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Rodríguez-Carrio J, Alperi-López M, López P, Alonso-Castro S, Ballina-García FJ, Suárez A. TNFα polymorphism as marker of immunosenescence for rheumatoid arthritis patients. Exp Gerontol 2014; 61:123-9. [PMID: 25510954 DOI: 10.1016/j.exger.2014.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 11/28/2014] [Accepted: 12/12/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Expansion of CD4(+)CD28(null), a common feature of immunosenescence, which has been reported in rheumatoid arthritis (RA) patients, may also be associated with a CD4(+) imbalance. Although the increase of CD4(+)CD28(null) cells has been related to TNFα exposure, nothing is known about the possible role of genetic variants of this cytokine. METHODS Participants were genotyped for TNFA rs1800629 (-308 G>A) and frequency of the CD4(+)CD28(null), regulatory T cells and Th1 cells subsets were quantified in peripheral blood samples by flow cytometry in 129 RA patients and 33 healthy controls. RESULTS The expansion of CD4(+)CD28(null) cells in RA patients was associated with TNFA genotype, even at diagnosis, and linked to markers of aggressive disease in patient carriers of the minor allele. Analysis of regulatory T cells and IFNγ-CD4(+) expression suggested that defective suppression and/or Th1-shift could underlie the expansion of this population in these patients. Finally, although treatment with TNFα-blockers reduced CD4(+)CD28(null) cells in most patients, only those carriers of the common GG genotype reached values within the range of HC and showed a disease activity improvement correlated to this decrease. CONCLUSIONS Our results provide evidence for a genetic basis of the premature immunosenescence of RA patients and highlight its potential role in clinical outcome after TNFα blockade.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Area of Immunology, Departament of Functional Biology, University of Oviedo, Asturias, Spain
| | - Mercedes Alperi-López
- Department of Rheumatology, Hospital Universitario Central de Asturias, Asturias, Spain
| | - Patricia López
- Area of Immunology, Departament of Functional Biology, University of Oviedo, Asturias, Spain
| | - Sara Alonso-Castro
- Department of Rheumatology, Hospital Universitario Central de Asturias, Asturias, Spain
| | | | - Ana Suárez
- Area of Immunology, Departament of Functional Biology, University of Oviedo, Asturias, Spain.
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Máchal J, Pávková-Goldbergová M, Hlinomaz O, Groch L, Vašků A. Patients with chronic three-vessel disease in a 15-year follow-up study: genetic and non-genetic predictors of survival. Medicine (Baltimore) 2014; 93:e278. [PMID: 25526459 PMCID: PMC4603099 DOI: 10.1097/md.0000000000000278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin-angiotensin-aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were obtained from the national insurance registry. All data were available in the case of 150 patients with 3VD. Statistical analysis used stepwise Cox regression with dominant, recessive, or additive mode of genetic expression. Involved variables included age, sex, BMI, blood pressure, diabetes, ejection fraction, left main stenosis, previously diagnosed coronary stenosis, myocardial infarction in personal history, and coronary bypass along with polymorphisms pre-selected by log-rank tests. Out of the 23 polymorphisms, four were included in the model construction. SNP in the IL-6 gene rs1800795 (-174 G/C) has been found to be a significant predictor of survival. This SNP was in a linkage disequilibrium with rs1800797 (-597 G/A) in the same gene (D'=1.0), which was also found to constitute a significant predictor of survival when rs1800795 was not included in the model construction. Age, increased BMI, diabetes, low EF, and left main stenosis were also significant predictors in all models. Age, increased BMI, diabetes, low ejection fraction, left main stenosis, and genetic variation in the IL-6 promoter were established as significant independent risk factors for the survival of patients with three-vessel disease.
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Affiliation(s)
- Jan Máchal
- From the Department of Pathophysiology, Faculty of Medicine, Masaryk University Brno, Czech Republic (JM, MPG, AV); International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic (JM, LG, OH); and First Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital, Brno, Czech Republic (OH, LG)
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López-Mejias R, Ubilla B, Genre F, Corrales A, Hernández JL, Ferraz-Amaro I, Tsang L, Llorca J, Blanco R, González-Juanatey C, Gonzalez-Gay MA, Dessein PH. Osteoprotegerin concentrations relate independently to established cardiovascular disease in rheumatoid arthritis. J Rheumatol 2014; 42:39-45. [PMID: 25362655 DOI: 10.3899/jrheum.140690] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE We determined whether osteoprotegerin (OPG) concentrations are associated with established cardiovascular disease (CVD) among patients with rheumatoid arthritis (RA). METHODS OPG concentrations were measured by ELISA in 151 patients with RA (54 with CVD) and 62 age-matched control subjects without CVD. Established CVD was composed of documented ischemic heart disease, cerebrovascular disease, and peripheral artery disease. RESULTS In patients with RA, age, body mass index (BMI), rheumatoid factor (RF) positivity, anticyclic citrullinated peptide (anti-CCP) antibody positivity, and joint erosion status were associated with OPG concentrations [partial R (p) = 0.175 (0.03), -0.277 (0.0009), 0.323 (< 0.0001), 0.217 (0.008), and 0.159 (0.05), respectively]. Median (interquartile range) OPG concentrations increased from 6.38 (3.46-9.31) to 7.07 (5.04-10.65) and 8.64 (6.00-11.52) ng/ml in controls and patients with RA who had CVD and those who did not, respectively (p = 0.0002). Upon adjustment for age, sex, traditional risk factors, and BMI in mixed regression models, OPG concentrations remained lower in controls compared to patients with RA without CVD (p = 0.05) and in the latter compared to those with CVD (p = 0.03); the association of OPG concentrations with CVD among patients with RA also persisted after additional adjustment for RF and anti-CCP antibody positivity, and erosion status (p = 0.04). CONCLUSION OPG concentrations are associated with disease severity and CVD prevalence in patients with RA. Whether consideration of OPG concentrations can improve CVD risk stratification in RA merits future longitudinal investigation.
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Affiliation(s)
- Raquel López-Mejias
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Begoña Ubilla
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Fernanda Genre
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Alfonso Corrales
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - José L Hernández
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Ivan Ferraz-Amaro
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Linda Tsang
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Javier Llorca
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Ricardo Blanco
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Carlos González-Juanatey
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Miguel A Gonzalez-Gay
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
| | - Patrick H Dessein
- From the Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, and the Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and Fundación Instituto de Investigación Marqués de Valdecilla, and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), and CIBER Epidemiología y Salud Pública (CIBERESP), Santander; the Rheumatology Division, Hospital Universitario de Canarias, Tenerife; the Cardiology Division, Hospital Lucus Augusti, Lugo, Spain; the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.P.H. Dessein and M.A. Gonzalez-Gay share senior authorship.R. López-Mejias, PhD; B. Ubilla, BSc; F. Genre, PhD; A. Corrales, MD, PhD; R. Blanco, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV; J.L. Hernández, MD, PhD, Department of Internal Medicine, Hospital Universitario Marques de Valdecilla, University of Cantabria, RETICEF, IFIMAV; I. Ferraz-Amaro, MD, Rheumatology Division, Hospital Universitario de Canarias; L. Tsang; P.H. Dessein, MD, FCP(SA), FRCP(UK), PhD, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand; J. Llorca, MD, PhD, Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBERESP, IFIMAV; C. Gonzalez-Juanatey, MD, PhD, Cardiology Division, Hospital Lucus Augusti; M.A. Gonzalez-Gay, MD, PhD, Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marques de Valdecilla, IFIMAV
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Hsue PY, Scherzer R, Grunfeld C, Imboden J, Wu Y, Del Puerto G, Nitta E, Shigenaga J, Schnell Heringer A, Ganz P, Graf J. Depletion of B-cells with rituximab improves endothelial function and reduces inflammation among individuals with rheumatoid arthritis. J Am Heart Assoc 2014; 3:e001267. [PMID: 25336464 PMCID: PMC4323827 DOI: 10.1161/jaha.114.001267] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Individuals with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease, partly due to systemic inflammation and endothelial dysfunction. B‐cells play an important pathogenic role in the inflammatory process that drives RA disease activity. Rituximab, a chimeric murine/human monoclonal antibody that depletes B‐cells, is an effective therapy for RA. The purpose of this study was to determine whether B‐cell depletion with rituximab reduces systemic inflammation and improves macrovascular (brachial artery flow‐mediated dilation, FMD) and microvascular (reactive hyperemia) endothelial function in RA patients. Methods and Results RA patients received a single course of rituximab (1000 mg IV infusion at baseline and on day 15). FMD, reactive hyperemia, inflammatory markers, and clinical assessments were performed at baseline, week 12, and week 24. Twenty patients (95% female, median age 54 years) completed the study. Following treatment, FMD improved from a baseline of 4.5±0.4% to 6.4±0.6% at 12 weeks (mean±SE; P<0.0001), followed by a decline at week 24; a similar pattern was observed for hyperemic velocity. Significant decreases in RA disease scores, high‐sensitivity C‐reactive protein, erythrocyte sedimentation rate, and circulating CD19+ B‐cells were sustained through week 24. Cholesterol and triglycerides became significantly although modestly elevated during the study. Conclusions Depletion of B‐cells with rituximab improved macrovascular and microvascular endothelial function and reduced systemic inflammation, despite modest elevation in lipids. Given these results, rituximab should be evaluated in the future for its possible role in reducing excess cardiovascular risk in RA. Clinical Trial Registration URL http://ClinicalTrials.gov. Unique identifier: NCT00844714.
