IMMUNE-RELATED MECHANISMS, MOLECULAR AND GENETIC CHARACTERISTICS OF PATIENTS WITH THE SYSTEMIC CONNECTIVE TISSUE DISEASES WITH CRYOGLOBULINEMIC SYNDROME

Introduction: Cryoglobulinemic syndrome (CGS) is an immune-related process caused by cryoglobulins composition in the blood in small or medium vessels. Most frequently, CGS is triggered by lymphotropic viruses, immune-related and oncological diseases. Objectives: Studying the immune-related mechanisms, molecular and genetic characteristics of patients with systemic autoimmune diseases (SAD) against the cryoglobulinemic syndrome. Methods: Among 380 patients with SAD, in 94 (57.6%) progressing chronic EBV-infection was diagnosed, and 22.1% of patients were diagnosed with progressing chronic HSV 1/2-infection based on DNA virus identification through the polymerase chain reaction (PCR) in three biological media (blood, saliva, mucus membrane scraping). Results: Analysis of the cryoglobulins in such patients showed that CGS was diagnosed in 118 (31.1%) patients with the mean concentration of CG1.68±0.33 g/l at a rate of 0.48 ±0.10g/l. The patients with the systemic connective tissue diseases with CGS demonstrated statistically lower miR-146а expression which resulted in the abnormal production of pro-inflammatory cytokines, the highest TLR9 expression on monocytes, slightly lower on lymphocytes, and the lowest on granulocytes; the increase in the relative amount of cytolytic T-lymphocytes, IL2 receptor lymphocytes, activated CD HLA DR+-lymphocytes against the reduction of NK-cells and regulatory suppressor CD4+/25+-cells was observed. The idiopathic and initiated oxidative monocyte capacity in CGS patients distinctly tended to increase, as compared to patients without CGS and normal individuals. Conclusions. Cryoglobulins may act as the so-called bridge between viral infections and the autoimmune processes. CGS was diagnosed in 31.1% of patients. Despite a substantial number of studies dedicated to the cryoglobulinemic syndrome, the peculiarities of the immune reaction of such patients need further research, since they create the risks of secondary vasculitis against SAD