5'-nukleotidaza i adenozin dezaminaza kod bolesnika sa reumatoidnim artritisom
Sažetak
Uvod/Cilj. U patogenetskoj osnovi reumatoidnog artritisa (RA) su inflamacija, promena imunog sistema i oštećenje ćelija. Značajnu ulogu u procesu oštećenja tkiva posredovanog inflamacijom imaju 5'-nukleotidaza (5'-NT) i adenozin dezaminaza (ADA). Cilj rada bio je određivanje aktivnosti adenozin dezaminaze i 5'-nukleotidaze u serumima obolelih od RA lečenih uz pomoć ili bez terapije metotreksatom (MTX), kao i utvrđivanje povezanosti ovih enzima sa aktivnošću bolesti. Metode. Ispitivanjem je bilo obuhvaćeno 160 bolesnika obolelih od RA, od kojih 60 nije bilo lečeno MTX (prosečne starosti 56,8 godina; 68,3% žena) i 100 bolesnika na terapiji MTX (prosečne starosti 59,8 godina, 88% žena), kao i 60 ispitanika kontrolne grupe (prosečne starosti 58,8 godina; 66,6% žena). Bolesnici sa hroničnim inflamatornim oboljenjima, hroničnom respiratornom, srčanom i bubrežnom insuficijencijom, težim akutnim oboljenjima, i drugim bolestima od značaja koje bi mogle da modifikuju inflamatorni odgovor bili su isključeni iz istraživanja. Rezultati. Nije zabeležena razlika u aktivnosti 5'-NT između ispitivanih grupa. Vrednosti ADA su se značajno razlikovale između ispitivanih grupa. Post- hoc analizom (Dunnett-ov T3 test) pokazano je da je aktivnost ADA u grupama značajno viša u odnosu na kontrolnu grupu bolesnika (p < 0,001), kao i da je aktivnost ADA u grupi bolesnika sa RA lečenih MTX bila značajno niža u odnosu na aktivnost u grupi bolesnika sa RA koji nisu primili MTX (p < 0,001). Nije bilo statistički značajne korelacije između DAS28 skora i aktivnosti ispitivanih enzima. Zaključak. Aktivnost adenozin dezaminaze povećana je kod bolesnika sa reumatoidnim artritisom. Primena metotreksata dovodi do smanjenja aktivnosti ovog enzima u serumu bolesnika sa reumatoidnim artritisom. Aktivnost 5'-nukleotidaze nije povećana kod bolesnika sa reumatoidnim artritisom i ne zavisi od terapije metotreksatom. Aktivnosti adenozin dezaminaze i 5'-nukleotidaze u serumu nisu dobri pokazatelji aktivnosti reumatoidnog artritisa.
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