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Affiliation(s)
- Priscilla Y Hsue
- Division of Cardiology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (P.Y.H., Y.W., E.N., A.S.H., P.G.)
| | - Rebecca Scherzer
- San Francisco Veterans Affairs Medical Center, Department of Medicine UCSF, University of California, San Francisco, CA (R.S., C.G., J.S.)
| | - Carl Grunfeld
- San Francisco Veterans Affairs Medical Center, Department of Medicine UCSF, University of California, San Francisco, CA (R.S., C.G., J.S.)
| | - John Imboden
- Division of Rheumatology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (J.I., G.P., J.G.)
| | - Yuaner Wu
- Division of Cardiology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (P.Y.H., Y.W., E.N., A.S.H., P.G.)
| | - Gus Del Puerto
- Division of Rheumatology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (J.I., G.P., J.G.)
| | - Elaine Nitta
- Division of Cardiology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (P.Y.H., Y.W., E.N., A.S.H., P.G.)
| | - Judy Shigenaga
- San Francisco Veterans Affairs Medical Center, Department of Medicine UCSF, University of California, San Francisco, CA (R.S., C.G., J.S.)
| | - Amanda Schnell Heringer
- Division of Cardiology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (P.Y.H., Y.W., E.N., A.S.H., P.G.)
| | - Peter Ganz
- Division of Cardiology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (P.Y.H., Y.W., E.N., A.S.H., P.G.)
| | - Jonathan Graf
- Division of Rheumatology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA (J.I., G.P., J.G.)
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Gupta U, Mir SS, Chauhan T, Garg N, Agarwal SK, Pande S, Mittal B. Influence of protein tyrosine phosphatase gene (PTPN22) polymorphisms on rheumatic heart disease susceptibility in North Indian population. ACTA ACUST UNITED AC 2014; 84:492-6. [DOI: 10.1111/tan.12440] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 07/24/2014] [Accepted: 08/11/2014] [Indexed: 01/18/2023]
Affiliation(s)
- U. Gupta
- Department of Genetics; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Lucknow India
- Department of Biosciences; Integral University; Lucknow India
| | - S. S. Mir
- Department of Biosciences; Integral University; Lucknow India
| | - T. Chauhan
- Department of Genetics; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Lucknow India
| | - N. Garg
- Department of Cardiology; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Lucknow India
| | - S. K. Agarwal
- Department of Cardiovascular and Thoracic Surgery; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Lucknow India
| | - S. Pande
- Department of Cardiovascular and Thoracic Surgery; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Lucknow India
| | - B. Mittal
- Department of Genetics; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS); Lucknow India
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Li F, Gao J, Sokolove J, Xu J, Zheng J, Zhu K, Pan Z. Polymorphisms in the TNF-α, TNFR1 gene and risk of rheumatoid arthritis in Chinese Han population. Int J Immunogenet 2014; 41:499-502. [PMID: 25263964 DOI: 10.1111/iji.12148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 07/22/2014] [Accepted: 08/06/2014] [Indexed: 11/28/2022]
Abstract
Recent advances have highlighted a major genetic contribution to the pathogenesis of rheumatoid arthritis (RA).The aim of this study was to investigate whether polymorphisms of TNF-α (rs1800630, rs1800629) and TNFR1 (rs767455) were associated with susceptibility to and clinical outcome of RA in Chinese Han population. The target gene polymorphisms were genotyped in 256 patients with RA and 331 healthy controls using a high resolution melting (HRM) method. ESR, CRP, RF anti-CCP and anti-GPI level were also assayed and compared in genotypes of each polymorphism. Significant difference was observed in the genotype distributions and allele frequencies of TNF-α rs1800629 (P = 0.001, P < 0.001, respectively) between patients with RA and controls. There is no evidence to suggest an association between genotypes of the 3 SNPs according to age, gender, disease duration, DAS28 and serum level of autoantibodies. This study identifies a potentially important role for TNF-α rs1800629 polymorphisms in the susceptibility to RA.However, further studies in larger cohorts are required.
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Affiliation(s)
- F Li
- Department of Rheumatology, Shandong University Qilu Hospital, Qingdao, Shandong, China; Department of Rheumatology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
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Rodríguez-Carrio J, Alperi-López M, López P, Alonso-Castro S, Ballina-García FJ, Suárez A. Red cell distribution width is associated with cardiovascular risk and disease parameters in rheumatoid arthritis. Rheumatology (Oxford) 2014; 54:641-6. [PMID: 25239880 DOI: 10.1093/rheumatology/keu345] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Since red cell distribution width (RDW) has been associated with cardiovascular (CV) disease and inflammation in several conditions, the main aim of this study was to evaluate its prognostic value in RA patients and its potential associations with clinical features. METHODS The history of CV events was retrospectively reviewed in 160 RA patients and RDW was recorded at disease onset and 6 and 12 months after diagnosis to calculate the accumulated value [area under the curve (AUC) RDW] and change during the first year (ΔRDW). In addition, RDW was analysed in 110 patients with established disease in relation to clinical features. RESULTS Increased RDW at diagnosis and AUC RDW were able to predict the occurrence of CV events in RA patients [hazard ratio (HR) 1.247 (95% CI 1.079, 1.441), P = 0.003 and HR 1.038 (95% CI 1.018, 1.059), P = 0.0001, respectively] after adjusting by potential confounding factors. Receiver operating characteristic curve analyses revealed a better power of discrimination for the AUC RDW (P = 3.394 × 10(-5)). In addition, an increase in RDW during the first year was associated with poor CV outcome (P = 0.010). On the other hand, RDW in patients with established RA was significantly associated with disease activity, acute phase reactants and severity. CONCLUSION RDW at disease onset may be used as an early marker of CV risk in RA, whereas in patients with established disease it was related to the activity of the disease. These findings suggest that RDW can be considered as a surrogate marker of inflammation and, consequently, CV risk in RA patients.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain
| | - Mercedes Alperi-López
- Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain
| | - Patricia López
- Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain
| | - Sara Alonso-Castro
- Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain
| | - Francisco J Ballina-García
- Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain
| | - Ana Suárez
- Area of Immunology, Department of Functional Biology, University of Oviedo and Department of Rheumatology, Hospital Universitario Central de Asturias, Oveido, Spain.
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Serum samples that have been stored long-term (>10 years) can be used as a suitable data source for developing cardiovascular risk prediction models in large observational rheumatoid arthritis cohorts. BIOMED RESEARCH INTERNATIONAL 2014; 2014:930925. [PMID: 25295280 PMCID: PMC4177784 DOI: 10.1155/2014/930925] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 08/22/2014] [Indexed: 12/03/2022]
Abstract
Objective. There is an unmet need for a specific cardiovascular risk (CV) algorithm for rheumatoid arthritis (RA) patients. Lipoprotein data are often not available in RA cohorts but could be obtained from frozen blood samples. The objective of this study was to estimate the storage effect on lipoproteins in long-term (>10 years) frozen serum samples. Methods. Data were used from an inception RA cohort. Multiple serum samples from 152 patients were analyzed for lipoproteins, being frozen for 1–26 years at −20°C. Storage effect on lipoproteins was estimated using longitudinal regression analyses and a lipid decay correction factor was developed. Clinical impact of the storage effect on lipoproteins was assessed by calculating the number of patients reclassified to another CV risk group according to the SCORE risk calculator after applying the decay correction factor. Results. There was a significant effect of storage time on total cholesterol (TC) (P < 0.001) and high density lipoprotein cholesterol (HDL-c) levels (P < 0.001), not LDL-c (P = 0.83). The lipid decay correction factor was 0.03 mmol/L and 0.024 mmol/L per additional year of storage for TC and HDL-c, respectively. The TC : HDL ratio decreased after correction for storage effect. After correction, only 5% of patients were reclassified to another CV risk group. Conclusion. A modest storage decay effect on lipoproteins was found that is unlikely to significantly affect CV risk stratification. Serum samples that have been stored long-term (>10 years) can be used to obtain valid lipid levels for developing CV risk prediction models in RA cohorts, even without applying a decay correction factor.
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Relationship between dimethylarginine dimethylaminohydrolase gene variants and asymmetric dimethylarginine in patients with rheumatoid arthritis. Atherosclerosis 2014; 237:38-44. [PMID: 25194333 DOI: 10.1016/j.atherosclerosis.2014.07.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/06/2014] [Accepted: 07/29/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The aim of our study was to determine whether Dimethylarginine Dimethylaminohydrolase (DDAH) 1 and 2 gene polymorphisms - the main enzyme involved in ADMA degradation - are associated with high Asymmetric Dimethylarginine (ADMA) levels in Rheumatoid Arthritis (RA). METHODS Serum ADMA levels were measured in 201 individuals with RA [155 females median age 67 (59-73)]. Four tag SNPs in DDAH1 gene and 2 in the DDAH2 gene were genotyped by using the LightCycler™ System. ADMA was initially compared across the genetic variables using one-way ANOVA and then multivariate analysis examined each of the genes after adjustment for parameters of systemic inflammation and insulin resistance, namely erythrocyte sedimentation rate (ESR) and homeostatic model assessment (HOMA), which we have previously shown affect ADMA levels in RA. RESULTS No significant relationship between DDAH genetic variables and ADMA levels was established in ANOVA analysis. Multivariate model adjusted for age, HOMA and ESR did not demonstrate any significant association between DDAH variants and ADMA. CONCLUSION The results of our study give no evidence to suggest that increased ADMA levels in RA relate to DDAH genetic polymorphisms. Better understanding of disease-related factors and their interactions with traditional CV risk factors may represent mechanisms responsible for ADMA accumulation in this population.
