mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2025-5-98-105mrj-1846Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSВозможности селективной плазмосорбции внеклеточной ДНК и NETs у пациентов с трудно поддающимся лечению ревматоидным артритом (первый опыт применения)Selective plasmosorption of extracellular DNA and NETs in patients with difficult-to-treat rheumatoid arthritis (first clinical experience)https://orcid.org/0000-0002-1663-7810АсееваЕ. А.AseevaE. A.

Елена Александровна Асеева 

115522, Москва, Каширское шоссе, 34А 

Elena Alexandrovna Aseeva 

34A, Kashirskoe Shosse, Moscow 115522 

eaasseeva@mail.ruhttps://orcid.org/0009-0005-1269-5799ПлетнёвЕ. А.PletnevE. A.

115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

https://orcid.org/0000-0001-5105-0313ПокровскийН. С.PokrovskyN. S.

121552, Москва, ул. Академика Чазова, 15А 

15A, Akademika Chazova Street, Moscow 121552 

https://orcid.org/0000-0002-5206-1732СоловьевС. К.SolovievS. K.

115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

https://orcid.org/0000-0002-6906-0621НиколаеваЕ. В.NikolaevaE. V.

115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

https://orcid.org/0000-0002-4160-7218НикишинаН. Ю.NikishinaN. Yu.

115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

https://orcid.org/0009-0006-8106-8091АбдуллинЕ. Т.AbdullinE. T.

121552, Москва, ул. Академика Чазова, 15А 

119991, Москва, Ленинские горы, 1 

15A, Akademika Chazova Street, Moscow 121552 

1, Leninskie Gory, Moscow 119991 

https://orcid.org/0000-0002-4503-7750БланкЛ. М.BlankL. M.

115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

https://orcid.org/0000-0002-4579-2836ЗоткинЕ. Г.ZotkinE. G.

115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

115522, Москва, Каширское шоссе, 34А

125993, Москва, ул. Баррикадная, 2/1, стр. 1

34A, Kashirskoe Shosse, Moscow 115522 

2/1, Barrikadnaya Street, Build. 1, Moscow 125993 

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A, Nasonova Research Institute of RheumatologyRussian FederationФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава РоссииРоссияNational Medical Research Centre of Cardiology named after Academician E.I. Chazov, Ministry of Health of RussiaRussian FederationФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава России ; ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»РоссияNational Medical Research Centre of Cardiology named after Academician E.I. Chazov, Ministry of Health of Russia ; Lomonosov Moscow State UniversityRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой» ; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A, Nasonova Research Institute of Rheumatology ; Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaRussian Federation20251810202519598105Copyright © Асеева Е.А., Плетнёв Е.А., Покровский Н.С., Соловьев С.К., Николаева Е.В., Никишина Н.Ю., Абдуллин Е.Т., Бланк Л.М., Зоткин Е.Г., Лила А.М., 20252025Асеева Е.А., Плетнёв Е.А., Покровский Н.С., Соловьев С.К., Николаева Е.В., Никишина Н.Ю., Абдуллин Е.Т., Бланк Л.М., Зоткин Е.Г., Лила А.М.Aseeva E.A., Pletnev E.A., Pokrovsky N.S., Soloviev S.K., Nikolaeva E.V., Nikishina N.Y., Abdullin E.T., Blank L.M., Zotkin E.G., Lila A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1846

Ревматоидный артрит, ассоциированный с интерстициальным заболеванием легких (РА-ИЗЛ), представляет собой особый клинико-патогенетический фенотип заболевания, сопровождающийся высокой воспалительной активностью, серопозитивностью и системными проявлениями. В последнее время все большее внимание уделяется роли внеклеточной ДНК и нейтрофильных внеклеточных ловушек (NETs) в патогенезе РА. Представлен первый случай применения селективной плазмосорбции внеклеточной ДНК и NETs у пациента с РА-ИЗЛ. На фоне терапии отмечались уменьшение боли и скованности в суставах, улучшение общего состояния пациента. Прослежена динамика лабораторных показателей. Данный клинический случай демонстрирует потенциал применения плазмосорбции ДНК-содержащих структур в лечении рефрактерных форм РА как метода, дополняющего эффект генно-инженерной биологической терапии.

Rheumatoid arthritis (RA) associated with interstitial lung disease (RA-ILD) represents a distinct clinical and pathogenetic phenotype characterized by high inflammatory activity, seropositivity, and systemic manifestations. In recent years, increasing attention has been directed to the role of extracellular DNA and neutrophil extracellular traps (NETs) in RA pathogenesis. This report presents the first case of selective plasmosorption of extracellular DNA and NETs in a patient with RA-ILD. The therapy was associated with a decrease in joint pain and stiffness and improvement of general condition. Laboratory parameters were also monitored dynamically. This clinical case demonstrates the potential of DNA-containing structure plasmosorption as an adjunctive method to enhance the effect of therapy with biological disease modifying antirheumatic drugs in refractory RA.

ревматоидный артритэкстракорпоральная терапиянейтрофильные внеклеточные ловушкивнеклеточная ДНКтерапевтический аферезrheumatoid arthritisextracorporeal therapyneutrophil extracellular trapsextracellular DNAtherapeutic apheresisСтатья подготовлена в рамках государственного задания № РК 125020501434-1 «Изучение иммунопатологии и подходы к терапии при системных ревматических заболеваниях».The article was prepared within the framework of the state assignment № PK 125020501434-1 “Investigation of immunopathology and approaches to therapy in systemic rheumatic diseases.”ReferencesНасонов ЕЛ, Лила АМ. Ревматоидный артрит: достижения и нерешенные проблемы. Терапевтический архив. 2019; 91(5):4-7.Nasonov EL, Lila AM. Rheumatoid arthritis: achievements and unresolved issues. Terapevticheskii arkhiv. 2019;91(5): 4-7. (In Russ.).Насонов ЕЛ, Ананьева ЛП, Авдеев СН. Интерстициальные заболевания легких при ревматоидном артрите: мультидисциплинарная проблема ревматологии и пульмонологии. 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The authors declare that there are no conflicts of interest present.