FEATURES OF THE CYTOKINE PROFILE AND DYSBIOTIC CHANGES IN THE COLON IN PATIENTS WITH RHEUMATOID ARTHRITIS ASSOCIATED WITH BORRELIA BURGDORFERI ON THE BACKGROUND OF COMPLEX THERAPY USING PROBIOTICS
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i1.13733Keywords:
Borrelia burgdorferi, Lyme arthritis, cytokines, dysbiosisAbstract
SUMMARY. An interesting fact is that the presence of arthritis in patients associated with Borrelia burgdorferi (B. burgdorferi) leads to significant changes in the microbiome, causing gut dysbiosis, triggering a cascade of inflammatory reactions with hyperproduction of proinflammatory cytokines, which in turn play an important role in the progression of the inflammatory process in joints. An imbalance towards the maximum values of pro-inflammatory cytokines contributes to an increased inflammatory reaction in the body, causes a more severe and aggressive course of the disease, and contributes to the destruction of bone tissue.
The aim – to evaluate the effect of the proposed scheme of complex treatment with the use of a probiotic on the dynamics of TNF-α, IL-6, IL-8, IL-4, IL-10 against the background of intestinal dysbiotic changes (IDC) in patients with rheumatoid arthritis (RA), associated B. burgdorferi.
Material and Methods. We examined 126 patients aged 19–73 with B. burgdorferi-associated RA, Lyme arthritis (LA), isolated RA, and and 30 people of the control group. Disease activity was assessed using the Disease Activity Score (DAS 28) index. Cytokine levels (TNF-α, IL-6, IL-8, IL-4, IL-10) were determined by enzyme-linked immunosorbent assay (ELISA). The qualitative and quantitative composition of the intestinal microbiota was determined by faecal culture, and the degree of dysbiosis was determined.
Results. After the use of complex therapy with "Remedium" probiotic, a statistically significant (p<0.05) decrease in the levels of pro-inflammatory cytokines (TNF-α, IL-6, IL-8) and a significant (p<0.05) increase in anti-inflammatory (IL-10, IL-4) among patients of all studied groups were established. The highest levels of pro-inflammatory cytokines before the prescribed therapy were in patients with RA associated with B. burgdorferi, and anti-inflammatory cytokines in patients with LA. After treatment, IDC decreased statistically significantly (p<0.05) towards normocenosis, the percentage of which increased by 5 times among patients with RA and by 2.3 times in patients with isolated RA.
Conclusions. The inclusion of probiotic in the complex therapy of patients with arthritis allows for a statistically significant (p<0.05) improvement in the IDC and contributes to a faster normalization of the interleukin profile of patients due to an increase in anti-inflammatory cytokines and a decrease in pro-inflammatory ones.
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