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Rodriguez-Jimenez NA, Garcia-Gonzalez CE, Ayala-Lopez KP, Trujillo-Hernandez B, Aguilar-Chavez EA, Rocha-Muñoz AD, Vasquez-Jimenez JC, Olivas-Flores E, Salazar-Paramo M, Corona-Sanchez EG, Vazquez-Del Mercado M, Varon-Villalpando E, Cota-Sanchez A, Cardona-Muñoz EG, Gamez-Nava JI, Gonzalez-Lopez L. Modifications in lipid levels are independent of serum TNF-α in rheumatoid arthritis: results of an observational 24-week cohort study comparing patients receiving etanercept plus methotrexate or methotrexate as monotherapy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:510305. [PMID: 25243145 PMCID: PMC4160615 DOI: 10.1155/2014/510305] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To compare the modifications in lipids between patients with rheumatoid arthritis (RA) receiving etanercept plus methotrexate (ETA + MTX) versus methotrexate (MTX) and their relationship with serum levels of tumor necrosis factor-alpha (TNF-α). METHODS In an observational cohort study, we compared changes in lipid levels in patients receiving ETA + MTX versus MTX in RA. These groups were assessed at baseline and at 4 and 24 weeks, measuring clinical outcomes, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and TNF-α. RESULTS Baseline values for lipid levels were similar in both groups. HDL-C levels increased significantly only in the ETA + MTX group (from 45.5 to 50.0 mg/dL at 4 weeks, a 10.2% increase, P < 0.001, and to 56.0 mg/dL at 24 weeks, a 25.1% increase, P < 0.001), while other lipids underwent no significant changes. ETA + MTX also exhibited a significant increase in TNF-α (44.8 pg/mL at baseline versus 281.4 pg/mL at 24 weeks, P < 0.001). The MTX group had no significant changes in lipids or TNF-α. Significant differences in HDL-C between groups were observed at 24 weeks (P = 0.04) and also in TNF-α (P = 0.01). CONCLUSION HDL-C levels increased significantly following treatment with ETA + MTX, without a relationship with decrease of TNF-α.
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Affiliation(s)
- Norma Alejandra Rodriguez-Jimenez
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico
| | - Carlos E. Garcia-Gonzalez
- Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico
| | | | | | - Erika Anita Aguilar-Chavez
- Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico
- Programa de Becarios en Investigacion en Salud, Unidad de Medicina Familiar 2, IMSS, Guadalajara, JAL, Mexico
| | - Alberto Daniel Rocha-Muñoz
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico
| | | | - Eva Olivas-Flores
- Departamento de Anestesiología, Hospital General Regional 180, IMSS, Tlajomulco, JAL, Mexico
| | - Mario Salazar-Paramo
- Division de Investigacion en Salud, UMAE, Hospital de Especialidades, Centro Medico Nacional de Occidente, IMSS, Mexico
| | | | | | | | - Adolfo Cota-Sanchez
- Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico
| | - Ernesto German Cardona-Muñoz
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (U de G), Guadalajara, JAL, Mexico
| | - Jorge I. Gamez-Nava
- Unidad de Investigacion en Epidemiologia Clinica, Hospital de Especialidades, Centro Medico Nacional de Occidente, IMSS, Guadalajara, JAL, Mexico
| | - Laura Gonzalez-Lopez
- Departamento de Medicina Interna-Reumatologia, Hospital General Regional 110, IMSS, 44716 Guadalajara, JAL, Mexico
- Programa de Doctorado en Salud Publica, CUCS, U de G, 44340 Guadalajara, JAL, Mexico
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Martín-Martínez MA, González-Juanatey C, Castañeda S, Llorca J, Ferraz-Amaro I, Fernández-Gutiérrez B, Díaz-González F, González-Gay MA. Recommendations for the management of cardiovascular risk in patients with rheumatoid arthritis: Scientific evidence and expert opinion. Semin Arthritis Rheum 2014; 44:1-8. [DOI: 10.1016/j.semarthrit.2014.01.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/02/2014] [Accepted: 01/21/2014] [Indexed: 11/30/2022]
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Amaya-Amaya J, Montoya-Sánchez L, Rojas-Villarraga A. Cardiovascular involvement in autoimmune diseases. BIOMED RESEARCH INTERNATIONAL 2014; 2014:367359. [PMID: 25177690 PMCID: PMC4142566 DOI: 10.1155/2014/367359] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/01/2014] [Indexed: 12/15/2022]
Abstract
Autoimmune diseases (AD) represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT) was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD.
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Affiliation(s)
- Jenny Amaya-Amaya
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, 11001000 Bogotá, Colombia
- Mederi, Hospital Universitario Mayor, Calle 24 No. 29-45, 11001000 Bogotá, Colombia
| | - Laura Montoya-Sánchez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, 11001000 Bogotá, Colombia
- Mederi, Hospital Universitario Mayor, Calle 24 No. 29-45, 11001000 Bogotá, Colombia
| | - Adriana Rojas-Villarraga
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, 11001000 Bogotá, Colombia
- Mederi, Hospital Universitario Mayor, Calle 24 No. 29-45, 11001000 Bogotá, Colombia
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Li S, Huang X, Zhong H, Chen Z, Peng Q, Deng Y, Qin X. Tumour necrosis factor alpha (TNF-α) genetic polymorphisms and the risk of autoimmune liver disease: a meta-analysis. J Genet 2014. [PMID: 24371186 DOI: 10.1007/s12041-013-0272-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Epidemiological studies have evaluated the association between tumour necrosis factor alpha (TNF-α)- 308G/A and (TNF-α)- 238G/A polymorphisms, and the risk of autoimmune liver disease (AILD), yet the results are conflicting. To derive a more precise estimation of the relationship, we performed this meta-analysis. A systematic review was conducted to identify all eligible studies of TNF-α polymorphisms and AILD risk. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association between the two TNF-α polymorphisms and AILD risk. A total of 15 eligible studies were identified. Overall, positive associations of -308G/A polymorphism with AILD risk were found (A vs G allele: OR =1.45, 95%CI = 1.13- 1.86; AA vs GG: OR = 2.74, 95%CI = 1.51- 4.96; GA vs GG: OR = 1.46, 95%CI = 1.11- 1.92;dominant model: OR = 1.57, 95%CI = 1.18- 2.10; recessive model: OR = 2.22, 95%CI = 1.31- 3.76). In subgroup analysis by ethnicity, a significantly higher risk was found in Caucasians. In subgroup analysis by AILD category, significant association was observed in autoimmune hepatitis and primary sclerosing cholangitis, especially in Caucasians. Patients carrying TNF-α-238A allele had a slightly decreased risk of developing AILD (OR = 0.65, 95%CI = 0.48- 0.87). However, we found both TNF-α polymorphisms were not associated with primary biliary cirrhosis risk, even in subgroup analysis. Our meta-analysis suggests that the TNF-α-308G/A and -238G/A polymorphisms may contribute to AILD susceptibility in Caucasians,especially for autoimmune hepatitis and primary sclerosing cholangitis. Nevertheless, we found both TNF-α polymorphisms were unlikely to be associated with the risk of primary biliary cirrhosis
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Affiliation(s)
- Shan Li
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People's Republic of China.
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López-Mejías R, Genre F, Corrales A, González-Juanatey C, Ubilla B, Llorca J, Miranda-Filloy JA, Pina T, Blanco R, Castañeda S, Martín J, González-Gay MA. Investigation of aPON1gene polymorphism (rs662 polymorphism) as predictor of subclinical atherosclerosis in patients with rheumatoid arthritis: Table 1. Ann Rheum Dis 2014; 73:1749-50. [DOI: 10.1136/annrheumdis-2014-205543] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Dessein PH, López-Mejias R, González-Juanatey C, Genre F, Miranda-Filloy JA, Llorca J, González-Gay MA. Independent relationship of osteoprotegerin concentrations with endothelial activation and carotid atherosclerosis in patients with severe rheumatoid arthritis. J Rheumatol 2014; 41:429-36. [PMID: 24488413 DOI: 10.3899/jrheum.131037] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Osteoprotegerin (OPG) may contribute to the link between systemic inflammation and increased cardiovascular risk. We investigated the relationship of OPG concentrations with endothelial activation and carotid atherosclerosis in rheumatoid arthritis (RA). METHODS OPG concentrations and those of endothelial activation molecules were measured by using ELISA in 34 patients who were treated with infliximab (IFX), both immediately before and after an IFX infusion. Carotid intima-media thickness (CIMT) and plaque were determined by ultrasound in 27 of the study participants. RESULTS Median (interquartile range) OPG concentrations decreased from 4.8 pmol/l (2.8-6.5) to 4.4 pmol/l (2.9-6.1; p = 0.04) upon IFX infusion. Baseline OPG concentrations were inversely associated with those of total and low-density lipoprotein (LDL) cholesterol (partial R = -0.50, p = 0.004, and R = -0.48, p = 0.007, respectively). Prior to IFX administration, OPG concentrations were associated with those of intercellular adhesion molecule (ICAM)-1 (partial R = 0.34, p = 0.05), CIMT (partial R = 0.51 to 0.52, p < 0.009), and plaque (OR = 1.52, 95% CI 1.01-2.29 to OR = 1.61, 95% CI 1.03-2.51; p < 0.04), independent of conventional risk factors and C-reactive protein concentrations or disease activity. Except for the OPG concentrations-plaque association (p = 0.09), these relationships remained significant subsequent to IFX administration (p < 0.05). Reductions in OPG levels related to those in vascular cell adhesion molecule (VCAM)-1 concentrations (partial R = 0.35, p = 0.04) and had borderline significance (p = 0.09) with those in ICAM-1 (partial R = 0.29) concentrations. CONCLUSION OPG concentrations are independently associated with endothelial activation and carotid atherosclerosis in RA. Reductions in OPG concentrations upon IFX administration are associated with decreased endothelial activation. OPG may be involved in increased cardiovascular disease risk and may improve its stratification in patients with RA.
