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1. Monocyte extracellular traps: features of generation in rheumatoid arthritis depending on the stage of autoimmune inflammation

Author

S. A. Bedina, E. E. Mozgovaya, A. S. Trofimenko, S. S. Spitsina, M. A. Mamus, I. A. Zborovskaya, Yu. R. Akhverdyan, and N. G. Krayushkina

Subjects
monocytes, rheumatoid arthritis, мets, etosis, autoimmune inflammation, Medicine
Abstract

Recent investigations have demonstrated the involvement of neutrophils and neutrophil extracellular traps (NETs) in the initiation and progression of autoimmune inflammation in rheumatoid arthritis (RA) patients. Simultaneously, macrophages/monocytes, which are the main antigen-presenting cells, play a key role in the immune response as a result of disruption of antigen processing and presentation. Studying the role of monocytes and monocyte extracellular traps (METs) in RA pathogenesis is promising and is of particular interest. The aim of the research was to study the features of the main parameters of monocyte extracellular generation traps in RA patients depending on the stage of autoimmune inflammation. Material and methods. 37 RA patients and 30 healthy individuals were enrolled in study. Circulating monocytes were purified with centrifugation procedure using iohexol with a 1068 kg/m3 density gradient. Cells were identified histochemically, and the extent of monocyte activation was assessed using common nitroblue tetrazolium test. The generation of METs was stimulated by phorbol-12-myristate-13-acetate (PMA), and visualized using fluorescence microscopy with SYBR green. Results and discussion. In patients with inactive RA, the number of monocytes in a state of generating both spontaneous and PMA-induced METs is higher compared to the reference group. The transformation of autoimmune inflammation from remission to the active phase was accompanied by a further increase in the proportion of monocytes that form METs spontaneously and in the presence of PMA (by 114.7 % and 44.2 %, respectively, relative to the comparison group). The growth rate of spontaneous METs formation is 2.6 times higher than induced METs; RA activation is evidenced by an increase in the number of monocytes in the process of spontaneous formation of METs by more than 17.8 %. Conclusions. The obtained data suggest METs participation in the initiation and maintenance of RA autoimmune inflammation along with NETs presumably through exhibition their citrulline neoepitopes. METs could probably be considered as a new potential diagnostic biomarker.

Published
2024
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2. Comparative characteristics of blood xanthine oxidoreductase profiles in discoid and systemic lupus erythematosus

Author

E. E. Mozgovaya, S. A. Bedina, A. S. Trofimenko, S. S. Spitsina, M. A. Mamus, and I. A. Zborovskaya

Subjects
discoid lupus erythematosus, systemic lupus erythematosus, xanthine oxidoreductase, xanthine oxidase, xanthine dehydrogenase, uric acid, blood, Medicine
Abstract

Discoid (DLE) and systemic lupus erythematosus (SLE) are chronic inflammatory diseases of the connective tissue. Along with pathogenetic features, they have common characteristics. Immune disorders and oxidative stress are involved in pathogenesis of DLE and SLE. Development of oxidative stress is closely associated with the activation of xanthine oxidoreductase (XOR) enzyme system.Aim of the study was to reveal the features of XOR activities profiles in blood of DLE and systemic lupus erythematosus (SLE) patients.Material and methods. 31 patients with DLE, 56 patients with SLE, 35 apparently healthy individuals were enrolled in study. The activities of two convertible forms of XOR (xanthine dehydrogenase (XDG; EC 1.17.1.4) and xanthine oxidase (XO; EC 1.17.3.2)) were measured in plasma, lysed WBC and lysed RBC. The level of uric acid (UA) was determined in plasma.Results and discussion. In contrast to the control, XO activity was higher and XDG activity was lower in plasma of DLE patients; activities of both XOR forms were decreased in lysed lymphocytes. Activity of XO was lower in plasma, XO and XDG activities were higher in lysed lymphocytes in DLE regardless of the SLE activity. XDG activity in plasma of and XO activity in lysed erythrocytes DLE patients was lower than in low activity SLE, but higher than in the subgroup with moderate and high disease activity. XDG activity of lysed erythrocytes in DLE was higher than in patients with low and moderate SLE activities, but lower than in patients with high diseases activity. Uric acid content in plasma of DLE patients was not differ from the control values, its level was increased at II and III degrees of SLE activity.Conclusions. Changes in XOR activity in plasma and lysed WBC in DLE and SLE are unidirectional, but are more pronounced in the systemic form of the disease. Thus, DLE and SLE are characterized by some common changes in XOR activity, at the same time, XOR blood profiles have distinctive features, which are characteristic for nosology.

Published
2024
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3. Antibodies to cyclic citrullinated peptide and angiopoietin-like protein type 4 as markers of immune inflammation and osteoporotic processes in rheumatoid arthritis patients

Author

G. Ya. Osmanova, V. A. Aleksandrov, A. V. Aleksandrov, L. N. Shilova, E. G. Cherkesova, N. V. Aleksandrova, and I. A. Zborovskaya

Subjects
rheumatoid arthritis, angiopoietin-like protein type 4, anti-citrullinated protein antibodies, bone mineral density, osteoporosis, fragility fractures, Immunologic diseases. Allergy, RC581-607
Abstract

Low-energy fractures in rheumatoid arthritis (RA) are more common in patients with high activity and long duration of disease, and with high titers of anti-citrullinated antibodies (ACPA). Increased expression of angiopoietin-like protein type 4 (ANGPTL4) in bone tissue has also been noted in inflammatory arthritis. The purpose of the present study was to analyze the effect of ACPA and ANGPTL4 on systemic bone mineral density in RA patients. Antibodies to ACPA and ANGPTL4 content were detected in blood serum of 96 RA patients (women, 91.7%) by enzyme immunoassay. Mineral density of the lumbar vertebrae (BMDL1-L4), hip neck, and entire femur (BMDtotal) was measured by dual-energy X-ray absorptiometry (DXA). In study group, the ACPA and ANGPTL4 tests were positive in 61.5% and 41.7% of patients, respectively. Negative correlations were shown between ACPA and BMDtotal, and of ANGPTL4 with BMDL1-L4 (p < 0.05). Separation of the patients into groups with low (n = 34) and high (n = 62) DAS28 activity demonstrated a significant increase in ACPA with increasing RA activity (p = 0.042). ACPA and ANGPTL4 scores were also significantly higher in the group of 45 RA patients with osteoporosis (OP) compared to the RA group without OP (n = 51) showing significant difference at p = 0.002 and p = 0.028, respectively. Patients’ age, body mass index (BMI), duration and activity of the disease had no significant effect on ACPA in the general group of RA patients. However, the correlation between ACPA and DAS28 proved to be significant in the group of RA patients with OP (b = 0.31, p = 0.039). Among all presented variables, the disease duration was the only significant factor for ANGPTL4 in the total group of RA patients (b = 0.31, p = 0.039). In the regression model, BMDtotal showed similar correlations with patients’ age (b = -0.28), BMI (b = 0.25), and ACPA level (b = -0.26). A search for association between BMDL1-L4 and various RA characteristics demonstrated a strong correlation with ANGPTL4 only (b = -0.74; R2 = 0.57). The revealed correlation between ANGPTL4 and decreased BMD specifically in the spongy layer of bone allows us to identify the RA patients with high ANGPTL4 levels as a risk group specifically for spinal fractures thus considering ANGPTL4 as a potential target for treatment of osteoporotic disorders.

Published
2024
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4. Peculiarities of immunological manifestations in patients with rheumatoid arthritis in the presence of chronic infection with Helicobacter pylori variant encoding cytotoxin-associated gene A

Author

A. V. Aleksandrov, L. N. Shilova, V. A. Aleksandrov, M. V. Levkina, O. V. Paramonova, N. V. Aleksandrova, and I. A. Zborovskaya

Subjects
rheumatoid arthritis, antibodies to cyclic citrullinated peptide, infection, diagnostics, helicobacter pylori, caga protein, Immunologic diseases. Allergy, RC581-607
Abstract

The study aimed to evaluate the association between cyclic citrullinated peptide antibody seropositivity and chronic Helicobacter pylori (H. pylori) infection in patients with rheumatoid arthritis (RA). We examined 92 women with moderate RA activity. Serum antibodies to cyclic citrullinated peptide (antiCCP), antibodies to H. pylori (anti-H. pylori-IgG), and total antibodies to H. pylori CagA antigen (antiCagA) were determined by enzyme immunoassay; the presence of anti-CagA-IgG positivity was confirmed by immunoblot. 68.5% of RA patients were positive for anti-H. pylori-IgG, and 44.4% of patients in this group were positive for anti-CagA-IgG. All the study participants were divided into three groups: I – H. pylori seronegative (H. pylori- ); II – H. pylori positive, CagA negative (H. pylori+/CagA- ); III – H. pylori positive and CagA positive (CagA+). The anti-CCP values in RA patients with CagA+ (group III) were significantly higher not only in comparison with patients seronegative for H. pylori (p < 0.001), but also in comparison with patients from group II (H. pylori+/CagA- ) (p = 0.041). A study of the influence of the RA activity, the presence of RF and H. pylori on anti-CCP content demonstrated a small proportion of anti-CCP variability (R2 = 0.09), with a high contribution of H. pylori (beta = 0.25). The addition of the CagA(+) index (beta = 0.503) to the presented model allowed us to describe the variability of anti-CCP in almost 30% of cases (R2 = 0.29). In the group of RA patients with anti-CCP values exceeding the established threshold value of 20 U/mL (normal index), there was an increase in the proportion of patients infected with H. pylori (p < 0.001), but not the proportion of CagA-positive patients (p = 0.06). When the threshold level was increased to 60 U/mL (three times the upper limit of normal) in patients with significantly high anti-CCP, the association with positivity for CagA became significant (p = 0.005). CagA is highly immunogenic and is capable of inducing an inflammatory response in the host that goes beyond the effect of H. pylori itself. Additional experimental studies are needed to investigate possible clinical and laboratory associations that may influence the treatment tactics of CagA+ patients with RA who are seropositive for anti-citrullinated antibodies, as well as to evaluate the possible effects of therapeutic intervention aimed at the eradication of H. pylori in this group.

