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[The immunologic predictors of effect of anti-B-cell therapy under rheumatoid arthritis].

The article deals with results of study targeted to reveal laboratory biomarkers which can be useful in prognosis of effectiveness of rituximab therapy under rheumatoid arthritis. The sampling consisted of 34 patients with rheumatoid arthritis (31 women, average age 49 years, 42-64 years, mean duration of disease 66, 36-132 months). All patients were examined and received two infusions of rituximab intravenously with interval in 2 weeks against the background of standard therapy. The serum concentration of C-reactive protein, IgM rheumatoid factor IgG, IgM, IgA were measured using immune nephelometric method. The level of cyclic citrullinated peptide antibodies, modified citrullinated vimentin antibodies and IgA rheumatoid factor was measured using method of immune enzyme analysis. The panel of 27 cytokines was measured using multiplex technology xMAP. Before rituximab therapy indices DAS28 (6,12; 5. 52-6, 81), SDA1 (34.3; 23, 8-45, 9) and CDAI (31.3; 21, 8-38.5) corresponded to high activity of rheumatoid arthritis. Up to 24th week of therapy good response on criteria EULAR was registered in 15 patients, moderate response in 18 patients and was absent in 1 patient. The remission on DAS achieved more rarely in patients with initially negative/ low positive values of IgM rheumatoid factor, basal level of IgM less than 2.4 g/l and duration of disease more than 40 months. In the group of patients who attained remission on CDAI up to 24th week of therapy higher basal level of IL-IRA, IL-2, IL-8, IL-15, Eotaxin, GM-CSF, IFN-gamma, MIP-1alpha and TNF-alpha was registered In patients who attained remission on DAS 28 higher level of IL-1beta. IL-2, IL-6, G-CSF, IFN-gamma, MIP-1alpha and TNF-alpha was registered in comparison with patients with disease in active mode. The detection of basal level of IgM rheumatoid factor, IgM and also certain cytokines (IL-1beta, IL-IRA, IL-2, IL-8, IL-15, GM-CSF, IFN-gamma, MIP-1alpha, Eotaxin, TNF-alpha) can be useful in prognosis of effectiveness of rituximab therapy under rheumatoid arthritis.