scholarly journals AB0167 PECULIARITIES OF INTERACTION OF CHRONIC INFLAMMATION AND DEPRESSION IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1110.1-1110
Author(s):  
A. Aleksandrov ◽  
N. Aleksandrova
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Inflammatory Cytokines ◽  
Depressive Disorders ◽  
Severe Depression ◽  
Mild Depression ◽  
Group Iii ◽  
Group I ◽  
Severity Of Depression ◽  
Pro Inflammatory Cytokines

Background:In patients with rheumatoid arthritis (RA), a high prevalence of depression and anxiety is observed, and the severity of these conditions depends on the degree of vitamin D deficiency. The role of the main mediator, with the help of which psychological and physical stress factors can contribute to the development of depression and systemic diseases, has been attributed to inflammation in recent years.Objectives:to assess the dependence of depressive disorders on vitamin D deficiency and the level of pro-inflammatory cytokines in patients with RA.Methods:88 women with a reliable diagnosis of RA (mean age 54.2 ± 12.0 years old, disease duration 9.0 [3.5; 16.0] years) were under observation. Beck’s depression inventory (BDI-II) was used to assess the presence of depressive symptoms. ELISA test was used to measure serum cytokines (IL-1, IL-6) and serum 25(OH)D levels.Results:The presence of depression was found in 66% of patients with RA. An insufficient level of 25(OH)D (<30 ng / ml) was determined in 89.8% of cases. In RA patients with no signs of depression, the level of 25(OH)D showed maximum values and significantly differed from that in the groups of patients with moderate (p = 0.028) and severe depression (p <0.001). A negative correlation (r = -0.38, n = 88, p <0.05) was established between the level of 25(OH)D and the severity of depression. A positive relationship was also found between 25(OH)D and ESR (r = 0.29, n = 73, p <0.05) and a negative relationship with the number of painful joints (r = -0.29, n = 76, p <0.05). Probably, vitamin D is indirectly involved in inflammatory processes in joints and in central sensitization, which provokes chronic pain and psychological disorders in patients with RA.The level of IL-6 in patients with RA with moderate and severe depression (n=18; 14.6 ± 6.7 pg/ml) significantly exceeded the parameters of patients with RA without depressive disorders (n=30; 9.8 ± 3.7; p = 0.003). There was also a tendency to increase IL-6 in the group of patients with moderate and severe depression compared with patients with mild depression (p = 0.06). IL-1β values significantly increased with the progression of depression (without depression – mild depression, p = 0.034; mild – moderate, p <0.001; moderate – severe depression, p = 0.044). A positive correlation of average severity was revealed between the degree of depression (according to BDI-II) and the dose of glucocorticoids (GC) at the time of the study (r = 0.33, p = 0.002). An increase in the GC dose in the short term can aggravate depressive disorders in RA patients (Table 1).Table 1.Indicators of levels of depression and IL-1β depending on the dose of GCGroup I (n=26), without GCGroup II (n=45),GC <10 mg / dayGroup III (n=17),GC ≥10 mg / dayDepression level according to BDI-II, points (Me [P25; P75])8,5[5;16]14[9;17]19[14;29] *III-IIL-1β level, pg / ml (M ± SD)4,57 ± 1,83*I-II6,04 ± 3,276,52 ± 5,16* - intergroup differences are reliable, p <0.05Patients who used GC in a daily dose of ≥10 mg / day (group III) had a higher degree of depression compared to patients with RA from group I (z = -2.98; p = 0.003). In patients with RA in the first group, the level of IL-1β was significantly higher (pI-II = 0.039) than in patients with GC prescription in minimal doses (up to 10 mg / day) (Table 1). Glucocorticoid hormones suppress pro-inflammatory cytokines. As a rule, this effect is not observed in patients with depression. This fact may indicate a violation of homeostatic mechanisms. IL-1β is thought to be the first step in the pro-inflammatory response to psychological stress and is capable of inducing a subsequent cascade of other inflammatory cytokine responses.Conclusion:Restoring the normal level of 25(OH)D in the blood serum of patients with RA can positively affect psychological indicators by reducing the severity of depression and manifestations of pain. The activation of pro-inflammatory cytokines during stress and depression suggests that suppression of the inflammatory response can also reduce the symptoms of depression in RA patients.Disclosure of Interests:None declared

scholarly journals THE EFFECT OF VITAMIN D ON THE SEVERITY OF DEPRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2019 ◽  
Vol 19 (1S) ◽  
pp. 197-199
Author(s):  
V A Aleksandrov ◽  
N V Nikitina ◽  
L N Shilova ◽  
N I Aleksandrov ◽  
N V Emelianov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Negative Correlation ◽  
Depressive Disorders ◽  
Mutual Influence ◽  
Average Power ◽  
Corticosteroid Hormones ◽  
Severity Of Depression ◽  
Inflammatory Changes ◽  
The Relationship