Published
2023
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5. Safety assessment of massive buttress dams in the presence of thermal cracks in them

Author

Vladimir A. Zimnyukov and Marina I. Zborovskaya

Subjects
massive concrete, temperature difference, cracking, harsh climate, temperature regime, thermal stress state, concrete cooling, surface insulation, pipe cooling, Architectural engineering. Structural engineering of buildings, TH845-895
Abstract

In the 1950s, the construction of hydropower facilities began in the regions of Siberia and the Far East, characterized by harsh climatic conditions, which should be taking into account to predict the stress state of dams. The aim of the study is an assessment of the conditions for the formation of temperature cracks in concrete dams and their influence on the further operation of the structure, as well as measures and technologies to combat cracking in massive concrete. Thermal stresses often exceed the stresses caused by the action of external loads and lead to the appearance of cracks in the concrete. Almost all modern concrete dams are subject to thermal cracking today. Appropriate design and technological measures must be provided for. When studying the thermally stressed state of lightweight concrete dams, the method of direct reproduction of thermal deformations on models made of brittle materials and computational methods oriented towards computer methods of solving problems are used. The results of modeling and computational studies of massive buttress dams are presented and the influence of the main influencing factors is considered, taking into account the effect of cracking on the operation of such dams.

Published
2023
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6. The Sustained Physical Activity Role in Overcoming Fatigue in Patients with Rheumatoid Arthritis

Author

Andrey V. Aleksandrov, Mikhail V. Nikitin, Vladislav A. Aleksandrov, Ludmila N. Shilova, Ninel V. Aleksandrova, and Irina A. Zborovskaya

Subjects
rheumatoid arthritis, fatigue, aerobic exercises, health resort treatment, Medicine (General), R5-920, Sports medicine, RC1200-1245
Abstract

Lack of knowledge about the causes of fatigue often leads to ignoring this symptom in rheumatoid arthritis (RA). The severity of fatiguein patients with RA can be significantly reduced by actively using non-pharmacological treatment strategies.Aim. To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients during long-term follow-up.Material and methods. The study involved 102 patients with RA (women 100%; average age 54.38 ± 11.3 years; disease duration9.5[5;15] years; DAS28-ESR activity 2.85[2.32;3.06] points; fatigue on the VAS scale ≥50), who completed the stage of sanatoriumtreatment in full (21 days) and provided data on aerobic physical activity (steps quantity per day) and fatigue scores on the BritishRheumatoid Arthritis Fatigue Scale – Numerical Rating Scale (BRAF-NRS V2). RA patients were divided into two groups according totheir level of physical activity: group I (n=53) with a sedentary lifestyle (less than 5–6 thousand steps/day) and group II (n=49) witha recommended (mobile) lifestyle (more than 7–8 thousand steps/day). Assessment of RA patients’ adherence to physical activity wascarried out 2 months after return from the sanatorium, and the dynamics of BRAF-NRS fatigue indexes were recorded.Results and discussion. Seventy-six people (74.5%) agreed to participate in the final survey: 32 patients from a group I and 44 patientsfrom a group II. Commitment to daily aerobic activity (more than 5,000 steps per day) was maintained by 34% of participants in thegroup I and 59% in the group II (p=0.033). The majority of respondents (51.3%) decreased the physical activity level and significantlyreduced the time for aerobic exercise after returning from the sanatorium, citing a lack of incentives and time. 47% of the groupI patients (15/32) felt able to devote more attention to physical activity, but only 25% confirmed a strong belief that they would dedicateat least 30 minutes to aerobic exercise 5 times a week over the next three months. In the group II, 48% of patients (p=0.044) reportedmaintaining or even increasing the corresponding physical activity level, confirming the effectiveness of individual physical activityprograms formed during the sanatorium treatment and then integrated into daily life. Two months after returning from the sanatorium,group II patients showed lower fatigue scores on all BRAF-NRS scales: NRS-severity (p=0.04), NRS-effect (p=0.005), and NRS-overcoming(p=0.034). The analysis of variance revealed a decrease in the level of fatigue in the medium term (up to 2 months) regardless of thelevel of physical activity of the patients, but in RA patients committed to an active lifestyle and regular aerobic physical activity (groupII), the positive changes were most pronounced (p

Published
2022
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7. Joint operation of the cellular structure as a system 'frame - filling ground - base'

Author

Vladimir A. Zimnyukov and Marina I. Zborovskaya

Subjects
cellular structure, frame, backfill soil, jansen’s formula, surface tension, moisture content of backfill soil, capillary adhesion, soil granulometric composition, Architectural engineering. Structural engineering of buildings, TH845-895
Abstract

Relevance. The experience of constructed cellular structures and the results of computational and model studies carried out in our country and abroad to assess the joint work of the complicated complex cellular frame - soil backfill of cells - foundation indicates the sufficient reliability of such hydraulic structures. The main difficulty in the design of cellular structures is to reproduce the volumetric work of the complex cellular frame - backfill soil - foundation soil to identify structural reserves. Objectives. To study, through laboratory studies, the interaction of the frame and backfill of the cell and the base at different soil moisture, taking into account such factors as the granulometric composition of the backfill soil, the role of the surface tension of moisture contained in the soil, the geometric parameters of the structure itself and a number of other factors. Methods. Experimental studies on the model of the operation of a cellular structure without a bottom on a non-rocky (sandy) foundation for stability, subject to the similarity criteria, as well as studies of cells with different geometry and sizes with changes in moisture and particle size distribution of the soil of the cells. Results. Based on the results of model studies, a dependence is proposed to take into account the effect of surface tension forces, considering the hydraulic radius of the cell cross-section, wetted perimeter, cross-sectional area of the cell, etc. The interaction of the cellular structure with the base is also explored, taking into account the above parameters. The results of laboratory studies on considering the interaction of the frame and backfill of the cell soil at different moisture content of the aggregate, taking into account the granulometric composition of the backfill soil surface tension of moisture contained in the soil, geometric parameters of the structure itself and a number of other factors.

Published
2021
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9. Comprehensive rehabilitation and resocialization in mental health care after surgery of head and neck tumors

Author

M. Magomed-Eminov, O. Orlova, D. Uklonskaya, D. Reshetov, Y. Zborovskaya, S. Matveeva, E. Romanova, and M. Fedina

Subjects
mental health, rehabilitation, head and neck tumors, resocialization, Psychiatry, RC435-571
Abstract

Introduction There is increasing number of head and neck tumors. Modern medical technologies allow to save lives, but lead to cosmetic and functional defects. DSM-V clarifies that “life threatening illness or debilitating medical condition is not necessarily considered a traumatic event”. However, cancer diagnosis and treatment influence on mental health. Patients after surgery of head and neck tumors need special rehabilitation, because of loss or impairment of speech function. This significantly reduces communicative potential, changes social status, reduces rehabilitation potential. Objectives During 6 years we have conducted studies to improve methods of psychological and pedagogical diagnostics, optimize speech therapy and psychological support for increasing effectiveness of speech rehabilitation. Methods Speech rehabilitation was carried out with correctional-pedagogical technologies and psychological support. We used Achieving Tendency Scale, Questionnaire measures of Affiliative Tendency and Sensitivity to Rejection, narrative interview, Scale of speech utterance implementation, rehabilitation potential evaluation, general condition assessment by ECOG and Karnovsky, auditory assessment. Speech therapy included methods for eliminating dysphagia, normalizing speech breathing, improving utterance realization. Psychological support kept meaning-narrative approach. Results Number of patients without difficulties or with slight difficulties in speech utterance implementation increased by 57.1%. Number of patients with high rehabilitation potential increased by 48.8%. Conclusions Psychological and pedagogical rehabilitation and resocialization after surgery of head and neck tumors has positive effect on mental health of patients, forms special rehabilitation motivation, helps to avoid disability and to transform life in new conditions. Disclosure No significant relationships.

Published
2022
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11. Capacity of second spillway of Boguchanskaya HPP

Author

Gouriev A. P., Khanov N. V., Fartukov V. A., Zborovskaya M. I., and Abidov M. M.

