiloartrite.

A total of 139 patients with ankylosing spondyloarthritis (AS) (65 with the central form of the disease and 74 with the peripheral one) were examined to clarify the signs corresponding to the activity of the inflammatory process. To determine the degree of the inflammatory process activity in AS irrespective of its clinical forms the same laboratory indices can be used. With the central form of the disease some indices directly correlate with the markedness of pain and constraint in the spine. The activity of the process in this variant clearly reflects the level of circulating immune complexes (CIC) and IgG. With the peripheral form of the disease some other indices are found to be most sensitive. The presence of some difference in combination of laboratory signs reflecting the activity of the inflammatory process of AS in both forms can evidence the heterogeneity of the mechanisms of inflammation.

[Ankylosing spondylarthritis beginning in childhood]. / Ankiloziruiushchii spondiloartrit, nachavshiisia v detskom vozraste.

As many as 200 patients underwent comparative clinicoroentgenological and genetic examinations. The patients suffered from ankylosing spondylarthritis and were followed up for a long time. The patients were distributed into 2 groups depending on the age at which the disease commenced. Group I included 40 persons with the juvenile variant of the disease onset (under 16 years), group II comprised 160 subjects who fell ill at an age over 16 years. It has been shown that the patients who fell ill at an age under 16 years are prone to a more acute disease onset with involvement of the peripheral joints, to a slower and not so pronounced damage to the spine whereas the rate and the degree of injury to the iliosacral joints are practically the same in both the groups. On the contrary, adults are characterized by a gradual onset with earlier clinicoroentgenological signs of injury to the axial skeleton, which leads to rapid derangement of the posture in such patients.

[Microbiocenosis and the status of the intestinal mucosa in alkylosing spondyloarthritis]. / Mikrobiotsenoz i sostoianie slizistoi obolochki kishechnika pri ankiloziruiushchem spondiloartrite.

Intestinal microbiocenosis was examined in 53 patients with ankylosing spondyloarthritis (AS). Of these, 23 had the central and 30 presented with the peripheral form. 34 patients underwent endoscopic examinations (rectoromanoscopy, ileocolonoscopy). As a result, in 74% of cases with the central form of AS and in 80% of cases with the peripheral form of AS, alterations in the intestinal microflora were revealed, which can be regarded as intestinal dysbacteriosis (ID), with dysbacteriosis being more pronounced in patients with the peripheral form. In such patients it manifested by a considerable decrease of the amount of bifido- and lactoflora, which promoted the increment of the amount of opportunistic microorganisms, particularly Klebsiella. Macroscopic signs of nonspecific inflammation of the small and large intestines were identified in 63% of patients with the central and in 67% of those with the peripheral form of AS. Mean-while histomorphological study of biopsy specimens of the intestinal mucosa showed that all the examinees had chronic inflammation of varying degree.