Objective: to study the dependence of depressive disorders in patients with rheumatoid arthritis (RA) on vitamin D deficiency in blood serum. Material and methods. 88 women were examined (mean age - 54.2 ± 12.0 years, disease duration - 9.0 [3.5; 16.0] years) with a reliable diagnosis of RA. An enzyme immunoassay was used to determine the 25(OH)D in the serum of patients with RA. Depression was assessed using the Beck scale. Results. In 89.8% of patients, an insufficient level of 25(OH)D was detected in the serum. The presence of depression was observed in 66% of patients with RA. A negative correlation of average power (r = -0.38) was found between the the level of 25(OH)D and the severity of depression. A negative correlation of average power (r = -0.38) was found between the the level of 25(OH)D and the severity of depression. The relationship between 25(OH)D and ESR (r = 0.29), depression and intake (r = 0.22) and dose (r = 0.26) of corticosteroid hormones, the number of painful joints (r = 0.25) indicates on the involvement of these predictors and their mutual influence in metabolic and psychological processes in RA. Vitamin D is indirectly involved in inflammatory changes and central sensitization, which provokes psychological disorders in patients with RA. Conclusion. Correction of the deficiency of 25(OH)D can positively affect the reduction of the severity of depression and pain in RA.

scholarly journals AB0827 SERUM NESPHATIN-1 IN PATHOGENESIS RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1437.2-1438
Author(s):  
T. Kvlividze ◽  
V. Polyakov ◽  
В. Zavodovsky ◽  
Y. Polyakova ◽  
L. Seewordova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Serum ◽  
Inflammatory Cytokines ◽  
Inflammatory Markers ◽  
Healthy People ◽  
Healthy Individuals ◽  
Markers Of Inflammation ◽  
High Level ◽  
Pro Inflammatory Cytokines

Background:Interest in highly specialized tissue cytokines contributed to the discovery of new biologically active molecules. Nesfatin-1 (NF) - discovered in 2006 as an anorexigenic factor. NF-1 is believed to be involved in the regulation of energy homeostasis by regulating appetite and water intake. The role of NF-1 in the pathogenesis of inflammatory diseases is poorly understood. Recently, studies have found a relationship between an increased level of NF-1 and inflammatory markers in various pathologies.Objectives:Study of the level of nesfatin-1 in the blood serum of healthy people, determination of the correlation between the level of NF-1 with the severity of clinical symptoms and classic markers of inflammation in patients with RA.Methods:120 persons were examined: 90 patients with RA and 30 healthy people. All patients underwent a complete clinical and laboratory examination. Plasma NF-1 levels were determined using commercial test systems (RaiBiotech, cat # EIA-NESF) according to the manufacturer’s instructions. Patients with various forms of RA were comparable in age to the group of healthy individuals. Statistical processing of clinical examination data was carried out using the “STATISTICA 10.0 for Windows” software package. Quantitative data were processed statistically using the parametric Student’s t-test, qualitative data using the non-parametric chi-square test. The significance of differences between groups was determined using analysis of variance. The results were considered statistically significant at p <0.05.Results:The average level of NF-1 in blood serum in healthy individuals was 31.79 ± 3.21 ng / ml (M ± σ). The level of normal NF-1 values in healthy individuals, defined as M ± 2σ, ranged from 25.3 to 37.83 ng / ml. There was no significant difference in the levels of circulating NF-1 and BMI in healthy individuals and patients with RA (p> 0.05). The inverse relationship of a lower level of NF-1 with an increase in BMI was not significant.Group 1 (66 patients with RA) with increased serum NF-1 levels (> 37.83 ng / ml), and group 2 (44 patients) with normal values (<37.83 ng / ml). A high level of NF-1 was characteristic for patients with high activity according to DAS28, RF seropositive, ACCP-positive, with extra-articular manifestations, who had been ill for 10 years or more. A reliable relationship between the level of NF-1 in the blood serum and laboratory parameters of RA activity - ESR, CRP, was shown, and secondary synovitis was more common. Our data show a direct correlation between the NF-1 level of the pro-inflammatory markers of RA.Conclusion:The positive correlation between the level of NF-1 and classical markers of inflammation, such as CRP and ESR, confirms the involvement of NF-1 in the pathophysiology of inflammation in RA. This is also evidenced by the correlation of a high level of NF-1 in the blood serum with a more severe clinical picture of RA. It is known that NF-1 can promote the release of pro-inflammatory cytokines such as interleukin-8 (IL-8), interleukin-6 (IL-6), and macrophage inflammatory protein-1a (MIP-1a) in the chondrocytes of RA patients.It is necessary to further study the role of NF-1 in the pathogenesis of systemic inflammatory reactions and the possibility of targeting pro-inflammatory cytokines, the possibility of regulating the level of NF-1 by drugs.References:[1]Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R. Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R., Polyakova Yu.V., Sivordova L.E., Yakovlev A.T., Zborovskaya I.A. Serum nesfatin -1 as a marker of systemic inflammation in rheumatoid arthritis. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2019; 64 (1): 53-56 (in Russ.).Disclosure of Interests:None declared

