HYPOSALIVATION AND SJOGREN'S SYNDROME IN RHEUMATOID ARTHRITIS

Yakimenko D. О.

DENTISTRY

Scentific article

It were studied oral lesions, violation of salivation in patients with rheumatoid arthritis in the presence of Sjögren's syndrome. The study involved 150 patients with RA, 27 men (18%) and 123 women (82%), mean age 50.1 + 0.44 years. Clinical and laboratory — instrumental study that included determining the speed of unstimulated salivation, hygienic index Green-Vermilion, common blood tests, urine, blood levels of total protein and fractions, glucose, bilirubin, creatinine, C-reactive protein (CRP) interleykinu-1 (IL-1). There rheumatoid factor, antibodies to cyclic citrullinated polypeptide (CVD), antinuclear antibodies (ANA) were revealed. Examined patients were divided depending on the availability of complaints and speed of unstimulated salivation into three groups: the first included 90 RA patients without complaints of dry mouth, in the second — 31 RA patients complaining of dry mouth, 3 — 29 RA patients with Sjögren's syndrome (salivation rate of less than 0.1 mL/min). The control group according to salivation rate put together 20 patients compared to sex and age without autoantibodies. It was found that all patients with RA beside the presence of complaints of dry mouth, had decrease salivation, that lead to lesions of the gastrointestinal tract and oral mucosa. In all patients with RA spontaneous salivation rate was significantly lower than in the control group (0.29 + 0.07 ml/min in 1 st, 025 + 0.005 ml/min in the 2 nd, 0.14 + 0.04 ml/min at 3 and 0.39 + 0.01 ml/min in the control group, respectively). If there are complaints of dry mouth spontaneous salivation rate was significantly lower than in their absence. The lowest rate of salivation in patients with RA and Sjigren's syndrome. They have the highest hygienic Green Vermilliona index, which indicates pronounced lesions of the oral cavity. Sjogren's syndrome is found in 19% of patients with RA. There the lowest rate of spontaneous salivation, the lowest index Green Vermilion (5.4 + 0.3), the highest content of inflammatory markers — C-reactive protein (22.6 + 0.7 mg/L) and IL-1 (27.9 + 0.8 pg/ml) in these patients. They are also have the highest friequens (in 96.6% of patients) and different types of ANA (in 68.9% of patients). The presence of a wide spectrum of autoantibodies characteristic of RA is associated with a reduction rate of spontaneous salivation, and often they suffer from Sjogren's syndrome. Reduced rate of spontaneous salivation with increasing degree of inflammatory autoimmune process can be explained by the presence of sialoadenitis varying degrees of severity, in majority of patientes with rheumatoid arthritis (80%), reaching maximum severity at high activity of rheumatic process. Thus, in rheumatoid arthritis decrease salivation, which is associated with increased activity of inflammation and with presence of autoantibodies. Sjogren's syndrome in rheumatoid arthritis is found in 19% of patients, is associated with a significant deterioration in oral hygiene, high activity of inflammation, the presence of a wide spectrum of autoantibodies (rheumatoid factor, antinuclear antibodies in low titer antibodies SSA/Ro and SSB/La), increased content C-reactive protein and interleukin-1).

rheumatoid arthritis, oral hygiene, hypоsalivation, Sjogren's syndrome

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«Bulletin of problems biology and medicine» Issue 1 part 1 (126), 2016 year, 384-387 pages, index UDK 616.72-002.77-06:616.316-008.811.4]-097