INQUIRY OF THE CORRELATION OF THE FEATURES OF ATHEROSCLEROSIS AND PROINFLAMMATORY CYTOKINES IN SYSTEMIC SCLEROSIS

Abstract

In a number of studies, it has been confirmed that cardiovascular complications caused by atherosclerotic damage of blood vessels lead to a decrease in life expectancy in systemic diseases. This calls for a systematic approach to the diagnosis and treatment of systemic sclerosis (SS) and further research to address this issue. The aim of the study was to analyze the relationship between risk factors and inflammatory mediators of early atherosclerosis in patients with systemic scleroderma. Materials and methods 86 patients involved in the study were divided into three groups according to the type of treatment: patients in group 1 (n-34) received conventional  treatment according to the recommendations of the standard of care for SS, group 2 (n-29) received treatment according to the standard of care for patients in the 2 nd group (n-29) statin (atorvastatin
drug in the amount of 20-40 mg for 6 months) in addition to traditional treatment, tocilizumab (8 mg/kg) according to the scheme (8 mg/kg) dose in the form of injection once every 4 weeks) was prescribed for 6 months. Before treatment and after treatment, general clinical (general blood analysis, general urine analysis), biochemical (AlT, AsT, bilirubin, urea, creatinine, total protein), lipid spectrum indicators (Chol, LDLP, HDLP, TG), cytokine (IL-6) was checked in blood serum based on immunological examinations (SRP, RF) and special laboratory analyses. An increase in the thickness of the intima media complex (IMC) (from 0.9 to 1.2 mm) and an atherosclerotic plaque (local enlargement of the IMC ≥ 1.2 mm) were used as criteria for atherosclerotic damage to the vessels. Through this examination, the thickness of IMC the right and left carotid arteries was checked and their average was calculated. In this way, atherosclerotic damage of vessels was evaluated. Results. Analyzing of cardiovascular risk factors in patients with SS according to the number of occurrences, it was found that among the patients included in our study, family anamnesis, arterial hypertension, the increase in the amount of total cholesterol and TG were reliably higher than in the control group (p<0.05 ). SS is a disease characterized by a high rate of cardiovascular complications. Early atherosclerosis risk factors were found in 77 (89.5%) patients in the study group and 17 (56.7%) in the control group. 1-3 risk factors were found in 32.5% of patients, 3-5 risk factors in 18.6% and more than 5 risk factors in 38.4%, and no risk factors were observed in 10.5% of patients. In the control group, 1-3 risk factors were recorded in 26.7%, 3-5 risk factors in 13.3%, and more than 5 early atherosclerosis risk factors in 16.7%. Changes in IL-6 levels in relation to disease activity and progression, IL-6 levels increased as disease activity increased in SS patients, and IL-6 levels were observed to be higher in the acute course of the disease. IL-6 cytokine was found to be correlated with lipid spectrum indicators and SRP, and it was distinguished that there is a positive correlation between IL-6 and SRP, atherosclerosis risk factors Chol, TG, LDLP and negative correlation between HDLPs. Conclusions In patients with systemic scleroderma, there was a positive correlation between IL-6 and SRP, atherosclerosis risk
factors, body weight index, Chol, TG, LDLP and negative correlation between HDLP. In patients with systemic scleroderma, a positive effect of monoclonal antibody drugs on the cardiovascular system was revealed, that is, it was manifested by an increase in the ejection fraction of the left ventricle by 6.1% and a decrease in the thickness of the IMС by 8.8%.