scholarly journals AB0103 THE AMBIGUOUS ROLE OF TISSUE CYTOKINES IN THE PATHOGENESIS OF RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1350.1-1351
Author(s):  
O. Korolik ◽  
В. Zavodovsky ◽  
E. Papichev ◽  
Y. Polyakova ◽  
S. L ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
High Activity ◽  
Inflammatory Cytokines ◽  
Stage Iii ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Individuals ◽  
Fetuin A ◽  
High Level ◽  
Extraarticular Manifestations ◽  
Pro Inflammatory Cytokines

Background:Cytokines stimulate the inflammatory response in the synovial membrane with rheumatoid arthritis (RA), initiate apoptosis of chondrocytes, activation of osteoclasts. The progression of comorbid diseases is also associated with the influence of cytokines. At the same time, anti-inflammatory cytokines are produced in various tissues. Their role in the pathogenesis of RA and its complications is ambiguous.Adiponectin (A) and Fetuin A (FA) are classified as negative acute phase proteins. Their concentration decreases with an increase in the level of pro-inflammatory cytokines: TNF-α, IL-1 and IL-6. Molecules A and FA, regardless of various factors and from each other, have similar effects in relation to pro-inflammatory cytokines, lipid and carbohydrate metabolism.Visfatin (V) and Nesfatin-1 (N-1) are pro-inflammatory adipokines. B is produced by cells of the mononuclear phagocytic system and connective tissue. N-1 - is produced by the cells of the intermediate and medulla oblongata and by the cells of the gastric mucosa.Objectives:to study the correlation of B, H-1, A and FA with the severity of inflammation in RAMethods:60 patients with RA and 30 healthy individuals were examined. The level of cytokines was determined by an indirect enzyme-linked immunosorbent assay using commercial test systems (Bio Vendor, cat No. RD195023100, Bio Vendor Human Fetuin-A, RaiBiotech, cat No. EIA-VIS-1, RaiBiotech, cat No. EIA-NESF). All patients underwent a full examination. Diagnosed with 2010 EULAR / ACR recommendations.Results:A decreased level of A (less than 0.8 μg/ml) was detected in 15 patients (25%), F-A (less than 653.55 μg/ml) in 16 (27%), a high level of V (more than 39 ng/ml) - in 55 (91%), N-1 (more than 37.95 ng/ml) - in 36 (60%), which is significantly more often than in healthy individuals. No significant difference in the levels of determined adipokines was found depending on the gender and body weight of patients with RA. The level of cytokines in RA is associated with high activity according to DAS 28, positivity by Anti-CCP, extraarticular manifestations of RA. The greatest correlation with extraarticular manifestations is with cutaneous and cerebral vasculitis. The levels of FA and N-1 also correlated with more pronounced radiological changes (X-ray stage III). FA circulating inhibitor of ectopic calcification. N-1 level is positively correlated with systolic blood pressure.Conclusion:A low level of A and FA, a high level of V and N-1 is characteristic of RA with the presence of high activity and positivity in the RF and Anti-CCP. An increased level of B is determined by more than 90% of patients, which indicates its high pro-inflammatory activity. The level of F and N-1 is also associated with the degree of damage to bone tissue (stage III, a lot of erosion). A positive correlation of level V and N-1, negative A and FA with the severity of inflammation in RA confirms the involvement of these proteins in the pathogenesis. A high level of A and V increases the risk of developing cardiovascular diseases and their complications, the effect of N-1 and FA is being studied. The effect of cytokines on osteoclasts and osteoblasts in RA is ambiguousReferences:[1]Visfatin and Rheumatoid Arthritis: Pathogenetic Implications and Clinical Utility. Polyakova Y. Curr Rheumatol Rev.2019[2]Serum nesfatin -1 as a marker of systemic inflammation in rheumatoid arthritis. Kvlividze T. Klinicheskaya Laboratornaya Diagnostika.2019; 64 (1):53-56 (in Russ)[3]Fetuin-A. Novel hepatokine in rheumatoid arthritis laboratory diagnostics. Papichev E. Klinicheskaya Laboratornaya Diagnostika.2018; 63 (12):756-760 (in Russ)Disclosure of Interests:None declared