Subjects
Environmental sciences, GE1-350
Abstract

The main problem in designing the discharge of water flow from the upstream to the downstream is to ensure the capacity of spillway structures. This article discusses the design options for the design top of the spillway: with water diversion through a short nozzle in the pressure mode and energy dissipation in stilling basin, with the pressure-free and pressure-free passage of water through spillway No. 2 and damping of the flow energy by jet discharge into the lower stream by the inclined face of the threshold in the stilling basin; with no pressure passage and pressure passage of water through spillway No 2 and energy dissipation of the flow by throwing the flow discharge into the downstream by the inclined face of the threshold of a stilling basin; with the passage of building expenses through the sill in no pressure and pressure-type short-nozzle modes, with the spillway No. 2’s horizontal water outlet at the level of 139.5 m, with a jet discharge by a toe-springboard at an angle of 35°, and with the outlet rib's mark of 143.8 m. This article aims to obtain the flow characteristics of the considered spillway option for the period of temporary operation of the hydrotechnical complex.

Published
2023
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12. Calculation of capacity of spillway № 2 Boguchanskoye HPP with free water overflow

Author

Guryev Alim, Khanov Nartmir, Mareeva Olga, Zborovskaya Marina, and Verkhoglyadova Aleksandra

Subjects
Environmental sciences, GE1-350
Abstract

The article considers a variant with the operation of spillway No. 2 of the Boguchanskaya HPP as the main spillway structure for the period of temporary operation of the hydroelectric complex. In the process of developing options for skipping construction costs, a calculation was made of the throughput with a free overflow through a flat threshold at the level of 167.0m at the FSL=175m and forcing the UVB to the level of 185.0 m with the damping of the flow energy in the water well. The task of the calculations is to obtain the discharge characteristics of the considered spillway option with the calculated flood hydrograph with a probability of 0.2%. At the same time, based on the throughput capacity of the spillway No. 1, the dependence of the turbine flow rate and the water depth in the downstream, as well as the transformation of the flood of a given probability, the estimated flow rate is 5500 m3/s, the maximum head H=18 m (determining) at a minimum threshold level of 167.0 m. Weir refers to weirs with a wide threshold. The throughput capacity of the spillway No. 2, operating in the free overflow mode, was determined. The change in the lateral compression coefficient depending on the head for the middle and outer working spans is considered. The outlines of free-falling jets behind the culverts operating in the free overflow mode are obtained, which makes it possible to refine the outlines of the side walls of the spillway.

Published
2023
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15. Multifunctional multilevel moisture sensor

Author

Vasily A. Fartukov, Vladimir A. Zimnyukov, and Marina I. Zborovskaya

Subjects
General Medicine
Abstract

Controlling the moisture level is especially important when irrigating various crops to obtain a resistant, stable harvest and save water resources. Over moistening of the soil adversely affects the soil structure and can lead to salinization, waterlogging, and acidification. In addition, the formation of surface water runoff from the fields causes depletion of nutrients, oxygen starvation, and, ultimately, soil degradation. The degradation of fields (areas of the field) leads to the withdrawal of the field from crop rotation (exploitation), a reduction in acreage, the need for agrotechnical measures, reclamation, and, as a result, high financial costs. Currently applied irrigation technologies lead to the withdrawal of up to 50% of irrigated land. Therefore, the technology of differentiated irrigation with constant control over the condition of the soil and plants will help eliminate these negative consequences while increasing the yield and reducing the consumption of water, electricity, and labor costs. For the implementation of this technology, sensors are needed to control the moisture and temperature of the soil at different depths and perform operational control of the water supply to the field. The implementation of a constant connection between the field and the plant with the water supply system will allow creating digital irrigation map and forming of a database about the irrigated field underlying the information and created advisory system. The system for the continuous monitoring of soil moisture and temperature at different depths is based on IT technology with data transmission via radio communication channels. It uses platforms for data transmission via such communication channels as LoRaWAN (highly economical wireless communication interface from ICBCom), GSM (Groupe Spécial Mobile - the global standard for digital mobile cellular communication), and the Internet.

Published
2022
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18. Joint operation of the cellular structure as a system 'frame - filling ground - base'

Author

Marina I. Zborovskaya and Vladimir A. Zimnyukov

Subjects
Aggregate (composite), Moisture, frame, Tension (physics), Architectural engineering. Structural engineering of buildings, Foundation (engineering), soil granulometric composition, moisture content of backfill soil, Wetted perimeter, backfill soil, Hydraulic structure, surface tension, TH845-895, Environmental science, Geotechnical engineering, jansen’s formula, cellular structure, Water content, Joint (geology), capillary adhesion
Abstract

Relevance. The experience of constructed cellular structures and the results of computational and model studies carried out in our country and abroad to assess the joint work of the complicated complex cellular frame - soil backfill of cells - foundation indicates the sufficient reliability of such hydraulic structures. The main difficulty in the design of cellular structures is to reproduce the volumetric work of the complex cellular frame - backfill soil - foundation soil to identify structural reserves. Objectives. To study, through laboratory studies, the interaction of the frame and backfill of the cell and the base at different soil moisture, taking into account such factors as the granulometric composition of the backfill soil, the role of the surface tension of moisture contained in the soil, the geometric parameters of the structure itself and a number of other factors. Methods. Experimental studies on the model of the operation of a cellular structure without a bottom on a non-rocky (sandy) foundation for stability, subject to the similarity criteria, as well as studies of cells with different geometry and sizes with changes in moisture and particle size distribution of the soil of the cells. Results. Based on the results of model studies, a dependence is proposed to take into account the effect of surface tension forces, considering the hydraulic radius of the cell cross-section, wetted perimeter, cross-sectional area of the cell, etc. The interaction of the cellular structure with the base is also explored, taking into account the above parameters. The results of laboratory studies on considering the interaction of the frame and backfill of the cell soil at different moisture content of the aggregate, taking into account the granulometric composition of the backfill soil surface tension of moisture contained in the soil, geometric parameters of the structure itself and a number of other factors.

Published
2021
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20. Early comprehensive rehabilitation of patient with postoperative dysphagia

Author

OS Orlova, MSh Magomed-Eminov, DV Uklonskaya, and YuM Zborovskaya

Abstract

Postoperative paresis and paralysis of the larynx, associated with breathing, voice and swallowing disorders, are actual problem of surgical treatment of the thyroid and mediastinal diseases. Traditionally, more attention is paid to phonation disorders treatment. Swallowing recovery methods are not described sufficiently. The paper reports a clinical case of early speech therapy intervention aimed at alleviating postoperative dysphagia caused by the limited flexibility of the larynx. Detailed swallowing disorder diagnosis in patient was carried out before and after the logopaedic correction of dysphagia. The main directions and results of the correctional and pedagogical work with psychological support within comprehensive rehabilitation are described. The findings confirm the need for correctional impact during the early stages of rehabilitation in case of dysphagia in surgical patients with the paresis or paralysis of the larynx.

Published
2022
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21. Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Author

