Patofiziološki aspekti poremećaja metabolizma purina u reumatoidnom artritisu
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The aim of the paper is testing the activity of purine metabolism enzyme at patients with rheumatoid arthritis, as well as testing the connection between the severity of clinical manifestation of rheumatoid arthritis and inflammation degree, and the activity of the enzyme which takes part in purine metabolism. The research included 160 patients diagnosed with rheumatoid arthritis (RA), 100 of which had late and 60 early RA, as well as 60 control group patients. Activity of 5’-nucleotidase showed significant connection with late RA. Disease activity in late RA showed mild, but significant negative correlation with AMP deaminase. Early rheumatoid arthritis showed strong and significant inverse correlation between RF values and activities of AMP deaminase (C=-0.89, p<0.05). There was no correlation between sedimentation rate, fibrinogen concentration and number of leucocytes, and RA stage. DАS28 score demonstrated connection with all inflammation markers at patients with late RA. VAS scal...e of pain showed significant correlation with CRP, while HAQ score showed correlation with CRP and RF. As for patients with early RA, sedimentation rate and CRP values correlated with DАS28 score. Binary regression analysis proved the presence of significant correlation between ADA activity and RA occurrence, as well as between sedimentation rate and RA occurrence. ADA activity was significantly higher at patients who were not treated with methotrexate, as compared to patients who were treated with methotrexate. We recorded increased activity of xanthine oxidase at patients who were not treated with methotrexate and thus concluded that patients with rheumatoid arthritis had significant changes in the activity of enzymes included in purine metabolism, which pointed to their important role in the occurrence and development of rheumatoid arthritis. Purine metabolism disorder and inflammation represent independent factors which have a significant role in pathogenesis and clinical manifestation of rheumatoid arthritis. Methotrexate has a favorable therapeutic effect as it reduces the number of granulocytes, activities of adenosine deaminase and xanthine oxidase at rheumatoid arthritis.