scholarly journals Prevalence and severity of depression in patients with the consequences of ischemic strokes and in patients with chronic brain ischemia

2021 ◽  
Vol 11 (10) ◽  
pp. 320-324
Author(s):  
A. Babirad
Keyword(s):  
Cerebral Ischemia ◽  
Brain Ischemia ◽  
Rating Scale ◽  
Severe Depression ◽  
Chronic Cerebral Ischemia ◽  
Mild Depression ◽  
Hamilton Depression Rating Scale ◽  
Chronic Brain Ischemia ◽  
Severity Of Depression

The aim of our study was to investigate the prevalence and severity of depression in patients with the consequences of ischemic strokes and in patients with chronic brain ischemia. Material and Methods. We examined 100 patients with consequences of ischemic strokes and 17 patients with chronic cerebral ischemia. The Hamilton Depression Rating Scale was used to assess the presence and degree of depression. Conclusions. Slightly less than half of the patients with chronic cerebral ischemia (47.1%) had no depression, 42.1% had mild depression, and only 11.8% of the patients had moderate and severe depression. A different situation was observed in the group of patients with the consequences of ischemic strokes. Among them, only 22.0% of patients had no depression, 44.0% had mild depression, and 34.0% of patients had moderate, severe, and extremely severe depression (p < 0.05).

scholarly journals Frequency and severity of depression in primary caregivers of psychotic patients.

2019 ◽  
Vol 26 (10) ◽  
pp. 1776-1782
Author(s):  
Shehla Gul ◽  
Muhammad Adnan Bashir ◽  
Sohail Ali
Keyword(s):  
General Health Questionnaire ◽  
Primary Caregivers ◽  
Severe Depression ◽  
Sampling Technique ◽  
Female Gender ◽  
Military Hospital ◽  
Mild Depression ◽  
Cross Sectional ◽  
Severity Of Depression ◽  
The Mean

Objectives: The study aimed at determining the frequency and severity of depression in primary caregivers of psychotic patients. Study Design: Cross sectional study. Setting: Out-patient as well as in-patient setting of Department of Psychiatry, Military Hospital Rawalpindi. Period: Six months, from 20th April 2017 to 19th October 2017. Material and Methods: Purposive, non-probable sampling technique was used. A total of 246 caregivers of the same number of psychotic patients were studied after consent, using the General Health Questionnaire 28 (GHQ-28) and Beck’s Depression Inventory (BDI). The mean total BDI scores were calculated and correlated with the socio-demographic variables. Results: The mean total GHQ-28 score of 246 caregivers was 7.32 (cut off score is >7) which indicate definite psychopathology among them. Out of 246 caregivers, 175 (71.1%) showed scores greater than 7 (GHQ positive) while 71 (28.9%) showed scores less than 7 (GHQ negative). The mean total BDI score of 175 caregivers (who were GHQ positive) was 17.83 (cut off score for depression is >9). Out of 175 GHQ positive caregivers, 72 (41.14%) showed subclinical or no depression, 49 (28%) showed mild depression, 40 (22.86%) showed moderate depression and 14 (8%) showed severe depression on BDI. The results show that there is considerable caregiver burden in relatives of psychotic patients. Conclusion: Caregivers of psychotic patients suffer clinical depression with obvious negative outcomes for the patient. Younger age group, female gender and illiteracy typically carry a greater risk of experiencing higher burden in terms of depression.