Naomi Ssenyonga, Charles Stiller, Kayo Nakata, Jaime Shalkow, Shelagh Redmond, Jean-Luc Bulliard, Fabio Girardi, Christine Fowler, Rafael Marcos-Gragera, Audrey Bonaventure, Nathalie Saint-Jacques, Pamela Minicozzi, Prithwish De, Miguel Rodríguez-Barranco, Siri Larønningen, Veronica Di Carlo, Margit Mägi, Mikhail Valkov, Karri Seppä, Dyfed Wyn Huws, Michel P Coleman, Claudia Allemani, Sabiha Bouzbid, Mokhtar Hamdi-Chérif, Lamia Kara, Kaouel Meguenni, Derbali Regagba, Sine Bayo, Traore Cheick Bougadari, Shyam Shunker Manraj, Karima Bendahhou, Akinade Ladipo, Olufemi Ogunbiyi, Nontuthuzelo Somdyala, María Agustina Chaplin, Florencia Moreno, Gladis Calabrano, Silvia Espinola, Beatriz Carballo Quintero, Rosalba Fita, Walter Laspada, Susana Ibañez, Carlos Lima, Allini Mafra Da Costa, Paulo César De Souza, Juliana Chaves, Cyntia Laporte, Maria Paula Curado, Jose Carlos de Oliveira, Claudia Veneziano, Donaldo Veneziano, Ana Beatriz Almeida, Maria Latorre, Gulnar Azevedo e Silva, Marise Rebelo, Marceli Santos, Juan Galaz, Mackarena Aparicio Aravena, Jocelyn Sanhueza Monsalve, Denise Herrmann, Solange Vargas, Victor Herrera, Claudia Uribe, Luis Eduardo Bravo, Luz Stella Garcia, Nelson Arias-Ortiz, Daniela Morantes, Daniel Jurado, María Yépez Chamorro, Sandra Delgado, Melissa Ramirez, Yaima Galán Alvarez, Priscila Torres, Fray Martínez-Reyes, Leyda Jaramillo, Rina Quinto, Jhoanna Castillo, Mariela Mendoza, Patricia Cueva, José Yépez, Bernard Bhakkan, Jacqueline Deloumeaux, Clarisse Joachim, Jonathan Macni, Rodolfo Carrillo, Jaime Shalkow Klincovstein, Rebeca Rivera Gomez, Patricia Perez, Ebert Poquioma, Guillermo Tortolero-Luna, Diego Zavala, Rafael Alonso, Enrique Barrios, Angela Eckstrand, Cindy Nikiforuk, Ryan Woods, Gail Noonan, Donna Turner, Eshwar Kumar, Bin Zhang, Jeff Dowden, Gregory Doyle, Gordon Walsh, Aniq Anam, Carol McClure, Kim Vriends, Christine Bertrand, Agnihotram Ramanakumar, Serena Kozie, Heather Stuart-Panko, Tara Freeman, Justin George, Rosa Avila, David O'Brien, Abby Holt, Lyn Almon, Kevin Ward, Sandy Kwong, Cyllene Morris, Randi Rycroft, Lloyd Mueller, Cathryn Phillips, Heather Brown, Betsy Cromartie, Julie Ruterbusch, Ann Schwartz, Gary Levin, Brad Wohler, Rana Bayakly, Scarlett Gomez, Meg McKinley, Rosemary Cress, Joni Davis, Brenda Hernandez, Christopher Johnson, Bozena Morawski, Laura Ruppert, Suzanne Bentler, Mary Charlton, Bin Huang, Thomas Tucker, Dennis Deapen, Lihua Liu, Mei-Chin Hsieh, Xiao-Cheng Wu, Molly Schwenn, Kimberly Stern, Susan Gershman, Richard Knowlton, Georgetta Alverson, Tamara Weaver, Jay Desai, Deirdre Rogers, Jeanette Jackson-Thompson, Debbi Lemons, Heather Zimmerman, Michelle Hood, Jenifer Roberts-Johnson, Whitney Hammond, Judith Rees, Karen Pawlish, Antoinette Stroup, Charles Key, Charles Wiggins, Amy Kahn, Maria Schymura, Soundarya Radhakrishnan, Chandrika Rao, Lynn Giljahn, Roberta Slocumb, Christy Dabbs, Raffaella Espinoza, Karen Aird, Todd Beran, Jim Rubertone, Stephen Slack, Junhie Oh, Tiffany Janes, Stephen Schwartz, Stephanie Chiodini, Deborah Hurley, Martin Whiteside, Saroj Rai, Melanie Williams, Kim Herget, Carol Sweeney, Alison Johnson, Mahesh Keitheri Cheteri, Patti Migliore Santiago, Steven Blankenship, Shawn Farley, Robert Borchers, Robin Malicki, Julia Espinoza, Joseph Grandpre, Brenda Edwards, Angela Mariotto, Hannah Weir, Reda Wilson, Ning Wang, Lei Yang, Jian-Shun Chen, Yu-Tong He, Guo-Hui Song, Xiao-Ping Gu, Dan Mei, Heng-Ming Ge, Tong-Hao Wu, Yan-Yan Li, De-Li Zhao, Feng Jin, Jian-Hua Zhang, Feng-Dong Zhu, Qian Junhua, Yan Lei Yang, Chun-Xiao Jiang, Wang Biao, Jian Wang, Qi-Long Li, He Yi, Xin Zhou, JianMei Dong, WeiWei Li, Fang-Xian Fu, Jian-Guo Chen, Jian Zhu, Yan-Hua Li, Yu-Qiang Lu, Min Fan, Su-Qin Huang, Guo-Ping Guo, Hua Zhaolai, Kuangrong Wei, Wan-Qing Chen, Wenqiang Wei, Hongmei Zeng, Anna Demetriou, Wai Kong Mang, Kai Cheong Ngan, Amal Kataki, Manigreeva Krishnatreya, Padmavathi Amma Jayalekshmi, Paul Sebastian, Preethi George, Aleyamma Mathew, Ambakumar Nandakumar, Reza Malekzadeh, Gholamreza Roshandel, Lital Keinan-Boker, Barbara Silverman, Hidemi Ito, Yuriko Koyanagi, Masako Sato, Fumio Tobori, Ichiro Nakata, Norihiro Teramoto, Masakazu Hattori, Yasuharu Kaizaki, Fumitaka Moki, Hiromi Sugiyama, Mai Utada, Makiko Nishimura, Keiichi Yoshida, Katsuki Kurosawa, Yuji Nemoto, Hiroto Narimatsu, Masahiko Sakaguchi, Seiki Kanemura, Michiko Naito, Rintaro Narisawa, Isao Miyashiro, Daisuke Mori, Mayuko Yoshitake, Izumi Oki, Norimasa Fukushima, Akiko Shibata, Keiichiro Iwasa, Chie Ono, Tomohiro Matsuda, Omar Nimri, Kyu-Won Jung, Young-Joo Won, Eiman Alawadhi, Amani Elbasmi, Azizah Ab Manan, Farzaana Adam, Erdenekhuu Nansalmaa, Undarmaa Tudev, Chimedsuren Ochir, Al Hareth Al Khater, Mufid El Mistiri, Gek Hsiang Lim, Yik Ying Teo, Chun-Ju Chiang, Wen-Chung Lee, Rangsiya Buasom, Suleeporn Sangrajrang, Krittika Suwanrungruang, Patravoot Vatanasapt, Karnchana Daoprasert, Donsuk Pongnikorn, Atit Leklob, Somphob Sangkitipaiboon, Sarayut Geater, Hutcha Sriplung, Okan Ceylan, Iskender Kög, Oya Dirican, Tülay Köse, Tulın Gurbuz, Füsun Emine Karašahin, Duygu Turhan, Umut Aktaş, Yakup Halat, Sultan Eser, Cankut Yakut, Merve Altinisik, Yasar Cavusoglu, Ayşe Türkköylü, Nuršen Üçüncü, Monika Hackl, Anna Zborovskaya, Olga Aleinikova, Kris Henau, Liesbet Van Eycken, Trayan Atanasov, Zdravka Valerianova, Mario Šekerija, Ladislav Dušek, Miroslav Zvolský, Lina Steinrud Mørch, Hans Storm, Charlotte Wessel Skovlund, Kaire Innos, Nea Malila, Jérémie Jégu, Michel Velten, Edouard Cornet, Xavier Troussard, Anne-Marie Bouvier, Anne-Valérie Guizard, Véronique Bouvier, Guy Launoy, Sandrine Dabakuyo Yonli, Marie-Laure Poillot, Marc Maynadié, Morgane Mounier, Lina Vaconnet, Anne-Sophie Woronoff, Mélanie Daoulas, Michel Robaszkiewicz, Jacqueline Clavel, Claire Poulalhon, Emmanuel Desandes, Brigitte Lacour, Isabelle Baldi, Camille Pouchieu, Brice Amadeo, Gaëlle Coureau, Alain Monnereau, Magali Audoin, Tania D'Almeida, Séverine Boyer, Karima Hammas, Brigitte Trétarre, Marc Colonna, Patricia Delafosse, Sandrine Plouvier, Anne Cowppli-Bony, Florence Molinié, Simona Bara, Olivier Ganry, Bénédicte Lapôtre-Ledoux, Laetitia Daubisse-Marliac, Nadine Bossard, Jacques Estève, Zoé Uhry, Roland Stabenow, Heide Wilsdorf-Köhler, Andrea Eberle, Sabine Luttmann, Imma Löhden, Alice Nennecke, Joachim Kieschke, Eunice Sirri, Christina Justenhoven, Sylke Zeissig, Bernd Holleczek, Nora Eisemann, Alexander Katalinic, Rachelle Asquez, Vijay Kumar, Eleni Petridou, Elínborg Ólafsdóttir, Laufey Tryggvadóttir, Deirdre Murray, Paul Walsh, Hildrun Sundseth, Guido Mazzoleni, Fabio Vittadello, Enzo Coviello, Francesco Cuccaro, Rocco Galasso, Giuseppe Sampietro, Michele Magoni, Antonino Ardizzone, Angelo D'Argenzio, Alessia Anna Di Prima, Antonella Ippolito, Anna Maria Lavecchia, Antonella Sutera Sardo, Gemma Gola, Paola Ballotari, Erica Giacomazzi, Stefano Ferretti, Luigino Dal Maso, Diego Serraino, Maria Vittoria Celesia, Rosa Angela Filiberti, Fabio Pannozzo, Anna Melcarne, Fabrizio Quarta, Anita Andreano, Antonio Giampiero Russo, Giuliano Carrozzi, Claudia Cirilli, Luca Cavalieri d'Oro, Magda Rognoni, Mario Fusco, Maria Francesca Vitale, Mario Usala, Rosanna Cusimano, Walter Mazzucco, Maria Michiara, Paolo Sgargi, Lorenza Boschetti, Giorgio Chiaranda, Pietro Seghini, Milena Maule, Franco Merletti, Eugenia Spata, Rosario Tumino, Pamela Mancuso, Massimo Vicentini, Tiziana Cassetti, Romano Sassatelli, Fabio Falcini, Stefania Giorgetti, Anna Luisa Caiazzo, Rossella Cavallo, Daniela Piras, Francesca Bella, Anselmo Madeddu, Anna Clara Fanetti, Sergio Maspero, Simona Carone, Antonia Mincuzzi, Giuseppa Candela, Tiziana Scuderi, Maria Adalgisa Gentilini, Roberto Rizzello, Stefano Rosso, Roberto Zanetti, Adele Caldarella, Teresa Intrieri, Fortunato Bianconi, Fabrizio Stracci, Paolo Contiero, Giovanna Tagliabue, Massimo Rugge, Manuel Zorzi, Simonetta Beggiato, Angelita Brustolin, Roberta De Angelis, Gemma Gatta, Anita Maurina, Marija Oniščuka, Mohsen Mousavi, Nadezda Lipunova, Ieva Vincerzevskienė, Dominic Agius, Neville Calleja, Sabine Siesling, Otto Visser, Tom Johannesen, Maciej Trojanowski, Tomasz Mierzwa, Jadwiga Rachtan, Kamila Kępska, Beata Kościańska, Joanna Wójcik-Tomaszewska, Marcin Motnyk, Anna Gos, Magdalena Bielska-Lasota, Joanna Didkowska, Urszula Wojciechowska, Gonçalo Forjaz de Lacerda, Raul Rego, Branca Carrito, Ana Pais, Maria José Bento, Jessica Rodrigues, Antonio Lourenço, Alexandra Mayer-da-Silva, Luminita Blaga, Daniela Coza, Lubov Gusenkova, Olga Lazarevich, Olga Prudnikova, Dmitri Mikhailovich Vjushkov, Alla Egorova, Andrey Orlov, Lidiya Pikalova, Lilia Zhuikova, Juraj Adamcik, Chakameh Safaei Diba, Vesna Zadnik, Tina Zagar, Marta De-La-Cruz, Arantza Lopez-de-Munain, Araceli Aleman, Dolores Rojas, Rosario Jiménez Chillarón, Ana Isabel Marcos Navarro, Montse Puigdemont, María-José Sánchez Perez, Paula Franch Sureda, Maria Ramos Montserrat, Maria Dolores Chirlaque López, Antonia Sánchez Gil, Eva Ardanaz, Marcela Guevara, Adela Cañete-Nieto, Rafael Peris-Bonet, Marià Carulla, Jaume Galceran, Fernando Almela, Consol Sabater, Staffan Khan, David Pettersson, Paul Dickman, Katharina Staehelin, Benjamin Struchen, Christian Herrmann, Seyed Mohsen Mousavi, Céline Egger Hayoz, Christine Bouchardy, Robin Schaffar, Philip Went, Manuela Maspoli-Conconi, Claudia Kuehni, Andrea Bordoni, Laura Ortelli, Arnaud Chiolero, Isabelle Konzelmann, Sabine Rohrmann, Miriam Wanner, John Broggio, Jem Rashbass, Deirdre Fitzpatrick, Anna Gavin, David Morrison, Catherine Thomson, Giles Greene, Dyfed Huws, Michel Coleman, Melissa Matz, Natalia Sanz, Richard Stephens, Elizabeth Chalker, Mirka Smith, Jessica Gugusheff, Hui You, Shu Qin Li, Sarah Dugdale, Julie Moore, Shoni Philpot, Rhonda Pfeiffer, Helen Thomas, Bruna Silva Ragaini, Alison Venn, Sue Evans, Luc Te Marvelde, Vedrana Savietto, Richard Trevithick, David Currow, Chris Lewis, Ssenyonga, Naomi, Stiller, Charle, Nakata, Kayo, Shalkow, Jaime, Redmond, Sheilagh, Bulliard, Jean-Luc, Girardi, Fabio, Fowler, Christine, Marcos-Gragera, Raphael, Bonaventure, Audrey, Saint-Jacques, Nathalie, Minicozzi, Pamela, De, Prithwish, Rodríguez-Barranco, Miguel, Larønningen, Siri, Di Carlo, Veronica, Mägi, Margit, Valkov, Mikhail, Seppä, Karri, Wyn Huws, Dyfed, Coleman, Michel P, Allemani, Claudia, and Mazzucco, Walter

