DIAGNOSTIC VALUE OF CERULOPLASMIN IN SYSTEMIC SCLERODERMA

Objective of study: refining immune diagnostics of systemic scleroderma through determining ceruloplasmin antibodies, its amount and enzymatic activity, as well as control of effectiveness of therapy with ceruloplasmin-based immobilized magnetocontrollable immunosorbents.

Materials and methods. 30 apparently healthy individuals and 68 patients with systemic scleroderma were examined. The study included patients with referral diagnosis of systemic scleroderma who signed an informed consent. The study was performed in accordance with the principles of World Medical Association Declaration of Helsinki rev. 2013 (ACR/EULAR). All participants had their blood tested with the method of immunoenzymatic determination of antibodies to ceruloplasmin upon admission to hospital and prior to discharge.Results. It was established that patients with systemic scleroderma show reduced oxidase activity of ceruloplasmin, increased ceruloplasmin levels, as well as elevated antibodies to ceruloplasmin compared with the control group. A link between the amount of antibodies to the studied enzyme, and the activity, nature, course and stage of the disease was established. It was found that there is a reliable negative correlation between the level of ceruloplasmin antibodies, and the amount of RBCs, the hemoglobin level. For the first time a complex assessment of three parameters was employed, the parameters being the enzymatic activity, ceruloplasmin amount, and antibodies to ceruloplasmin. It was established that autoantibodies to ceruloplasmin are more often found in systemic scleroderma patients who show a high disease activity, subacute course with involvement of the liver, lungs, and with anemia. It was found that antibodies to ceruloplasmin are detected at early stages of systemic scleroderma development and can be used in timely diagnosis of the condition. It was shown that the change of parameters under study over time can serve as a basis on which to evaluate the effectiveness of administered therapy.

Conclusion. Decreased enzymatic activity of ceruloplasmin, its elevated amount and increased antibodies to ceruloplasmin can be taken as additional diagnostic tools in evaluation of systemic scleroderma activity. These parameters promote a more accurate assessment of the disease activity and of the nature of the pathologic process; they can serve as an indication of a variety of clinical forms of the disease. Employing these parameters for monitoring of administered therapy in hospital settings permits a more accurate assessment of its effectiveness and making adjustments. Studying ceruloplasmin antibody formation, amount of ceruloplasmin and its biochemical activity extends the existing concept of rheumatic disease pathogeny, outlines a way forward for further research and reflects the involvement of antioxidant system in immune disorders.

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