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Affiliation(s)
- Patrick H Dessein
- From the Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IFIMAV, Santander; Cardiology Division, Hospital Xeral-Calde, Lugo; Rheumatology Division, Hospital Xeral-Calde, Lugo; Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IFIMAV, and CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain
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The effect of disease duration and disease activity on the risk of cardiovascular disease in rheumatoid arthritis patients. Ann Rheum Dis 2014; 74:998-1003. [DOI: 10.1136/annrheumdis-2013-204531] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 01/03/2014] [Indexed: 11/03/2022]
Abstract
ObjectiveDisease duration and disease activity may be associated with an increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA). The objectives of this study were to investigate (1) the relationship between duration of inflammation and the development of CVD in RA patients and (2) the relationship between RA disease activity over time and CVD in patients with RA.MethodsRA patients with a follow-up of ≥6 months in the Nijmegen early RA cohort without prior CVD were included. Disease activity over time was calculated using the time-averaged 28 joint disease activity score (DAS28) for each patient. Kaplan–Meier survival analysis and Cox proportional hazards regression were used for the analyses.ResultsDuring follow-up of the 855 patients that were included, 154 CV events occurred. The course of hazards over time did not indicate a change in the risk of CVD over the course of RA (disease duration), which is also reflected by the absence of a deflection in the survival curves. The survival distributions did not differ between patients with a disease duration of <10 years or >10 years (Log-rank test: p=0.82). Time-averaged DAS28 was significantly associated with CVD (p=0.002) after correction for confounders.ConclusionsDisease duration does not appear to independently affect the risk of CVD. The risk of CVD in RA patients was not increased after 10 years of disease duration compared with the first 10 years. Disease activity over time may contribute to the risk of CVD.
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Rodríguez-Carrio J, de Paz B, López P, Prado C, Alperi-López M, Ballina-García FJ, Suárez A. IFNα serum levels are associated with endothelial progenitor cells imbalance and disease features in rheumatoid arthritis patients. PLoS One 2014; 9:e86069. [PMID: 24465874 PMCID: PMC3897639 DOI: 10.1371/journal.pone.0086069] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 12/07/2013] [Indexed: 11/19/2022] Open
Abstract
Introduction IFNα has been largely implicated in the ethiopathogenesis of autoimmune diseases but only recently it has been linked to endothelial damage and accelerated atherosclerosis in autoimmunity. In addition, proinflammatory conditions are supposed to be implicated in the cardiovascular status of these patients. Since a role for IFNα in endothelial damage and impaired Endothelial Progenitor Cell (EPC) number and function has been reported in other diseases, we aimed to evaluate the potential associations of IFNα serum levels on EPC populations and cytokine profiles in Rheumatoid Arthritis (RA) patients. Methods pre-EPC, EPC and mature EPC (mEPC) populations were quantified by flow cytometry analyzing their differential CD34, CD133 and VEGFR2 expression in blood samples from 120 RA patients, 52 healthy controls (HC), and 83 systemic lupus erythematosus (SLE) patients as disease control. Cytokine serum levels were measured by immunoassays and clinical and immunological data, including cardiovascular (CV) events and CV risk factors, were retrospectively obtained by reviewing clinical records. Results Long-standing, but not recent onset RA patients displayed a significant depletion of all endothelial progenitor populations, unless high IFNα levels were present. In fact, the IFNhigh RA patient group (n = 40, 33%), showed increased EPC levels, comparable to SLE patients. In addition, high IFNα serum levels were associated with higher disease activity (DAS28), presence of autoantibodies, higher levels of IL-1β, IL-6, IL-10 and MIP-1α, lower amounts of TGF-β, and increased mEPC/EPC ratio, thus suggesting higher rates of endothelial damage and an endothelial repair failure. Finally, the relationship between high IFNα levels and occurrence of CV events observed in RA patients seems to support this hypothesis. Conclusions IFNα serum marker could be used to identify a group of RA patients with increased disease activity, EPC imbalance, enhanced proinflammatory profile and higher cardiovascular risk, probably due, at least in part, to an impaired endothelial repair.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Area Of Immunology, Department Of Functional Biology, Faculty Of Medicine, University Of Oviedo, Oviedo, Spain
| | - Banesa de Paz
- Area Of Immunology, Department Of Functional Biology, Faculty Of Medicine, University Of Oviedo, Oviedo, Spain
| | - Patricia López
- Area Of Immunology, Department Of Functional Biology, Faculty Of Medicine, University Of Oviedo, Oviedo, Spain
| | - Catuxa Prado
- Area Of Immunology, Department Of Functional Biology, Faculty Of Medicine, University Of Oviedo, Oviedo, Spain
| | - Mercedes Alperi-López
- Department Of Rheumatology, Hospital Universitario Central De Asturias, Oviedo, Spain
| | | | - Ana Suárez
- Area Of Immunology, Department Of Functional Biology, Faculty Of Medicine, University Of Oviedo, Oviedo, Spain
- * E-mail:
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Rodríguez-Carrio J, Alperi-López M, López P, Alonso-Castro S, Ballina-García FJ, Suárez A. Angiogenic T cells are decreased in rheumatoid arthritis patients. Ann Rheum Dis 2014; 74:921-7. [PMID: 24399233 DOI: 10.1136/annrheumdis-2013-204250] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 12/15/2013] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The mechanisms underlying the increased cardiovascular risk (CVR) of rheumatoid arthritis (RA) patients remain unclear. Since the recently discovered angiogenic T cells (Tang) could have a role in endothelial repair through cooperating with endothelial progenitor cells (EPC), the main aim of this study was to analyse the Tang and EPC populations in relation to disease-specific features and traditional CVR factors. METHODS Tang (CD3(+)CD31(+)CXCR4(+)) and EPC (CD34(+)VEGFR2(+)CD133(+)) populations were quantified by flow cytometry in peripheral blood samples from 103 RA patients and 18 matched healthy controls (HC). Clinical features and traditional CVR factors were obtained from clinical records, and 28-joint Disease Activity Score was used for measuring disease activity. Interferon (IFN) α serum levels were measured by immunoassays. RESULTS Tang and EPC were strongly decreased in RA patients. In HC, but not in patients, both populations were positively correlated and inversely related to low density lipoprotein- and total-cholesterol levels. Sex, diabetes, dyslipidaemia, hypertension or obesity did not significantly influence Tang in patients, although detected in smokers. However, Tang were closely related to disease activity, autoantibody positivity and IFNα levels. Multiple regression analysis adjusted for traditional CVR factors confirmed that only disease activity, age at diagnosis, antinuclear antibody positivity and smoking habit could predict Tang frequency. Finally, patients who had suffered a CV event since their RA diagnosis presented higher Tang decrease and IFNα levels than those who were CV event-free. CONCLUSIONS Disease-specific parameters, including disease activity, autoantibody profiles and IFNα levels, are associated with Tang decrease in RA, thus probably accounting for CVR.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Asturias, Spain
| | - Mercedes Alperi-López
- Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Patricia López
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Asturias, Spain
| | - Sara Alonso-Castro
- Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Ana Suárez
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Asturias, Spain
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Torres T, Chiricozzi A, Chimenti S, Saraceno R. Genetic Markers for Cardiovascular Disease in Psoriasis: The Missing Piece. Mol Diagn Ther 2013; 18:93-5. [DOI: 10.1007/s40291-013-0056-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Dessein PH, Woodiwiss AJ, Norton GR, Solomon A. Rheumatoid arthritis is associated with reduced adiposity but not with unfavorable major cardiovascular risk factor profiles and enhanced carotid atherosclerosis in black Africans from a developing population: a cross-sectional study. Arthritis Res Ther 2013; 15:R96. [PMID: 23968456 PMCID: PMC3979152 DOI: 10.1186/ar4276] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 08/22/2013] [Indexed: 01/05/2023] Open
Abstract
Introduction Rheumatoid arthritis (RA) is characterized by inflamed joint-derived cytokine-mediated high-grade systemic inflammation that enhances cardiovascular metabolic risk and disease in developed populations. We investigated the potential impact of RA on cardiovascular risk factors including systemic inflammation and atherosclerosis, and their relationships in black Africans from a developing population. Methods We evaluated demographic features, adiposity indices, major traditional cardiovascular risk factors, circulating C-reactive protein and interleukin-6 concentrations and ultrasound determined carotid intima-media thickness (cIMT) in 274 black Africans; 115 had established RA. Data were analyzed in confounder-adjusted mixed regression models. Results The body mass index and waist-height ratio were lower in RA compared to non-RA subjects (29.2 (6.6) versus 33.7 (8.0), P < 0.0001 and 0.58 (0.09) versus 0.62 (0.1), P = 0.0003, respectively). Dyslipidemia was less prevalent in patients with RA (odds ratio (OR) (95% confidence interval (CI) = 0.54 (0.30 to1.00)); this disparity was no longer significant after further adjustment for reduced adiposity and chloroquine use. RA was also not associated with hypertension, current smoking and diabetes. The number of major traditional risk factors did not differ by RA status (1.1 (0.8) versus 1.2 (0.9), P = 0.7). Circulating C-reactive protein concentrations were similar and serum interleukin-6 concentrations reduced in RA (7.2 (3.1) versus 6.7 (3.1) mg/l, P = 0.7 and 3.9 (1.9) versus 6.3 (1.9) pg/ml, P < 0.0001, respectively). The cIMT was 0.700 (0.085) and 0.701 (0.111) mm in RA and non-RA subjects, respectively (P = 0.7). RA disease activity and severity parameters were consistently unrelated to systemic inflammation, despite the presence of clinically active disease in 82.6% of patients. In all participants, adiposity indices, smoking and converting angiotensin inhibitor non-use were associated with increased systemic inflammation, which related to more atherogenic lipid profiles, and circulating low density lipoprotein concentrations were associated with cIMT (partial R = 0.153, P = 0.032); RA did not impact on these relationships (interaction P ≥0.1). Conclusions Among black Africans, patients with established RA experience reduced overall and abdominal adiposity but no enhanced major traditional risk factor and atherosclerosis burden. This study further suggests that an absent interleukin-6 release by inflamed RA joints into the circulation may account for this unaltered cardiovascular disease risk.