Subjects
Adolescent, Australia, 610 Medicine & health, lymphoma, Settore MED/42 - Igiene Generale E Applicata, survival, United States, Europe, Leukemia, Myeloid, Acute, Young Adult, children, population-based/cancer registry, 360 Social problems & social services, survival, leukemia, cancer registry, Hematologic Neoplasms, leukaemia, Pediatrics, Perinatology and Child Health, Developmental and Educational Psychology, cancer, Humans, Registries, haematological malignancy, Child
Abstract

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.

Published
2022
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23. Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Author

Ssenyonga, Naomi, primary, Stiller, Charles, additional, Nakata, Kayo, additional, Shalkow, Jaime, additional, Redmond, Shelagh, additional, Bulliard, Jean-Luc, additional, Girardi, Fabio, additional, Fowler, Christine, additional, Marcos-Gragera, Rafael, additional, Bonaventure, Audrey, additional, Saint-Jacques, Nathalie, additional, Minicozzi, Pamela, additional, De, Prithwish, additional, Rodríguez-Barranco, Miguel, additional, Larønningen, Siri, additional, Di Carlo, Veronica, additional, Mägi, Margit, additional, Valkov, Mikhail, additional, Seppä, Karri, additional, Wyn Huws, Dyfed, additional, Coleman, Michel P, additional, Allemani, Claudia, additional, Bouzbid, Sabiha, additional, Hamdi-Chérif, Mokhtar, additional, Kara, Lamia, additional, Meguenni, Kaouel, additional, Regagba, Derbali, additional, Bayo, Sine, additional, Cheick Bougadari, Traore, additional, Manraj, Shyam Shunker, additional, Bendahhou, Karima, additional, Ladipo, Akinade, additional, Ogunbiyi, Olufemi, additional, Somdyala, Nontuthuzelo, additional, Chaplin, María Agustina, additional, Moreno, Florencia, additional, Calabrano, Gladis, additional, Espinola, Silvia, additional, Carballo Quintero, Beatriz, additional, Fita, Rosalba, additional, Laspada, Walter, additional, Ibañez, Susana, additional, Lima, Carlos, additional, Mafra Da Costa, Allini, additional, De Souza, Paulo César, additional, Chaves, Juliana, additional, Laporte, Cyntia, additional, Curado, Maria Paula, additional, de Oliveira, Jose Carlos, additional, Veneziano, Claudia, additional, Veneziano, Donaldo, additional, Almeida, Ana Beatriz, additional, Latorre, Maria, additional, Azevedo e Silva, Gulnar, additional, Rebelo, Marise, additional, Santos, Marceli, additional, Galaz, Juan, additional, Aparicio Aravena, Mackarena, additional, Sanhueza Monsalve, Jocelyn, additional, Herrmann, Denise, additional, Vargas, Solange, additional, Herrera, Victor, additional, Uribe, Claudia, additional, Bravo, Luis Eduardo, additional, Garcia, Luz Stella, additional, Arias-Ortiz, Nelson, additional, Morantes, Daniela, additional, Jurado, Daniel, additional, Yépez Chamorro, María, additional, Delgado, Sandra, additional, Ramirez, Melissa, additional, Galán Alvarez, Yaima, additional, Torres, Priscila, additional, Martínez-Reyes, Fray, additional, Jaramillo, Leyda, additional, Quinto, Rina, additional, Castillo, Jhoanna, additional, Mendoza, Mariela, additional, Cueva, Patricia, additional, Yépez, José, additional, Bhakkan, Bernard, additional, Deloumeaux, Jacqueline, additional, Joachim, Clarisse, additional, Macni, Jonathan, additional, Carrillo, Rodolfo, additional, Shalkow Klincovstein, Jaime, additional, Rivera Gomez, Rebeca, additional, Perez, Patricia, additional, Poquioma, Ebert, additional, Tortolero-Luna, Guillermo, additional, Zavala, Diego, additional, Alonso, Rafael, additional, Barrios, Enrique, additional, Eckstrand, Angela, additional, Nikiforuk, Cindy, additional, Woods, Ryan, additional, Noonan, Gail, additional, Turner, Donna, additional, Kumar, Eshwar, additional, Zhang, Bin, additional, Dowden, Jeff, additional, Doyle, Gregory, additional, Walsh, Gordon, additional, Anam, Aniq, additional, McClure, Carol, additional, Vriends, Kim, additional, Bertrand, Christine, additional, Ramanakumar, Agnihotram, additional, Kozie, Serena, additional, Stuart-Panko, Heather, additional, Freeman, Tara, additional, George, Justin, additional, Avila, Rosa, additional, O'Brien, David, additional, Holt, Abby, additional, Almon, Lyn, additional, Ward, Kevin, additional, Kwong, Sandy, additional, Morris, Cyllene, additional, Rycroft, Randi, additional, Mueller, Lloyd, additional, Phillips, Cathryn, additional, Brown, Heather, additional, Cromartie, Betsy, additional, Ruterbusch, Julie, additional, Schwartz, Ann, additional, Levin, Gary, additional, Wohler, Brad, additional, Bayakly, Rana, additional, Gomez, Scarlett, additional, McKinley, Meg, additional, Cress, Rosemary, additional, Davis, Joni, additional, Hernandez, Brenda, additional, Johnson, Christopher, additional, Morawski, Bozena, additional, Ruppert, Laura, additional, Bentler, Suzanne, additional, Charlton, Mary, additional, Huang, Bin, additional, Tucker, Thomas, additional, Deapen, Dennis, additional, Liu, Lihua, additional, Hsieh, Mei-Chin, additional, Wu, Xiao-Cheng, additional, Schwenn, Molly, additional, Stern, Kimberly, additional, Gershman, Susan, additional, Knowlton, Richard, additional, Alverson, Georgetta, additional, Weaver, Tamara, additional, Desai, Jay, additional, Rogers, Deirdre, additional, Jackson-Thompson, Jeanette, additional, Lemons, Debbi, additional, Zimmerman, Heather, additional, Hood, Michelle, additional, Roberts-Johnson, Jenifer, additional, Hammond, Whitney, additional, Rees, Judith, additional, Pawlish, Karen, additional, Stroup, Antoinette, additional, Key, Charles, additional, Wiggins, Charles, additional, Kahn, Amy, additional, Schymura, Maria, additional, Radhakrishnan, Soundarya, additional, Rao, Chandrika, additional, Giljahn, Lynn, additional, Slocumb, Roberta, additional, Dabbs, Christy, additional, Espinoza, Raffaella, additional, Aird, Karen, additional, Beran, Todd, additional, Rubertone, Jim, additional, Slack, Stephen, additional, Oh, Junhie, additional, Janes, Tiffany, additional, Schwartz, Stephen, additional, Chiodini, Stephanie, additional, Hurley, Deborah, additional, Whiteside, Martin, additional, Rai, Saroj, additional, Williams, Melanie, additional, Herget, Kim, additional, Sweeney, Carol, additional, Johnson, Alison, additional, Keitheri Cheteri, Mahesh, additional, Migliore Santiago, Patti, additional, Blankenship, Steven, additional, Farley, Shawn, additional, Borchers, Robert, additional, Malicki, Robin, additional, Espinoza, Julia, additional, Grandpre, Joseph, additional, Edwards, Brenda, additional, Mariotto, Angela, additional, Weir, Hannah, additional, Wilson, Reda, additional, Wang, Ning, additional, Yang, Lei, additional, Chen, Jian-Shun, additional, He, Yu-Tong, additional, Song, Guo-Hui, additional, Gu, Xiao-Ping, additional, Mei, Dan, additional, Ge, Heng-Ming, additional, Wu, Tong-Hao, additional, Li, Yan-Yan, additional, Zhao, De-Li, additional, Jin, Feng, additional, Zhang, Jian-Hua, additional, Zhu, Feng-Dong, additional, Junhua, Qian, additional, Yang, Yan Lei, additional, Jiang, Chun-Xiao, additional, Biao, Wang, additional, Wang, Jian, additional, Li, Qi-Long, additional, Yi, He, additional, Zhou, Xin, additional, Dong, JianMei, additional, Li, WeiWei, additional, Fu, Fang-Xian, additional, Chen, Jian-Guo, additional, Zhu, Jian, additional, Li, Yan-Hua, additional, Lu, Yu-Qiang, additional, Fan, Min, additional, Huang, Su-Qin, additional, Guo, Guo-Ping, additional, Zhaolai, Hua, additional, Wei, Kuangrong, additional, Chen, Wan-Qing, additional, Wei, Wenqiang, additional, Zeng, Hongmei, additional, Demetriou, Anna, additional, Mang, Wai Kong, additional, Ngan, Kai Cheong, additional, Kataki, Amal, additional, Krishnatreya, Manigreeva, additional, Jayalekshmi, Padmavathi Amma, additional, Sebastian, Paul, additional, George, Preethi, additional, Mathew, Aleyamma, additional, Nandakumar, Ambakumar, additional, Malekzadeh, Reza, additional, Roshandel, Gholamreza, additional, Keinan-Boker, Lital, additional, Silverman, Barbara, additional, Ito, Hidemi, additional, Koyanagi, Yuriko, additional, Sato, Masako, additional, Tobori, Fumio, additional, Nakata, Ichiro, additional, Teramoto, Norihiro, additional, Hattori, Masakazu, additional, Kaizaki, Yasuharu, additional, Moki, Fumitaka, additional, Sugiyama, Hiromi, additional, Utada, Mai, additional, Nishimura, Makiko, additional, Yoshida, Keiichi, additional, Kurosawa, Katsuki, additional, Nemoto, Yuji, additional, Narimatsu, Hiroto, additional, Sakaguchi, Masahiko, additional, Kanemura, Seiki, additional, Naito, Michiko, additional, Narisawa, Rintaro, additional, Miyashiro, Isao, additional, Mori, Daisuke, additional, Yoshitake, Mayuko, additional, Oki, Izumi, additional, Fukushima, Norimasa, additional, Shibata, Akiko, additional, Iwasa, Keiichiro, additional, Ono, Chie, additional, Matsuda, Tomohiro, additional, Nimri, Omar, additional, Jung, Kyu-Won, additional, Won, Young-Joo, additional, Alawadhi, Eiman, additional, Elbasmi, Amani, additional, Ab Manan, Azizah, additional, Adam, Farzaana, additional, Nansalmaa, Erdenekhuu, additional, Tudev, Undarmaa, additional, Ochir, Chimedsuren, additional, Al