[Active forms of oxygen and pathogenesis of rheumatoid arthritis and systemic lupus erythematosus]

In this paper the authors underline the significance of studies into the body's free radical oxidation, analyze the involvement of free radical reactions in the maintenance of homeostasis. They indicate that free radical metabolic changes leading to oxidative stress play a role in the pathogenesis of many human diseases. Particular emphasis is laid on the contribution of active forms of oxygen (AFO) in the development of autoimmune diseases, including rheumatic diseases. The history of this problem is outlined. There are examples that confirm the enhancement of free radical processes and the inhibition of the antioxidative system in rheumatic arthritis (RA) and some other rheumatic diseases. The essential drugs used in the treatment of RA patients are demonstrated to also act due to the inhibited "respiratory outbreak" of phagocytes. The key point of the paper is the role of free radical reactions in the pathogenesis of systemic lupus erythematosus (SLE). There is evidence suggesting that there is a reduction in antioxidative defense and a rise in neutrophilic production of AFO in SLE patients. Consideration is also given to the possible participation of AFO in the formation of DNA antibodies, the effects of AFO on the immune system, atherogenesis in SLE. Taking into account a possible contribution of AFO in the pathogenesis of SLE, it is expedient to include antiradical agents into the multimodality therapy for this disease and promising to continue investigations in this field.