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Corrales A, Parra JA, González-Juanatey C, Rueda-Gotor J, Blanco R, Llorca J, González-Gay MA. Cardiovascular risk stratification in rheumatic diseases: carotid ultrasound is more sensitive than Coronary Artery Calcification Score to detect subclinical atherosclerosis in patients with rheumatoid arthritis. Ann Rheum Dis 2013; 72:1764-70. [DOI: 10.1136/annrheumdis-2013-203688] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Amaya-Amaya J, Sarmiento-Monroy JC, Mantilla RD, Pineda-Tamayo R, Rojas-Villarraga A, Anaya JM. Novel risk factors for cardiovascular disease in rheumatoid arthritis. Immunol Res 2013; 56:267-86. [DOI: 10.1007/s12026-013-8398-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Verschuren JJW, Ocak G, Dekker FW, Rabelink TJ, Jukema JW, Rotmans JI. Candidate gene analysis of arteriovenous fistula failure in hemodialysis patients. Clin J Am Soc Nephrol 2013; 8:1358-66. [PMID: 23559680 DOI: 10.2215/cjn.11091012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Arteriovenous fistula (AVF) failure remains an important cause of morbidity in hemodialysis patients. The exact underlying mechanisms responsible for AVF failure are unknown but processes like proliferation, inflammation, vascular remodeling, and thrombosis are thought to be involved. The current objective was to investigate the association between AVF failure and single nucleotide polymorphisms (SNPs) in genes related to these pathophysiologic processes in a large population of incident hemodialysis patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A total of 479 incident hemodialysis patients were included between January 1997 and April 2004. Follow-up lasted 2 years or until AVF failure, defined as surgery, percutaneous endovascular intervention, or abandonment of the vascular access. Forty-three SNPs in 26 genes, related to proliferation, inflammation, endothelial function, vascular remodeling, coagulation, and calcium/phosphate metabolism, were genotyped. Relations were analyzed using Cox regression analysis. RESULTS In total, 207 (43.2%) patients developed AVF failure. After adjustment, two SNPs were significantly associated with an increased risk of AVF failure. The hazard ratio (95% confidence interval) of LRP1 rs1466535 was 1.75 (1.15 to 2.66) and patients with factor V Leiden had a hazard ratio of 2.54 (1.41 to 4.56) to develop AVF failure. The other SNPs were not associated with AVF failure. CONCLUSIONS In this large cohort of hemodialysis patients, only 2 of the 43 candidate SNPs were associated with an increased risk of AVF failure. Whether other factors, like local hemodynamic circumstances, are more important or other SNPs play a role in AVF failure remains to be elucidated.
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Corrales A, González-Juanatey C, Peiró ME, Blanco R, Llorca J, González-Gay MA. Carotid ultrasound is useful for the cardiovascular risk stratification of patients with rheumatoid arthritis: results of a population-based study. Ann Rheum Dis 2013; 73:722-7. [PMID: 23505241 DOI: 10.1136/annrheumdis-2012-203101] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine if the use of carotid ultrasonography (US) may improve the stratification of the cardiovascular (CV) risk in rheumatoid arthritis (RA). METHODS A set of 370 consecutive patients without history of CV events were studied to assess carotid intima-media thickness (cIMT) and plaques. As previously proposed, CV risk was calculated according to the modified EULAR systematic coronary risk evaluation (mSCORE) for RA that was adapted by the application of a multiplier factor of 1.5 in those patients fulfilling ≥ 2 of 3 specific criteria. RESULTS The mean disease duration was 9.8 years, 250 (68%) had rheumatoid factor/anticyclic citrullinated peptide positivity and 61 (17%) extra-articular manifestations. 43 were excluded because they had type 2 diabetes mellitus or severe chronic kidney disease. CV risk was categorised in the remaining 327 RA patients according to the mSCORE: mild (96 cases; 29.3%), moderate (201; 61.5%) and high/very high risk (30; 9.2%). Only five patients were reclassified as having high/very high CV risk when the mSCORE was applied. Severe carotid US abnormalities (cIMT >0.90 mm and/or plaques) were uncommon in patients with low mSCORE (13%). Nevertheless, in patients with moderate mSCORE, severe carotid US abnormalities were observed in 63% of cases. A model that included a chart mSCORE risk ≥ 5% plus the presence of severe carotid US findings in patients with moderate mSCORE risk (≥ 1% and <5%) yielded high sensitivity for high/very high CV risk (93 (95% CI 88 to 96)). CONCLUSIONS Our results support the use of carotid US in the assessment of CV risk in patients with RA.
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Affiliation(s)
- Alfonso Corrales
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, , Santander, Spain
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Kerola AM, Kerola T, Kauppi MJ, Kautiainen H, Virta LJ, Puolakka K, Nieminen TVM. Cardiovascular comorbidities antedating the diagnosis of rheumatoid arthritis. Ann Rheum Dis 2012. [PMID: 23178207 DOI: 10.1136/annrheumdis-2012-202398] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the prevalence of coronary heart disease (CHD) and chronic hypertension among patients with rheumatoid arthritis (RA) at the time of diagnosis, in comparison with age-specific and sex-specific non-RA subjects. Furthermore, the impacts of age at the onset of RA, as well as gender and the presence of rheumatoid factor (RF) on the risk of these comorbidities, were evaluated. METHODS A cohort of 7209 RA patients diagnosed between January 2004 and December 2007 was identified, based on a Finnish nationwide register on special reimbursements for medication costs. The presence of CHD and chronic hypertension antedating the diagnosis of RA was identified from the same register. The prevalence of the cardiovascular comorbidities was compared with the general Finnish population, and a standardised rate ratio (SRR) for both these cardiovascular diseases was calculated. RESULTS The risk of having CHD at RA diagnosis was slightly elevated, the SRR being 1.10 (95% CI 1.01 to 1.20). Younger age at the onset of RA seemed to be related with higher SRR for CHD. In a subset analysis, an increased prevalence of hypertension (SRR 1.19, 95% CI 1.10 to 1.30) and CHD (SRR 1.15, 95% CI 1.00 to 1.32) was apparent only among the RF negative RA cases. CONCLUSIONS The SRR for CHD is augmented in RA patients already at disease onset, and more pronouncedly in early onset RA. The findings highlight the importance of early prevention of atherosclerosis, regardless of RF status.
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Affiliation(s)
- Anne M Kerola
- Medical School, University of Helsinki, , Helsinki, Finland
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Cardiovascular disease in rheumatoid arthritis: a systematic literature review in latin america. ARTHRITIS 2012. [PMID: 23193471 PMCID: PMC3501796 DOI: 10.1155/2012/371909] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background. Cardiovascular disease (CVD) is the major predictor of poor prognosis in rheumatoid arthritis (RA) patients. There is an increasing interest to identify "nontraditional" risk factors for this condition. Latin Americans (LA) are considered as a minority subpopulation and ethnically different due to admixture characteristics. To date, there are no systematic reviews of the literature published in LA and the Caribbean about CVD in RA patients. Methods. The systematic literature review was done by two blinded reviewers who independently assessed studies for eligibility. The search was completed through PubMed, LILACS, SciELO, and Virtual Health Library scientific databases. Results. The search retrieved 10,083 potential studies. A total of 16 articles concerning cardiovascular risk factors and measurement of any cardiovascular outcome in LA were included. The prevalence of CVD in LA patients with RA was 35.3%. Non-traditional risk factors associated to CVD in this population were HLA-DRB1 shared epitope alleles, rheumatoid factor, markers of chronic inflammation, long duration of RA, steroids, familial autoimmunity, and thrombogenic factors. Conclusions. There is limited data about CVD and RA in LA. We propose to evaluate cardiovascular risk factors comprehensively in the Latin RA patient and to generate specific public health policies in order to diminish morbi-mortality rates.
