Connective tissue diseases: development predictors, multimorbidity variants, physical treatment methods. (Literature review)

Connective tissue diseases require early diagnosis, interdisciplinary strategy and integration of pharmacological and non-drug methods. Physical treatment methods demonstrate proven effectiveness in the context of a comprehensive approach to therapy. Physical therapy with a high level of evidence (I, A) improves the function of joints and lungs, as well as contributes to the reduction of fibrosis severity. UVA-1 phototherapy is a method of choice for improving the skin elasticity in scleroderma and skin forms of the connective tissue diseases by inhibiting TGF-β and collagen synthesis. Ultrasound therapy in combination with hyaluronidase, high-intensity dye laser therapy are indicated for reduction of the vascular disorders in tissues. Cryotherapy (whole-body and local), electrophoresis with corticosteroids have a local anti-inflammatory effect, complement the range of non-drug interventions, improving the quality of life of patients, but require individualization of parameters. Personalization of treatment based on genetic markers, as well as the introduction of innovative methods (targeted therapy) can reduce the risk of complications, but problems of resistance and iatrogenic effects remain. Further research should be aimed at the study of the role of microbiome and development of pathogenetically substantiated drugs.