FEATURES OF MICROBIOME IN RHEUMATOID ARTHRITIS
Rheumatoid arthritis is an immuno-inflammatory disease with a multifactorial etiology and affects directly or indirectly organs and systems of the body. The study of the peculiarities of the formation of the microbiome is of great importance both in understanding the pathogenesis and in increasing the effectiveness of the treatment of rheumatoid arthritis. The purpose of the study: to identify the spread of microbiological disorders of the intestinal microflora and to establish the characteristic features of changes in the microbiome in rheumatoid arthritis. A clinical and microbiological examination of 60 patients with rheumatoid arthritis and 40 practically healthy individuals of the comparison group was carried out. The microbiocenosis of open biotopes of the body was studied by bacteriological method: the large intestine, nasal mucosa and urine. The analysis of the presented data revealed general trends in the formation of the microbiome of the patients ' body In the intestinal microbiome, on the mucous membranes of the upper respiratory and urinary tract, along with microorganisms that are predominantly localized in these biotopes, atypical bacteria were found. When studying the representation of the main microorganisms of the intestinal microflora, a significant change in their quantitative composition was found. In patients with a high frequency, microbiological disorders of the intestinal microflora were detected with the development of II-III degree of microbiological disorders, which was accompanied by the identification of an association of opportunistic microorganisms in the intestine. Opportunistic Enterobacteriae, representatives of the intestinal microflora, have been found in open biotopes. These violations of the microbiome can be caused by a violation of the barrier function of the intestinal mucosa and, as a result, the translocation of microorganisms from typical habitats. Information about the potential of translocated infectious agents to stimulate autoimmunity in genetically predisposed people allows us to consider the intestinal microbiome as a new therapeutic target in the treatment of rheumatoid arthritis.