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Atherosclerosis in rheumatoid arthritis. Mediators Inflamm 2012; 2012:489608. [PMID: 23125485 PMCID: PMC3483738 DOI: 10.1155/2012/489608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 09/30/2012] [Indexed: 12/03/2022] Open
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Corrales A, Robledo G, Castañeda S, Miranda-Filloy JA, Blanco R, Fernández-Gutiérrez B, Balsa A, González-Alvaro I, Gómez-Vaquero C, Llorca J, Martín J, González-Gay MA. Analysis of the interferon gamma (rs2430561, +874T/A) functional gene variant in relation to the presence of cardiovascular events in rheumatoid arthritis. PLoS One 2012; 7:e47166. [PMID: 23077565 PMCID: PMC3471910 DOI: 10.1371/journal.pone.0047166] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/10/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased cardiovascular (CV) morbidity and mortality. Since interferon-gamma (IFN-γ) has a direct effect on inflammation, in this study we assessed the potential association of the IFNG functional gene variant rs2430561 with CV disease in patients with RA. METHODS One thousand six hundred and thirty-five patients fulfilling the 1987 American College of Rheumatology classification criteria for RA were genotyped for the IFNG (rs2430561, +874T/A) gene polymorphism using TaqMan genotyping assay. Patients were stratified according to the presence of CV events or not. Logistic regression models to explain the presence of CV disease according to the IFNG rs2430561 allele distribution were performed. The potential influence of this variant in the development of subclinical atherosclerosis was also analyzed in a subgroup of patients with no history of CV events to determine carotid artery intima-media thickness (IMT) (n = 286) and presence of carotid plaques. Levels of the cytokine were determined in a subgroup of patients by ELISA. RESULTS Adjusted logistic regression model disclosed that presence of the minor allele A was not associated with increased risk of suffering CV events in RA patients. Besides, differences did not achieve statistical significance regarding carotid IMT and presence of carotid plaques in RA patients carrying IFNG rs2430561 variant allele. Levels of IFN-γ were higher in patients who had suffered CV events compared to patients who did not. CONCLUSION Our results do not support a role of IFNG rs2430561 (+874T/A) functional gene variant in the development of CV disease in RA patients.
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Affiliation(s)
- Mercedes García-Bermúdez
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas, IPBLN-C.S.I.C., Granada, Spain
| | - Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Alfonso Corrales
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | - Gema Robledo
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas, IPBLN-C.S.I.C., Granada, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain
| | | | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Carmen Gómez-Vaquero
- Department of Rheumatology, Hospital Universitario de Bellvitge, IDIBELL, ĹHospitalet del Llobregat, Barcelona, Spain
| | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV, Santander, Spain
| | - Javier Martín
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas, IPBLN-C.S.I.C., Granada, Spain
| | - Miguel A. González-Gay
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
- * E-mail:
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Atherosclerosis and rheumatoid arthritis: more than a simple association. Mediators Inflamm 2012; 2012:147354. [PMID: 23024462 PMCID: PMC3449150 DOI: 10.1155/2012/147354] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 07/10/2012] [Indexed: 11/17/2022] Open
Abstract
In the last decades a large amount of evidence linked rheumatoid arthritis (RA) to atherosclerosis. In fact, RA patients have an increased risk of cardiovascular events that is not fully explained by other classic cardiovascular risk factors. RA and atherosclerosis may share several common pathomechanisms and inflammation undoubtedly plays a primary role. The proinflammatory cytokines such as tumor necrosis factor alpha and interleukin-6, involved in the pathogenesis of RA, are also independently predictive of subsequent cardiovascular disease (CVD). In RA, inflammation alters HDL constituents and the concentration of LDL and HDL, thus facilitating atherosclerosis and CVD events. On the other hand, also the increase of oxidative processes, frequently observed in RA, induces atherosclerosis. Interestingly, some genetic polymorphisms associated with RA occurrence enhance atherosclerosis, however, other polymorphisms associated with RA susceptibility do not increase CVD risk. Several other mechanisms may influence atherosclerotic processes in RA. Moreover, atherosclerosis may be directly mediated also by underlying autoimmune processes, and indirectly by the occurrence of metabolic syndrome and impaired physical activity. Finally, the effects of RA therapies on cardiovascular system in general and on atherosclerosis in particular are really wide and different. However, the starting point of every RA treatment is that disease control, or better remission, is the best way we have for the reduction of CVD occurrence.
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González-Gay M, González-Vela C, González-Juanatey C. Psoriasis: una enfermedad cutánea relacionada con riesgo cardiovascular elevado. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:595-8. [DOI: 10.1016/j.ad.2012.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 10/30/2011] [Accepted: 01/15/2012] [Indexed: 01/06/2023] Open
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González-Gay M, González-Vela C, González-Juanatey C. Psoriasis: a Skin Disease Associated With Increased Cardiovascular Risk. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Boechat NDO, Ogusku MM, Boechat AL, Sadahiro A. Interaction between smoking and HLA-DRB1*04 gene is associated with a high cardiovascular risk in Brazilian Amazon patients with rheumatoid arthritis. PLoS One 2012; 7:e41588. [PMID: 22912672 PMCID: PMC3418250 DOI: 10.1371/journal.pone.0041588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 06/22/2012] [Indexed: 12/14/2022] Open
Abstract
Background Rheumatoid Arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joints that affects approximately 1% of the population worldwide. The HLA-DRB1 gene locus plays a major role in genetic susceptibility to RA, a condition that has been associated with a high cardiovascular morbidity and mortality in many studies. Methodology/Principal Findings The aim of this work was to investigate which types of HLA class II genes are associated with RA in patients from the Brazilian Amazon and their influence on high cardiovascular risk status in this population. For this purpose, a case-control study was carried out with a total of 350 non-Indian individuals made up of a cohort of 132 consecutive RA sufferers and 218 healthy controls. A χ2 test showed that HLADRB1*04 (p<0.0016; OR = 1.89; 95% CI = 1.29–2.79) and HLADRB1*10 (p = 0.0377; OR = 3.81; 95% CI = 1.16–12.50) are the major HLA genes associated with susceptibility to RA. A logistic regression model also showed that the interaction between HLADRB1*04 (p = 0.027; OR = 6.02; 95% CI = 1.21–29.7), age (p = 0.0001; OR = 1.26; 95% CI = 1.13–1.39) and smoking (p = 0.0001; OR = 23.6; 95% CI = 4.25–32.1) is associated with a probability of a high cardiovascular risk status at an early age. Conclusions/Significance The results of this study show for the first time that HLA class II type is associated with RA in Brazilian Amazon populations and that a specific interaction between the HLA-DRB1*04 gene and smoking is associated with a high cardiovascular risk status, as initially reported in the European population. This study therefore contributes to an understanding of gene-environment interactions in RA patients.
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Affiliation(s)
- Narjara de Oliveira Boechat
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brasil
- Clínica de Artrite Reumatoide, Hospital Geral Adriano Jorge, Manaus, Brasil
| | - Mauricio Morish Ogusku
- Laboratório de Micobacteriologia, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Amazonas, Brasil
| | - Antonio Luiz Boechat
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brasil
- Clínica de Artrite Reumatoide, Hospital Geral Adriano Jorge, Manaus, Brasil
- * E-mail:
| | - Aya Sadahiro
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brasil
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Genetic markers of cardiovascular disease in rheumatoid arthritis. Mediators Inflamm 2012; 2012:574817. [PMID: 22927710 PMCID: PMC3419432 DOI: 10.1155/2012/574817] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 05/28/2012] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular (CV) disease is the most common cause of premature mortality in patients with rheumatoid arthritis (RA). It is the result of an accelerated atherosclerotic process. Both RA and atherosclerosis are complex polygenic diseases. Besides traditional CV risk factors and chronic inflammation, a number of studies have confirmed the role of genetic factors in the development of the atherogenesis observed in RA. In this regard, besides a strong association between the HLA-DRB1∗04 shared epitope alleles and both endothelial dysfunction, an early step in the atherosclerotic process, and clinically evident CV disease, other polymorphisms belonging to genes implicated in inflammatory and metabolic pathways, located inside and outside the HLA region, such as the 308 variant (G > A, rs1800629) of the TNFA locus, the rs1801131 polymorphism (A > C; position + 1298) of the MTHFR locus, or a deletion of 32 base pairs on the CCR5 gene, seem to be associated with the risk of CV disease in patients with RA. Despite considerable effort to decipher the genetic basis of CV disease in RA, further studies are required to better establish the genetic influence in the increased risk of CV events observed in patients with RA.
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Corrales A, Castañeda S, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, González-Álvaro I, Llorca J, Martín J, González-Gay MA. Association Study of MIA3 rs17465637 Polymorphism with Cardiovascular Disease in Rheumatoid Arthritis Patients. DNA Cell Biol 2012; 31:1412-7. [DOI: 10.1089/dna.2012.1672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Alfonso Corrales
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | - Santos Castañeda
- Rheumatology Department, Hospital Universitario la Princesa, IIS-Princesa, Madrid, Spain
| | | | | | | | - Alejandro Balsa
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
| | | | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV, Santander, Spain
| | - Javier Martín
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Miguel A. González-Gay
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
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Abstract
PURPOSE OF REVIEW To highlight recent evidence regarding the contribution of traditional and nontraditional [e.g. inflammatory markers, rheumatoid arthritis (RA) features] risk factors toward the excess cardiovascular risk in RA. RECENT FINDINGS The impact of traditional risk factors on the development of cardiovascular disease in persons with RA is an area of active research. Some are more prevalent among people with RA (e.g. smoking); others appear to have paradoxical relationships (e.g. body mass index), and findings remain inconsistent with others (e.g. dyslipidemia). Collectively the data suggest that cardiovascular risk factors behave differently in RA. Thus, risk scores developed for the general population based on traditional cardiovascular risk factors alone are unlikely to accurately estimate cardiovascular risk in RA, highlighting the need for RA-specific risk prediction tools.Nontraditional risk factors, in particular RA disease activity/severity measures, including inflammatory markers, disease activity scores, seropositivity, physical disability, destructive changes on joint radiographs, extra-articular manifestations, and corticosteroid use, have repeatedly shown significant associations with increased cardiovascular risk. Medications used to treat RA may also affect cardiovascular risk. A recent meta-analysis suggests that all nonsteroidal anti-inflammatory drugs confer some cardiovascular risk. The cardiovascular risks/benefits associated with use of disease-modifying antirheumatic drugs and/or biologics remain controversial, as does the role of statins in RA. SUMMARY Cardiovascular disease remains a major problem for people with RA. Future work should focus on further delineating the underlying biological mechanisms involved, developing and evaluating risk assessment tools and biomarkers, as well as prevention/treatment strategies specific to the RA population.