Khater, Al Hareth, additional, El Mistiri, Mufid, additional, Lim, Gek Hsiang, additional, Teo, Yik Ying, additional, Chiang, Chun-Ju, additional, Lee, Wen-Chung, additional, Buasom, Rangsiya, additional, Sangrajrang, Suleeporn, additional, Suwanrungruang, Krittika, additional, Vatanasapt, Patravoot, additional, Daoprasert, Karnchana, additional, Pongnikorn, Donsuk, additional, Leklob, Atit, additional, Sangkitipaiboon, Somphob, additional, Geater, Sarayut, additional, Sriplung, Hutcha, additional, Ceylan, Okan, additional, Kög, Iskender, additional, Dirican, Oya, additional, Köse, Tülay, additional, Gurbuz, Tulın, additional, Karašahin, Füsun Emine, additional, Turhan, Duygu, additional, Aktaş, Umut, additional, Halat, Yakup, additional, Eser, Sultan, additional, Yakut, Cankut, additional, Altinisik, Merve, additional, Cavusoglu, Yasar, additional, Türkköylü, Ayşe, additional, Üçüncü, Nuršen, additional, Hackl, Monika, additional, Zborovskaya, Anna, additional, Aleinikova, Olga, additional, Henau, Kris, additional, Van Eycken, Liesbet, additional, Atanasov, Trayan, additional, Valerianova, Zdravka, additional, Šekerija, Mario, additional, Dušek, Ladislav, additional, Zvolský, Miroslav, additional, Steinrud Mørch, Lina, additional, Storm, Hans, additional, Wessel Skovlund, Charlotte, additional, Innos, Kaire, additional, Malila, Nea, additional, Jégu, Jérémie, additional, Velten, Michel, additional, Cornet, Edouard, additional, Troussard, Xavier, additional, Bouvier, Anne-Marie, additional, Guizard, Anne-Valérie, additional, Bouvier, Véronique, additional, Launoy, Guy, additional, Dabakuyo Yonli, Sandrine, additional, Poillot, Marie-Laure, additional, Maynadié, Marc, additional, Mounier, Morgane, additional, Vaconnet, Lina, additional, Woronoff, Anne-Sophie, additional, Daoulas, Mélanie, additional, Robaszkiewicz, Michel, additional, Clavel, Jacqueline, additional, Poulalhon, Claire, additional, Desandes, Emmanuel, additional, Lacour, Brigitte, additional, Baldi, Isabelle, additional, Pouchieu, Camille, additional, Amadeo, Brice, additional, Coureau, Gaëlle, additional, Monnereau, Alain, additional, Audoin, Magali, additional, D'Almeida, Tania, additional, Boyer, Séverine, additional, Hammas, Karima, additional, Trétarre, Brigitte, additional, Colonna, Marc, additional, Delafosse, Patricia, additional, Plouvier, Sandrine, additional, Cowppli-Bony, Anne, additional, Molinié, Florence, additional, Bara, Simona, additional, Ganry, Olivier, additional, Lapôtre-Ledoux, Bénédicte, additional, Daubisse-Marliac, Laetitia, additional, Bossard, Nadine, additional, Estève, Jacques, additional, Uhry, Zoé, additional, Stabenow, Roland, additional, Wilsdorf-Köhler, Heide, additional, Eberle, Andrea, additional, Luttmann, Sabine, additional, Löhden, Imma, additional, Nennecke, Alice, additional, Kieschke, Joachim, additional, Sirri, Eunice, additional, Justenhoven, Christina, additional, Zeissig, Sylke, additional, Holleczek, Bernd, additional, Eisemann, Nora, additional, Katalinic, Alexander, additional, Asquez, Rachelle, additional, Kumar, Vijay, additional, Petridou, Eleni, additional, Ólafsdóttir, Elínborg, additional, Tryggvadóttir, Laufey, additional, Murray, Deirdre, additional, Walsh, Paul, additional, Sundseth, Hildrun, additional, Mazzoleni, Guido, additional, Vittadello, Fabio, additional, Coviello, Enzo, additional, Cuccaro, Francesco, additional, Galasso, Rocco, additional, Sampietro, Giuseppe, additional, Magoni, Michele, additional, Ardizzone, Antonino, additional, D'Argenzio, Angelo, additional, Di Prima, Alessia Anna, additional, Ippolito, Antonella, additional, Lavecchia, Anna Maria, additional, Sutera Sardo, Antonella, additional, Gola, Gemma, additional, Ballotari, Paola, additional, Giacomazzi, Erica, additional, Ferretti, Stefano, additional, Dal Maso, Luigino, additional, Serraino, Diego, additional, Celesia, Maria Vittoria, additional, Filiberti, Rosa Angela, additional, Pannozzo, Fabio, additional, Melcarne, Anna, additional, Quarta, Fabrizio, additional, Andreano, Anita, additional, Russo, Antonio Giampiero, additional, Carrozzi, Giuliano, additional, Cirilli, Claudia, additional, Cavalieri d'Oro, Luca, additional, Rognoni, Magda, additional, Fusco, Mario, additional, Vitale, Maria Francesca, additional, Usala, Mario, additional, Cusimano, Rosanna, additional, Mazzucco, Walter, additional, Michiara, Maria, additional, Sgargi, Paolo, additional, Boschetti, Lorenza, additional, Chiaranda, Giorgio, additional, Seghini, Pietro, additional, Maule, Milena, additional, Merletti, Franco, additional, Spata, Eugenia, additional, Tumino, Rosario, additional, Mancuso, Pamela, additional, Vicentini, Massimo, additional, Cassetti, Tiziana, additional, Sassatelli, Romano, additional, Falcini, Fabio, additional, Giorgetti, Stefania, additional, Caiazzo, Anna Luisa, additional, Cavallo, Rossella, additional, Piras, Daniela, additional, Bella, Francesca, additional, Madeddu, Anselmo, additional, Fanetti, Anna Clara, additional, Maspero, Sergio, additional, Carone, Simona, additional, Mincuzzi, Antonia, additional, Candela, Giuseppa, additional, Scuderi, Tiziana, additional, Gentilini, Maria Adalgisa, additional, Rizzello, Roberto, additional, Rosso, Stefano, additional, Zanetti, Roberto, additional, Caldarella, Adele, additional, Intrieri, Teresa, additional, Bianconi, Fortunato, additional, Stracci, Fabrizio, additional, Contiero, Paolo, additional, Tagliabue, Giovanna, additional, Rugge, Massimo, additional, Zorzi, Manuel, additional, Beggiato, Simonetta, additional, Brustolin, Angelita, additional, De Angelis, Roberta, additional, Gatta, Gemma, additional, Maurina, Anita, additional, Oniščuka, Marija, additional, Mousavi, Mohsen, additional, Lipunova, Nadezda, additional, Vincerzevskienė, Ieva, additional, Agius, Dominic, additional, Calleja, Neville, additional, Siesling, Sabine, additional, Visser, Otto, additional, Johannesen, Tom, additional, Trojanowski, Maciej, additional, Mierzwa, Tomasz, additional, Rachtan, Jadwiga, additional, Kępska, Kamila, additional, Kościańska, Beata, additional, Wójcik-Tomaszewska, Joanna, additional, Motnyk, Marcin, additional, Gos, Anna, additional, Bielska-Lasota, Magdalena, additional, Didkowska, Joanna, additional, Wojciechowska, Urszula, additional, Forjaz de Lacerda, Gonçalo, additional, Rego, Raul, additional, Carrito, Branca, additional, Pais, Ana, additional, Bento, Maria José, additional, Rodrigues, Jessica, additional, Lourenço, Antonio, additional, Mayer-da-Silva, Alexandra, additional, Blaga, Luminita, additional, Coza, Daniela, additional, Gusenkova, Lubov, additional, Lazarevich, Olga, additional, Prudnikova, Olga, additional, Vjushkov, Dmitri Mikhailovich, additional, Egorova, Alla, additional, Orlov, Andrey, additional, Pikalova, Lidiya, additional, Zhuikova, Lilia, additional, Adamcik, Juraj, additional, Safaei Diba, Chakameh, additional, Zadnik, Vesna, additional, Zagar, Tina, additional, De-La-Cruz, Marta, additional, Lopez-de-Munain, Arantza, additional, Aleman, Araceli, additional, Rojas, Dolores, additional, Chillarón, Rosario Jiménez, additional, Navarro, Ana Isabel Marcos, additional, Puigdemont, Montse, additional, Sánchez Perez, María-José, additional, Franch Sureda, Paula, additional, Ramos Montserrat, Maria, additional, Chirlaque López, Maria Dolores, additional, Sánchez Gil, Antonia, additional, Ardanaz, Eva, additional, Guevara, Marcela, additional, Cañete-Nieto, Adela, additional, Peris-Bonet, Rafael, additional, Carulla, Marià, additional, Galceran, Jaume, additional, Almela, Fernando, additional, Sabater, Consol, additional, Khan, Staffan, additional, Pettersson, David, additional, Dickman, Paul, additional, Staehelin, Katharina, additional, Struchen, Benjamin, additional, Herrmann, Christian, additional, Mousavi, Seyed Mohsen, additional, Egger Hayoz, Céline, additional, Bouchardy, Christine, additional, Schaffar, Robin, additional, Went, Philip, additional, Maspoli-Conconi, Manuela, additional, Kuehni, Claudia, additional, Bordoni, Andrea, additional, Ortelli, Laura, additional, Chiolero, Arnaud, additional, Konzelmann, Isabelle, additional, Rohrmann, Sabine, additional, Wanner, Miriam, additional, Broggio, John, additional, Rashbass, Jem, additional, Fitzpatrick, Deirdre, additional, Gavin, Anna, additional, Morrison, David, additional, Thomson, Catherine, additional, Greene, Giles, additional, Huws, Dyfed, additional, Coleman, Michel, additional, Matz, Melissa, additional, Sanz, Natalia, additional, Ssenyonga, Naomi, additional, Stephens, Richard, additional, Chalker, Elizabeth, additional, Smith, Mirka, additional, Gugusheff, Jessica, additional, You, Hui, additional, Qin Li, Shu, additional, Dugdale, Sarah, additional, Moore, Julie, additional, Philpot, Shoni, additional, Pfeiffer, Rhonda, additional, Thomas, Helen, additional, Silva Ragaini, Bruna, additional, Venn, Alison, additional, Evans, Sue, additional, Te Marvelde, Luc, additional, Savietto, Vedrana, additional, Trevithick, Richard, additional, Currow, David, additional, and Lewis, Chris, additional

