Clinical and Pathogenetic Significance of Osteoassociated Microelements in the Joint Diseases. Report I. Microelementosis in the Blood
Relevance. Microelementosis (imbalance in the body of certain microelements — ME) is considered as one of the most important clinical and pathogenetic components of degenerative and inflammatory joint diseases, and ME can play the role of co-factors involved in the processes of articular inflammation. The objective: to study the levels in the blood serum and to assess the clinical and pathogenetic significance of osteoassociated ME (cobalt — Co, copper — Cu, iron — Fe, litium — Li, manganese — Mn, lead — Pb, strontium — Sr, zinc — Zn) in a variety of arthritis — rheumatoid (RA), Chlamydia-induced urogenital reactive arthritis (ReA), psoriatic (PsA), gouty (GA) and osteoarthritis (OA). Material and methods. There were 262 patients under observation, among them 89 persons suffering from RA, 31 — ReA, 35 — PsA, 49 — GA and 58 — OA. The distribution of males and females in these groups were 1 : 2, 2 : 1, 1 : 1, 11 : 1, 1 : 3, respectively, the average age of the patients was 47, 34, 42, 48 and 58 years, and the duration of clinical manifestations of the disease — 10, 4, 11, 7 and 12 years. ME in the blood serum were studied using atomic absorption spectrometer with electrographite atomizer SolAAr-Mk2-MOZe. Results. Microelementosis in arthritis is manifested by increased blood concentrations of toxic Li, Pb and Sr, moreover, the feature of ReA is a normal ferremia level, PsA — hyperkupremia, and OA — hypozincemia. Microelement blood composition depends on the activity, clinical and laboratory signs of disease, the prevalence of articular process, aggravation of bone destructive changes in the joints (subchondral sclerosis, osteocystosis, bone erosions, epiphyseal osteoporosis, etc), the presence of systemic osteoporosis, spondylopathies (osteochondrosis, spondyloarthrosis) and extra-articular manifestations of arthritis (lesions of the skin, muscles, peripheral nervous system, lymph nodes, internal organs). Blood indexes of Co, Cu, Li, Mn, Pb, Sn and Zn in RA, PsA and GA may have a certain prognostic value. Conclusions. In all the studied joint diseases, there is the disturbance of microelemental blood composition, which is involved in the pathogenetic development of RA, ReA, PsA, GA, OA and determines their clinical course, and in the future it will be possible to apply more rational medical technology for the diagnosis and treatment of joint diseases, to develop medications to correct microelementosis, to improve the quality of predicting the effectiveness of therapeutic interventions.
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