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Role of adipokines in atherosclerosis: interferences with cardiovascular complications in rheumatic diseases. Mediators Inflamm 2012; 2012:125458. [PMID: 22910888 PMCID: PMC3403095 DOI: 10.1155/2012/125458] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 06/19/2012] [Indexed: 01/08/2023] Open
Abstract
Patients with rheumatic diseases have an increased risk of mortality by cardiovascular events. In fact, several rheumatic diseases such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis are associated with a higher prevalence of cardiovascular diseases (CVDs). Although traditional cardiovascular risk factors have been involved in the pathogenesis of cardiovascular diseases in rheumatic patients, these alterations do not completely explain the enhanced cardiovascular risk in this population. Obesity and its pathologic alteration of fat mass and dysfunction, due to an altered pattern of secretion of proinflammatory adipokines, could be one of the links between cardiovascular and rheumatic diseases. Indeed, the incidence of CVDs is augmented in obese individuals with rheumatic disorders. Thus, in this paper we explore in detail the relationships among adipokines, rheumatic diseases, and cardiovascular complications by giving to the reader a holistic vision and several suggestions for future perspectives and potential clinical implications.
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Louvain de Souza T, de Souza Campos Fernandes RC, Medina-Acosta E. HIV-1 control in battlegrounds: important host genetic variations for HIV-1 mother-to-child transmission and progression to clinical pediatric AIDS. Future Virol 2012. [DOI: 10.2217/fvl.12.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
HIV-1 mother-to-child transmission (MTCT) is the passing of maternal HIV-1 to the offspring during pregnancy, labor and delivery, and/or breastfeeding. HIV-1 MTCT and the evolution to pediatric AIDS are multifactorial, dynamic and variable phenotypic conditions. Both genetic and nongenetic variables can influence susceptibility to HIV-1 MTCT or the rate of progression to clinical pediatric AIDS. In this review, we summarize the current state of knowledge about the roles of genetic variations seen in host immune response genes, and those that have been independently associated, mostly through population genetics of candidate genes, with interindividual susceptibility to HIV-1 MTCT, and progression to pediatric AIDS. We examine common and rare host genetic variations at coding and noncoding polymorphisms, whether functional or not, in agonists and antagonists of the immune response, which have been implicated in HIV-1 control in battlegrounds of cell entry, replication and evolution to AIDS. Further, we point to over 380 single-nucleotide polymorphisms, mostly within the HLA super region, recently identified in unbiased genome-wide association studies of HIV replication and evolution in adults, still unexplored in the context of HIV-1 MTCT, and which are likely to also influence susceptibility to pediatric HIV-1/AIDS.
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Affiliation(s)
- Thais Louvain de Souza
- Molecular Identification & Diagnosis Unit, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Brazil
| | - Regina Célia de Souza Campos Fernandes
- Municipal Program for the Surveillance of Sexually Transmitted Diseases & Acquired Immunodeficiency Syndrome of Campos dos Goytacazes, Brazil
- Faculty of Medicine of Campos, Campos dos Goytacazes, Brazil
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Solomon A, Woodiwiss AJ, Abdool-Carrim AT, Stevens BA, Norton GR, Dessein PH. The carotid artery atherosclerosis burden and its relation to cardiovascular risk factors in black and white Africans with established rheumatoid arthritis: a cross-sectional study. J Rheumatol 2012; 39:1798-806. [PMID: 22753659 DOI: 10.3899/jrheum.120073] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Black Africans currently experience a distinctly low frequency of atherosclerotic cardiovascular disease. Whether this protection persists in those with rheumatoid arthritis (RA) is unknown. We compared the carotid atherosclerosis burden and its relationships with cardiovascular (CV) risk factors between Africans with RA from a developing black and developed CV population. METHODS We performed high resolution B-mode ultrasonography and assessed CV risk factors in 243 patients with established RA, of whom 121 were black and 122 white. Data were analyzed in age, sex, and healthcare center-adjusted regression models. RESULTS The mean±SD common carotid intima-media thickness (cIMT) was 0.694±0.097 mm in black and 0.712±0.136 mm in white patients (adjusted p=0.8). Plaque prevalence was also similar in black compared to white cases (35.5% and 44.3%, respectively; adjusted OR 0.83, 95% CI 0.32-2.20, p=0.7). Interactions between population grouping and several CV risk factors were independently associated with cIMT and plaque. In stratified analysis, that is, in each population group separately, risk factors associated with cIMT or/and plaque comprised the systolic blood pressure (p=0.02), serum cholesterol/high-density lipoprotein cholesterol ratio (p=0.004), C-reactive protein concentrations (p=0.01), and the presence of extraarticular manifestations (p=0.01) in whites but, contrastingly, the Arthritis Impact Measurement Scales tension score (p=0.04) and use of nonsteroidal antiinflammatory agent (p=0.03) in black patients. The Framingham score was significantly associated with atherosclerosis only in whites (p<0.0001). CONCLUSION The carotid atherosclerosis burden is similar in black compared to white Africans with RA, but relationships between modifiable CV risk factors and atherosclerosis vary substantially among Africans with RA.
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Affiliation(s)
- Ahmed Solomon
- Department of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, PO Box 1012, Melville 2109, Johannesburg, South Africa
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López-Mejías R, García-Bermúdez M, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, González-Álvaro I, Llorca J, Martín J, González-Gay MA. NFKB1-94ATTG ins/del polymorphism (rs28362491) is associated with cardiovascular disease in patients with rheumatoid arthritis. Atherosclerosis 2012; 224:426-9. [PMID: 22742859 DOI: 10.1016/j.atherosclerosis.2012.06.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 05/22/2012] [Accepted: 06/04/2012] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is an inflammatory disease associated with increased cardiovascular (CV) mortality. A recent study has disclosed association between NFKB1-94ATTG ins/del polymorphism and higher risk of coronary heart disease in healthy Caucasians. Because of that, we assessed the influence of this polymorphism in the risk of CV disease in RA patients. MATERIAL AND METHODS 1437 Spanish patients with RA were genotyped for the NFKB1-94ATTG ins/del polymorphism. Two hundred and seventy-one of them (18.8%) had experienced CV events. RESULTS After adjusting for sex, age at RA diagnosis and traditional CV risk factors RA patients carrying the NFKB1 del/del genotype had higher risk of CV events than those with ins/ins genotype (Hazard ratio [HR] = 1.76, 95% CI: 1.05-2.97, p = 0.03), while heterozygous patients had an intermediate (but non-significant) risk (HR = 1.31, 95% CI: 0.90-1.92, p = 0.16). CONCLUSION Our results suggest that NFKB1-94ATTG ins/del polymorphism is associated with CV disease in patients with RA.
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Affiliation(s)
- Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, s/n 39008 Santander, Spain
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Blanco R, Fernández-Gutiérrez B, Balsa A, González-Álvaro I, Gómez-Vaquero C, Llorca J, Martín J, González-Gay MA. Association of the methionine sulfoxide reductase A rs10903323 gene polymorphism with cardiovascular disease in patients with rheumatoid arthritis. Scand J Rheumatol 2012; 41:350-3. [DOI: 10.3109/03009742.2012.677063] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chen Y, Dawes PT, Packham JC, Mattey DL. Interaction between smoking and functional polymorphism in the TGFB1 gene is associated with ischaemic heart disease and myocardial infarction in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2012; 14:R81. [PMID: 22513132 PMCID: PMC3446455 DOI: 10.1186/ar3804] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 03/15/2012] [Accepted: 04/18/2012] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION Transforming growth factor-beta1 (TGF-beta1) is a pleiotropic cytokine that plays important roles in immunity and inflammation. Some studies have suggested that polymorphism in the TGFB1 gene is associated with heart disease in the general population. The purpose of the present study was to determine whether common single-nucleotide polymorphisms (SNP) in the TGFB1 gene are associated with ischaemic heart disease (IHD) and/or myocardial infarction (MI) in patients with rheumatoid arthritis (RA), and to investigate the influence of smoking on any association. METHODS PCR-based assays were used to determine the genotypes of TGFB1 SNPs including TGFB1-509 C/T (rs1800469, in the promoter region), +868 T/C (rs1800470, in exon 1) and +913 G/C (rs1800471, in exon 1) in 414 subjects with established RA. Genotyping for the +868 SNP was also carried out on a second study population of RA patients (n = 259) with early disease. Serum levels of TGF-beta1 were measured using a commercial ELISA kit. Smoking history and IHD/MI status were obtained on each patient. Associations with IHD/MI were assessed using contingency tables and logistic regression analyses. RESULTS The heterozygous genotype of TGFB+868 was associated with an increased risk of IHD (OR 2.14, 95% CI 1.30 - 3.55) and MI (OR 2.42, 95% CI 1.30-4.50), compared to the homozygous genotypes combined. Smoking was an independent risk for IHD and MI, and evidence of interaction between smoking and TGFB+868 was found. Multivariate analyses indicated that the strongest associations with IHD and MI were due to the combined effect of the TGFB1+868 TC genotype and smoking (OR 2.75, 95% CI 1.59-4.75; and OR 2.58 95% CI 1.33-4.99, respectively), independent of other cardiovascular risk factors. The association of the +868 TC genotype and evidence of +868 TC-smoking interaction with IHD were replicated in a second population of RA patients with early disease. Serum TGF-beta1 levels were not associated with TGFB1 genetic variations, smoking or IHD/MI status. CONCLUSIONS Interaction between smoking and polymorphism in the TGFB1 gene may influence the risk of IHD and MI in patients with RA.
