CLINICAL AND LABORATORY EXAMINATION PATIENTS WITH PSORIATIC ARTHRITIS

Aim. The relationship of cause-and-effect mechanisms of exacerbation and progressing with defining of the role of stress reaction in the psoriatic arthritis (PA) development has been examined in the article by analyzing the characteristics of medical history, current dynamics as well as clinical, instrumental and laboratory examinations. The objective was to study the role of basic indices of laboratory examinations of patients to clarify their role in the pathogenesis of PA and to develop the comprehensive system of integrated diagnostics of patients with PA which involves the musculoskeletal system in psoriasis with indication of characteristic features. Material and Methods. Patients with PA were additionally tested for the stress-realizing of immune-endocrine system. The concentration of trigger cytokines - IL-1β, IL-8, IL-17, IL-22, stress hormones - ACTH and cortisol, state of cellantibody mediated immunity (CD3+, CD4+, CD8+, CD16+, CD22+, IRI, IgÌ, IgG levels) in the serum of patients were defined. Results and Discussion. Clinical progression and characteristics of instrumental examinations of PA are extremely versatile and nowadays their study has still been insufficient. We have detected the possible changes of stressreaction mediator concentrations in the serum of patients with PA (i.e. decreasing of the status of cell immunity indices (CD3+, CD4+, CD8+ Ò- lymphocytes, Â- lymphocytes CD22+ fraction, IRI with compensatory increasing of the levels of CD16+ Ò-cells, cytokines - IL-1β, IL-8, IL-17, IL-22, stress hormone - cortisol, immunoglobulins IgÌ, IgG, CIC) irrespective of the disease duration which proves the intensity of their stress-realizing mechanisms, even with clinical stabilization of skin and joint process . Conclusions. Thus, the final diagnosis of PA is determined only upon combination of anamnestic, clinical, instrumental and laboratory data and the results of additional examinations. The indices mentioned above are key mediators of stress-realizing immune-neuroendocrine system and play an ambiguous role in the development of PA, and their various effects require further study. Key words: psoriatic arthritis, musculoskeletal system, mediators, stress-realizingmechanisms, immuneneuroendocrine system