Published
2022
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30. Calculation of capacity of spillway № 2 Boguchanskoye HPP with free water overflow

Author

Alim Guryev, Nartmir Khanov, Olga Mareeva, Marina Zborovskaya, and Aleksandra Verkhoglyadova

Subjects
General Earth and Planetary Sciences, General Environmental Science
Abstract

The article considers a variant with the operation of spillway No. 2 of the Boguchanskaya HPP as the main spillway structure for the period of temporary operation of the hydroelectric complex. In the process of developing options for skipping construction costs, a calculation was made of the throughput with a free overflow through a flat threshold at the level of 167.0m at the FSL=175m and forcing the UVB to the level of 185.0 m with the damping of the flow energy in the water well. The task of the calculations is to obtain the discharge characteristics of the considered spillway option with the calculated flood hydrograph with a probability of 0.2%. At the same time, based on the throughput capacity of the spillway No. 1, the dependence of the turbine flow rate and the water depth in the downstream, as well as the transformation of the flood of a given probability, the estimated flow rate is 5500 m3/s, the maximum head H=18 m (determining) at a minimum threshold level of 167.0 m. Weir refers to weirs with a wide threshold. The throughput capacity of the spillway No. 2, operating in the free overflow mode, was determined. The change in the lateral compression coefficient depending on the head for the middle and outer working spans is considered. The outlines of free-falling jets behind the culverts operating in the free overflow mode are obtained, which makes it possible to refine the outlines of the side walls of the spillway.

