Zavodovskiĭ B V, Kovalenko E A, Fofanova N A, Novikova O V, Zborovskiĭ A B
Ter Arkh. 1999;71(5):47-50.
To improve the efficacy of osteoarthrosis (AO) treatment by chondroprotectors by defining individual indications for their use, based on the initial level of antibodies to cartilaginous glycosaminoglycans (GAG) in the blood serum.
Anti-GAG were detected by indirect solid-phase enzyme immunoassay. The antigen was a sulfated GAG preparation GAG-polysulfate (arteparon) manufactured by Luitpold-Werk (Germany). Sera of 110 OA patients were tested. Fifty of them were treated by rumalon, 20 with arteparon, and protocols of 40 patients included no chondroprotectors.
The highest levels of anti-GAG were found in OA patients with multiple involvement of the joints, rapidly progressing disease, and secondary synovitis. The titer of antibodies increases with disease duration and in patients with the roentgenological stage of OA, reaching the maximum by 10-15 years of disease or by stage III. Efficacy of chondroprotectors was lower at lower levels of antibodies to cartilaginous GAG.
Chondroprotector therapy of patients with initially high levels of antibodies to GAG is unadvisable, for it can lead to exacerbations, specifically, to secondary synovitis.
通过根据血清中软骨糖胺聚糖（GAG）抗体的初始水平确定软骨保护剂的个体使用指征，提高骨关节炎（OA）的治疗效果。
采用间接固相酶免疫测定法检测抗GAG。抗原是德国Luitpold-Werk公司生产的硫酸化GAG制剂GAG-聚硫酸盐（阿特帕龙）。检测了110例OA患者的血清。其中50例用鲁马隆治疗，20例用阿特帕龙治疗，40例患者的治疗方案中未使用软骨保护剂。
在关节多部位受累、疾病进展迅速和继发性滑膜炎的OA患者中发现抗GAG水平最高。抗体滴度随疾病持续时间以及OA患者的影像学分期而升高，在疾病10 - 15年或III期时达到最高。软骨保护剂在软骨GAG抗体水平较低时疗效较低。
对初始GAG抗体水平较高的患者进行软骨保护剂治疗不可取，因为这可能导致病情加重，特别是继发性滑膜炎。
