Issue №5-93, 2019

The role of systemic inflammatory response in the initiation and progression of joint lesions

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1 Bolotov D.D., 1 Novikov A.A., 2 Novikova N.A., 2 Yakovchenko A.V., 3 Mankirova A.V.

1 Federal Bureau of medico-social examination of the Ministry of labor of Russia, Moscow, Russia
2 I.M. Sechenov First Moscow state medical University, Moscow, Russia
3 Moscow State University of Medicine and Dentistry, Moscow, Russia


ABSTRACT

Subclinical manifestations of a low-intensity inflammatory process have a significant impact on the development, courseand clinical prognosis of the degenerative-dystrophic process. They also lead to structural changes in the vascular networkin the focus of chronic inflammation. Subsequent cellular reactions that occur under the action of chemokines and cytokinessupport developing inflammation, including through structural changes in tissues. The endothelial-mesenchymal transition,which changes the phenotype of the endotheliocyte to myofi broblast, for its part increases the activity of the formation ofnew structures. As a result of changes in the functional activity of endotheliocytes, pericytes, fi broblasts, macrophages, lymphocytes,epithelial cells, etc. in combination with angiogenesis, increased permeability of vascular walls and edema, lead tothe emigration and infi ltration of tissues with inflammatory cells, an increase in the number and activity of fi broblasts withthe development of fi brosis and a change in the structure of tissue. Thus, the development of a degenerative-dystrophicdisease is based on an imbalance of counter-regulatory factors: pro-inflammatory, anti-inflammatory and inflammatory factors,which not only leads to the formation of a chronic systemic inflammatory response and supports it in one area, but alsocreates conditions for the formation of new foci of chronic inflammation, new sources of phlogogen’s. Given the generalizationof the results of the research, the treatment and rehabilitation plan should be based on a combination of the use of etiotropic,pathogenetic and sanogenetic principles. Potentiation of eff ects when choosing a therapeutic strategy and tacticsallows activating the formation of inflammation completion factors, including chemokines, specialized pro-resolving lipidmediators, contributing to the reduction of newly formed vessels and the restoration of normal cellular tissue composition.Subclinical manifestations of a low-intensity inflammatory process have a significant impact on the development, courseand clinical prognosis of the degenerative-dystrophic process. They also lead to structural changes in the vascular networkin the focus of chronic inflammation. Subsequent cellular reactions that occur under the action of chemokines and cytokinessupport developing inflammation, including through structural changes in tissues. The endothelial-mesenchymal transition,which changes the phenotype of the endotheliocyte to myofi broblast, for its part increases the activity of the formation ofnew structures. As a result of changes in the functional activity of endotheliocytes, pericytes, fi broblasts, macrophages, lymphocytes, epithelial cells, etc. in combination with angiogenesis, increased permeability of vascular walls and edema, leadto the emigration of leukocytes and infi ltration of tissues with inflammatory cells, an increase in the number and activity offi broblasts with the development of fi brosis and a change in the structure of tissue. Thus, the development of a degenerative-dystrophic disease is based on an imbalance of counter-regulatory factors: pro-inflammatory, anti-inflammatory andinflammatory factors, which not only leads to the formation of a chronic systemic inflammatory response and supports itin one area, but also creates conditions for the formation of new foci of chronic inflammation, new sources of phlogogen’s.Given the generalization of the results of the research, the treatment and rehabilitation plan should be based on a combinationof the use of etiotropic, pathogenetic and sanogenetic principles. Potentiation of eff ects when choosing a therapeuticstrategy and tactics allows activating the formation of inflammation completion factors, including chemokines, specializedpro-resolving lipid mediators, contributing to the reduction of newly formed vessels and the restoration of normal cellulartissue composition.


KEYWORDS: degenerative-dystrophic process, chronic systemic inflammatory response, osteoarthritis, deforming osteoarthrosis, imbalance of counter-regulatory factors.



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