Clinical prognosis of associated forms of alcoholism with co-morbid brain impairment

2011 ◽  
Vol 26 (S2) ◽  
pp. 12-12
Author(s):  
N.A. Bokhan
Keyword(s):  
Depressive Disorders ◽  
Cognitive Disorders ◽  
Alcohol Withdrawal Syndrome ◽  
Social Adaptation ◽  
Clinical Prognosis ◽  
Group Iii ◽  
Group I ◽  
Traumatic Group ◽  
Group Ii ◽  
Depressive States

ObjectiveIdentification of clinical differences of formation and prognosis of severity of associated forms of alcoholism in relevant variants of co-morbid brain impairment.Material and methodsWith clinical-psychopathological method we examined inpatient samples with stage 2 alcoholism with co-morbid traumatic (group I, n = 105); hypertensive (group II, n = 45) and vertebrogenic (spinal cord artery syndrome) (group III, n = 37) brain impairment. Control - 30 patients with alcoholism without co-morbid pathology.ResultsIn group I alcoholism is forming at early age in persons with pre-morbidly problematic social adaptation - in 62,2% conditioned by presence of excitable traits of the character. Dominance of dysphoria in intoxication and in alcohol withdrawal syndrome (AWS) predetermines formation of psychopath-like degradation with total and persistent social disadaptation. Beyond AWS, reactive lability, lingering asthenic-sub-depressive states with inclusion of dysphoric, hysteric-excitable components remain during low quality of remission. In group II later formation of alcoholism in 26,7% of cases was preceded by psychodisadaptive disturbances conditioned by pre-morbidly anxious constitution of personality. In structure of AWS anxious-phobic modality of depressive disorders against the background of cardiovascular manifestations of toxicogenic effects of ethanol determines development of torpid asthenic-depressive states (with cardiophobic and hypochondriac components). For patients from group III we have identified intermediary tempo of increasing of progression of alcoholism with obligate diencephalic psychovegetative, psychosensory and severe psychoorganic cognitive disorders against the background of asthenic, more seldom dysphoric variants of change of the personality.ConclusionPrognosis of associated forms of alcoholism is various in distinguished variants (traumatic, hypertensive, vertebrogenic) comorbid brain impairment.

scholarly journals The potential for correction of depressive disorders in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 48 (5) ◽  
pp. 299-306
Author(s):  
E. V. Bolotova ◽  
A. V. Dudnikova ◽  
V. V. Trembach
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Vitamin D ◽  
Depressive Disorders ◽  
Severe Depression ◽  
Chronic Obstructive ◽  
Control Groups ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Vitamin D Levels ◽  
And Control

Background: The use of vitamin D in the treatment of depressive disorders in patients with chronic obstructive pulmonary disease (COPD) is justified by its pathophysiology, but it is not always feasible in clinical practice. This may be related to the lack of guidelines for implementation for this patient group, as well as to the inadequate sample of patients with baseline high vitamin D levels or mild psychoemotional distress.Objective: To assess the changes of psychoemotional status over time in COPD patients against the maintenance of vitamin D levels at>34.3 ng/ml for one year.Materials and methods: The study included 264 COPD patients randomized into the treatment and control groups (135 and 129 patients, respectively). The patients in both groups were divided into 4 subgroups according to their forced expiratory volume in 1 second (FEV1) values and vitamin D levels. All the patients were administered an inactive vitamin D (colecalciferol): in the main group, according to the scheme ensuring maintenance of the micronutrient value above the goal for 12 months, and in the control group according to the standard scheme of correction of vitamin D deficiency. Depression symptoms were assessed in Geriatric Depression Scale (GDS-15) at the beginning of the study and at its end.Results: After 12 months of vitamin D treatment, the main group showed a statistically significant decrease in the rate of severe depression (14.8% vs 6.7%, χ2=4.67, p=0.04) and an increase in the proportion of patients with normal psychoemotional status (28.2% vs 49.6%, χ2=13.11, p=0.03). In addition, there was a significant difference between the rates of severe depression in the main and control groups after 12 months of treatment: 6.7% vs 14.7% (χ2=4.52, p=0.02).Conclusion: Maintenance of vitamin D levels above 34.3 ng/ml in COPD patients for 12 months reduces the proportion of patients with severe depression.

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