T.F. Golubova 1, O.I. Garmash 1, L.L. Aliev 2
1 State Scientific and Research Institute of Children’s Balneology, Physiotherapy and Medical Rehabilitation, Evpatoria, Russia
2 ІFGAOVO» Crimean Federal University name V.I. Vernadsky «Crimea State Medical University name S. I. Georgievsky, Simferopol, Russia
A study of the level of cytokines and endothelial parameters in children with juvenile rheumatoid arthritis was carried out. An increase in the level of proinflammatory cytokines and the destruction of endothelial cells, which take an active part in microcirculation processes, have been established. With prolonged exposure to the inflammatory immune factor, intense depletion and perversion of the compensatory dilator capacity of the endothelium occurs and vasoconstriction becomes the primary response. The revealed interrelation with the parameters of immunological reactivity reflects the participation of the endothelium in the mechanisms of the development of the disease. Sanatorium treatment with application of peloid applications on the affected joints in children with JRA promoted clinico-laboratory improvement. The immunomodulatory effect of sanatorium treatment on the increased level of proinflammatory cytokines was observed in children with JRA, more significant in patients with oligoarthritis, with a duration of disease of up to 5 years, with a minimum degree of activity of the process. Sanatorium treatment with the use of mud applications, mainly through the thermal factor, reduces the vasoconstrictor effect, with significant vasodilation occurs, which possibly increases the permeability of the vascular wall and creates a condition for capillary leakage-liquid, that is, it has an anti-inflammatory effect.
Keywords: children, juvenile rheumatoid arthritis, cytokines, endothelial parameters, sanatorium treatment.