Published
2023
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38. POS0626 CREATININE-BASED CKD-EPI EQUATION LEADS TO OVERESTIMATION OF GLOMERULAR FILTRATION RATE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Author

V. Aleksandrov, I. Alekhina, A. Aleksandrov, L. Shilova, N. Aleksandrova, and I. Zborovskaya

Subjects
Rheumatology, Immunology, Immunology and Allergy, General Biochemistry, Genetics and Molecular Biology
Abstract

BackgroundAccurate calculation of glomerular filtration rate (GFR) is an important aspect of clinical care for rheumatologic patients [1, 2, 3].ObjectivesTo choose the optimal method of determining the GFR to assess the severity of renal dysfunction in patients with rheumatoid arthritis (RA).MethodsAn open cross-sectional study was performed involving 96 patients with a reliable diagnosis of RA (mean age 54.4±11.6 years, duration of disease 10.7±8.56 years, 57.3% with moderate RA activity).For comparative assessment of renal function, we used the estimated glomerular filtration rate (eGFR) using the CKD-EPI formulas on the National Kidney Foundation website (USA): creatinine-based equation (eGFRcr), cystatin C-based equation (eGFRcyst) and calculated creatinine and cystatin C equation (eGFRcr-cyst). The 2009 CKD-EPI creatinine equation (eGFRcr) was used as a reference for comparative calculations of GFR. Based on the eGFRcr measurements, patients with RA were divided into four groups: I, >90 ml/min/1.73 m2; II, 89-60 ml/min/1.73 m2; III, 45-59 ml/min/1.73 m2; and IV, 2.ResultsThe mean eGFRcr, presented as a reference in this study, was 70.0±18.7 ml/min/1.73 m2. Signs of hyperfiltration using eGFRcr (>90 ml/min/1.73 m2) were observed in 16 (10.1%) patients with RA, mild decrease of renal function (60-89 ml/min/1.73 m2) was registered in 52 (32.9%), moderate/severe decrease (2) - in 28 (17.8%) patients with RA. Decreased eGFRcr was differentially associated with increased patient age (r=0.46; p=0.003), disease duration (r=0.24; p=0.017), cumulative dose of hormones (r=0.66; p=0.007), lower height (r= 0.35; p=0.001).Analysis of eGFR values demonstrated significant differences using the selected methods (χ2=9.91, p= 0.007). Intergroup differences (in degree of decrease in eGFR) were statistically significant for all variants of eGFR calculation (eGFRcr, eGFRcyst, eGFRcr-cyst; H-test and Median-test, pTable 1.Group distribution of RA patients according to eGFR, n(%)Group IGroup IIGroup IIIGroup IVeGFRcr16 (17.0)52 (54.2)20 (20.8)8 (8.33)eGFRcr-cys22 (22.9)39 (40.6)20 (20.8)15 (15.6)eGFRcyst29 (30.2)29 (30.2)22 (22.9)16 (16.7)The use of eGFRcyst showed that only 12 of 29 people in the first group had optimal (>90 ml/min/1.73 m2) eGFRcr (p=0.031), and 17 patients entered the group with slightly decreased (60-89 ml/min/1.73 m2) eGFRcr. A similar, but less significant situation (12 of 22 people and 10 patients, p=0.02) was also observed with eGFRcr-cyst. In the second group of RA patients 19 patients corresponded to the chosen criteria in determination of eGFRcyst, and 8 patients entered groups (III and IV) with more severe decrease of renal function (2 patients were included into group I) (p=0,011). Significant differences in this group were also noted when comparing the proportions according to eGFRcr with eGFRcr-cyst (p=0.044). A probable decrease in renal filtration function with eGFRcr (compared with the alternative use of eGFRcr-cyst or eGFRcyst) can be observed in 11-18% of RA patients in group 1 (high/optimal renal function) and up to 10% of RA patients in group 2 (slight decrease). No significant differences were found using the three estimated CKD-EPI formulas in RA patients with moderate/significant decrease in GFR (p>0.05).ConclusionCurrently, the overall diagnostic performance of the CKD-EPI equation based on creatinine and cystatin C may be the most optimal (in comparison with other calculated CKD-EPI formulas) in patients with RA, and may also be useful for confirming eGFRcr results >60 ml/min/1.73m2.References[1]Saisho K. et al. Mod Rheumatol. 2016;26(3):331-5.[2]Couderc M. et al. Arthritis Care Res (Hoboken). 2016;68(5):638-44.[3]Aleksandrov V. et al. Ann Rheum Dis. 2021;80(S1):1059. doi:10.1136/annrheumdis-2021-eular.2275.Disclosure of InterestsNone declared

Published
2022
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40. AB0138 XANTHINE OXIDOREDUCTASE: BLOOD PROFILE IN SYSTEMIC CONNECTIVE TISSUE DISEASES

Author

E. Mozgovaya, S. Bedina, A. Trofimenko, M. Mamus, S. Spitsina, and I. Zborovskaya

Subjects
Rheumatology, Immunology, Immunology and Allergy, General Biochemistry, Genetics and Molecular Biology
Abstract

BackgroundSystemic lupus erythematosus (SLE) and systemic scleroderma (SSc) are systemic connective tissue diseases. Their development is based on a generalized immune inflammatory process. Deep immunological and metabolic disorders in these diseases have along with general characteristic distinctive features. XOR is a multifunctional enzyme. The reactions catalyzed by XOR are a source of reactive forms of oxygen and nitrogen, nitric oxide, which are of great physiological importance, and are also responsible for the development of many pathophysiological reactions. Analysis of changes in the activity of interconverting forms of XOR (xanthine oxidase (XO), ЕС 1.17.3.2 and xanthine dehydrogenase (XDG), ЕС 1.17.1.4) in plasma and blood cells is of interest.Objectivesto characterize differences of XO and XDG activities profiles in blood of SLE and SSc patients.MethodsThe researcher was carried out in agreement with the WMA Declaration of Helsinki principles. 56 SLE patients and 51 SSc patients were enrolled in this study. Diagnosis of SLE was verified using the SLICC criteria (2012). SSc was verified according to ACR/EULAR criteria (2013). The reference group consisted of 35 healthy controls. XO and XDG activities were measured in plasma, lysed WBC, lysed RBC using spectrophotometric method [1]. Results were expressed as Me (Q25; Q75). The Mann-Whitney U test was used for statistical analysis, differences were considered significant when pResultsMean age of SLE patients was 35 (31; 42) years, mean duration of disease was 8 (5; 11) years. Mean age of SSc patients was 43 (38; 48) years, mean SSc duration was 8 (6; 9) years. The enzyme indices included in the study did not depend on the sex and age of healthy individuals. XO activity was increased in plasma of SLE and SSc patients (pConclusionChanges in the activity of oxidase and dehydrogenase forms of XOR were revealed in plasma, lysed WBC, lysed RBC of SLE and SSc patients, which determine characteristic blood profiles in these diseases. Changes in the balance of XOR enzymatic activities can affect the exchange of purine nucleotides, the pool of reactive oxygen and nitrogen species in body tissues, participating in the processes inherent in these diseases.References[1]Mozgovaya E.E. et al. Siberian Journal of Life Sciences and Agriculture 2021;3:288-304.Disclosure of InterestsNone declared

Published
2022
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41. AB0039 MONOCYTE EXTRACELLULAR TRAPS: A NEW POTENTIAL DIAGNOSTIC BIOMARKER IN RHEUMATOID ARTHRITIS?

Author

I. Zborovskaya, S. Bedina, E. Mozgovaya, A. Trofimenko, M. Mamus, and S. Spitsina

Subjects
Rheumatology, Immunology, Immunology and Allergy, General Biochemistry, Genetics and Molecular Biology
Abstract

BackgroundStudies demonstrating the important role of neutrophil extracellular traps (NETs) in the pathogenesis of autoimmune diseases, including rheumatoid arthritis (RA), have been published extensively in recent years. The researchers are also discussing the possibility of considering NET as a source of potential diagnostic biomarker in RA. As compared with NETs, the monocyte extracellular traps (METs) formation by mononuclear phagocytes, although they have also been implicated in the development of autoimmune reactions, has been studied insufficiently. No studies have been reported on the MET formation in active RA patients.ObjectivesAssesssment of METs generation by peripheral blood monocytes from RA patients in association with the disease exacerbation.MethodsThe research was carried out in agreement with the WMA Declaration of Helsinki principles after the local ethical board approval. Circulating monocytes were isolated with one-step density gradient centrifugation using double layers of the in-lab-made ficoll-amidotrizoate gradient. Composition of isolated cellular fractions, their viability, and non-specific activation were evaluated by light microscopy using common Romanowsky-Giemsa staining, trypan blue exclusion test as well as NBT test. METs were induced by LPS. Monocyte fractions contained low extents of activated and dead cells. Spontaneous and induced formation of extracellular traps was assessed using fluorescence microscopy [1]. Results were presented as values (95%CI).Results30 healthy volunteers (9 males and 21 females, mean age 37.2 years) were enrolled as a reference group. 37 patients (6 males and 31 females, mean age 42.7 years) with verified RA according to the ACR/EULAR 2010 criteria were included in the study. RA disease activity was assessed using DAS28 score did not exceeded 2.6 in every patient at the inclusion timepoint. In 16 (15.4%) patients, the activity of DAS 28 exceeded 3.2 at subsequent visits (after 3, 8 and 12 months). Spontaneous and induced MET formation by isolated monocytes in RA patients (DAS 283.2) was 18.1 (17.8-18.4)% and 38.2 (38.0-38.4)%, respectively. Spontaneous and induced MET formation by isolated neutrophils in active RA patients (DAS 28>3.2) was significantly higher than in inactive RA patients and in comparison to the reference group. Induced MET formation was also significantly higher than spontaneous one (рConclusionMETs formation by isolated monocytes can be considered as a new potential diagnostic biomarker associated with RA flare. Further study of the mechanisms of MET formation and their composition may improve our understanding of the role of monocytes and METs in the pathogenesis of RA.References[1]Bedina S., et al. Medical immunology 2021; 23(5):1165-1170.Disclosure of InterestsNone declared

Published
2022
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