Increasing the number of immune-related complications of systemic connective tissue diseases requires continuous improvement of methods for their diagnosis and treatment. Despite the fact that significant advances have been made today in the study of systemic connective tissue diseases, the question of the use of maintenance therapy in patients, which may help to prevent their occurrence, remains relevant. Recent studies indicate that the use of biguanides (metformin), which have anti-inflammatory effects, is promising. Assessment of the status of the immune system patients with systemic connective tissue diseases, which received in the complex scheme of treatment of biguanides (metformin), determined the purpose of our work. 38 patients with systemic connective tissue diseases, aged 36–58 years, were examined. To confirm the main diagnosis (systemic connective tissue diseases), patients underwent clinical, general laboratory, immunological and instrumental studies, based on the results of which, according to international diagnostic criteria using international protocols, the following systemic connective tissue diseases were diagnosed: rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis. All patients who participated in the study were informed, in writing, that the studies were in accordance with the established standards of the Declaration of Helsinki adopted in 1964 and revised by the 59th General Assembly of the WMA (Seoul, October 2008). Investigated the total complementary activity of blood serum, the level of circulating immune complexes, the phagocytic activity of neutrophils and monocytes (absorptive capacity: spontaneous and stimulated; the ability to process: spontaneous, physiological, chemically strong and weak), population and subpopulation composition of lymphocytes before and after treatment. Statistical processing of the results of the study was carried out using generally accepted methods of variation statistics. Patients with systemic connective tissue disease receiving metformin in combination with baseline therapy showed normalization of total complementary activity of blood serum (p<0.05), stabilization of phagocytosis, as indicated increase in the spontaneous exciting ability of neutrophils by 1.1-fold (p<0.05) and strongly stimulated oxidative activity of monocytes by 1.1-fold (p<0.05), increase in induced absorption capacity of monocytes to the level of norm (p<0.05). The number of regulatory CD4+/25+ lymphocytes increased by 1.2-fold (p <0.05) and there was a tendency to normalize the number of activated T lymphocytes (CD3+/ HLA-DR+) (p<0.05). Patients with systemic connective tissue diseases, who received only basic therapy, showed a decrease in the number of T-helper cells (CD3+/4+) by 1.3-fold (p<0.05), of activated B lymphocytes (CD25+) by 2.2-fold (p<0.05) and T lymphocytes (CD3+/ HLA-DR+) by 2.0-fold (p<0.05). The peculiarities of the effect of metformin on indicators of the immune system of patients with systemic connective tissue diseases receiving long-term basic therapy give reason to view this drug as a promising prophylactic immunoregulatory factor in the development of immune-dependent disorders.
Full text: PDF (Ukr) 449K