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Affiliation(s)
- Ying Chen
- Haywood Rheumatology Centre, Haywood Hospital, High Lane, Burslem, Stoke-on-Trent, Staffordshire, ST6 7AG, UK
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ÄRLESTIG LISBETH, RANTAPÄÄ-DAHLQVIST SOLBRITT. Polymorphisms of the Genes EncodingCD40and Growth Differentiation Factor 15 and in the 9p21.3 Region in Patients with Rheumatoid Arthritis and Cardiovascular Disease. J Rheumatol 2012; 39:939-45. [DOI: 10.3899/jrheum.111336] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective.Genes or gene products associated with coronary artery disease in the general population were analyzed in rheumatoid arthritis (RA) patients with atherothrombotic manifestations (ATM).Methods.A cross-sectional study of 681 individuals (498 women; 183 men) with RA (American College of Rheumatology criteria), a mean age of 60.6 ± 13.2 years, and mean disease duration of 15.5 ± 12.6 years who were consecutively recruited and followed for 6 years. The prevalence of ATM [i.e., myocardial infarction, angina pectoris with intervention, deep vein thrombosis/pulmonary embolism (DVT/PE), and/or stroke/transient ischemic attack (TIA)] was recorded. Polymorphisms were analyzed in the genes coding for growth differentiation factor 15 (GDF15)/monocyte inhibitory cytokine-1 (MIC-1; rs1058587),CD40(rs1535045 and rs3765459), and the 9p21.3 locus (rs1333049). Controls were randomly selected (n = 687; matched for age and sex).Results.The distribution of genotypes ofGDF15/MIC-1differed significantly between patients with RA and controls (chi-squared = 6.40, 2 df, p = 0.041). ATM were associated with polymorphism of theGDF15/MIC-1G allele (OR 2.21, 95% CI 1.17–4.18), and with CC genotype of the 9p21.3 locus (rs1333049; OR 1.92, 95% CI 1.15–3.19). Stroke/TIA in women was associated withGDF15/MIC-1GG genotype (OR 3.75, 95% CI 1.06–13.33), while stroke/TIA in men was associated withCD40homozygous major alleles (OR 6.48, 95% CI 1.31–32.0 and OR 2.78, 95% CI 0.78–9.91, respectively). DVT/PE was associated with polymorphism in theGDF15/MIC-1gene (rs1058587) minor allele (OR 3.53, 95% CI 1.30–9.58).Conclusion.The gene polymorphisms analyzed were associated with different ATM in RA. TheGDF15/MIC-1gene polymorphism was also associated with RAper se, suggesting a common etiology for RA and ATM.
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López-Mejías R, González-Juanatey C, García-Bermúdez M, Castañeda S, Miranda-Filloy JA, Blanco R, Llorca J, Martín J, González-Gay MA. The lp13.3 genomic region -rs599839- is associated with endothelial dysfunction in patients with rheumatoid arthritis. Arthritis Res Ther 2012; 14:R42. [PMID: 22380622 PMCID: PMC3446409 DOI: 10.1186/ar3755] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 11/08/2011] [Accepted: 03/01/2012] [Indexed: 01/16/2023] Open
Abstract
Introduction Rheumatoid arthritis (RA) is an inflammatory disease associated with accelerated atherosclerosis and high risk of cardiovascular (CV) disease. Since genome-wide association studies demonstrated association between rs599839 polymorphism and coronary artery disease, in the present study we assessed the potential association of this polymorphism with endothelial dysfunction, an early step in atherogenesis. Methods A total of 128 RA patients without history of CV events were genotyped for rs599839 A/G polymorphism. The presence of endothelial dysfunction was assessed by brachial ultrasonography (brachial flow-mediated endothelium-dependent (FMD)). Results Patients carrying the allele G exhibited more severe endothelial dysfunction (FMD%: 4.61 ± 3.94%) than those carrying the wild allele A (FMD%: 6.01 ± 5.15%) (P = 0.08). Adjustment for gender, age at the time of study, follow-up time and classic CV risk factors disclosed a significant association between the rs599839 polymorphism and FMD (G vs. A: P = 0.0062). Conclusions Our results confirm an association of the rs599839 polymorphism with endothelial dysfunction in RA.
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Affiliation(s)
- Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
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García-Bermúdez M, López-Mejías R, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Blanco R, Fernández-Gutiérrez B, Balsa A, González-Alvaro I, Gómez-Vaquero C, Llorca J, Martín J, González-Gay MA. Lack of association between TLR4 rs4986790 polymorphism and risk of cardiovascular disease in patients with rheumatoid arthritis. DNA Cell Biol 2012; 31:1214-20. [PMID: 22360682 DOI: 10.1089/dna.2011.1582] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased cardiovascular (CV) mortality. Toll-like receptor-4 (TLR4) activates the innate immune response via NF-kB pathway and mitogen-activated protein kinase signaling, leading to expression of proinflammatory cytokines and chemokines. The G allele of TLR4 rs4986790 (+896A>G, Asp299Gly) gene polymorphism has been implicated in reduction of risk of atherosclerosis. In this study, 1481 RA patients fulfilling the 1987 American College of Rheumatology (ACR) criteria were genotyped for the rs4986790 TLR4 variant to determine the influence of this variant in the risk of CV events in these patients. Also, HLA-DRB1 status was determined using molecular based methods. Moreover, potential influence of rs4986790 variant in the development of subclinical atherosclerosis was assessed in a subgroup of RA patients with no history of CV events by the measurement of surrogate markers of subclinical atherosclerosis. No statistically significant differences in allele or genotype frequencies for the rs4986790 variant between RA patients who experienced CV events or not were found. Likewise, no significant association between this gene variant and any of the surrogate markers of subclinical atherosclerosis was found. In summary, results in our study do not support the hypothesis that the rs4986790 (+896A>G, Asp299Gly) TLR4 variant may influence predisposition for subclinical atherosclerosis and clinically evident CV disease in RA patients.
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López-Mejías R, García-Bermúdez M, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, González-Álvaro I, Llorca J, Martín J, González-Gay MA. Lack of association between the CXCL12 rs501120 polymorphism and cardiovascular disease in Spanish patients with rheumatoid arthritis. Hum Immunol 2012; 73:543-6. [PMID: 22386691 DOI: 10.1016/j.humimm.2012.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 02/07/2012] [Accepted: 02/10/2012] [Indexed: 02/03/2023]
Abstract
Rheumatoid arthritis (RA) is an inflammatory disease associated with accelerated atherosclerosis. CXCL12 is a strong chemotactic signal for lymphocytes. Because previous genome-wide association studies demonstrated an association between CXCL12 rs501120 and coronary artery disease, in the present study we assessed the potential association of this polymorphism with the risk of cardiovascular (CV) disease in 1,321 Spanish patients with RA. A subgroup of patients without CV events was also studied to determine the presence of subclinical atherosclerosis by ultrasonography (brachial flow-mediated endothelium-dependent vasodilatation and carotid intima-media wall thickness). However, no significant differences in genotypic and allelic frequencies between RA patients with and without CV events were observed, as was also the case when values of surrogate markers of atherosclerosis were assessed according to CXCL12 rs501120 genotype frequencies. In conclusion, our results do not confirm an association of the CXCL12 rs501120 polymorphism with atherosclerosis or with CV disease in RA.
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Affiliation(s)
- Raquel López-Mejías
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, 39008 Santander, Spain.
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Lack of association between IL6 single nucleotide polymorphisms and cardiovascular disease in Spanish patients with rheumatoid arthritis. Atherosclerosis 2011; 219:655-8. [DOI: 10.1016/j.atherosclerosis.2011.07.124] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 07/30/2011] [Accepted: 07/31/2011] [Indexed: 11/19/2022]
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Subclinical atherosclerosis and endothelial dysfunction in patients with early rheumatoid arthritis as evidenced by measurement of carotid intima-media thickness and flow-mediated vasodilatation: an observational study. Semin Arthritis Rheum 2011; 41:669-75. [PMID: 22035626 DOI: 10.1016/j.semarthrit.2011.08.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 08/13/2011] [Accepted: 08/23/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE In this study, we aimed to investigate the frequency of endothelial dysfunction and subclinical atherosclerosis in early rheumatoid arthritis (RA) patients by carotid intima-media thickness (cIMT) and endothelial-dependent flow mediated vasodilatation (ED-FMD) as compared with healthy controls. METHODS The study included 35 early RA patients (disease duration <12 months) and 35 healthy controls. Intima-media thickness of common carotid artery and ED-FMD of brachial artery were measured by high-resolution ultrasonography. Disease activity of RA was assessed by Disease Activity Score and activities of daily living were determined by Health Assessment Questionnaire-Disability Index Score. RESULTS RA patients (age 38.3 ± 10.6 years) had average disease duration of 0.46 ± 0.28 years and 22 patients (62.9%) were rheumatoid factor (RF) positive (RF titer >9.56 IU/mL). There were no significant differences between age, sex, and lipid profiles of patient and control group. cIMT was significantly higher in RA patients (0.50 ± 0.16 mm) than in controls (0.44 ± 0.09 mm) (P = 0.007). Similarly, FMD% was significantly lower in RA patients [5.26 (2.9-10.6)] as compared with controls [10.34 (7.4-14.3)] (P = 0.004). Age, systolic blood pressure, tender joint count, and swollen joint count had significant correlations with patient cIMT. RF titer came out to be the major risk factor for increased cIMT of the patients. CONCLUSIONS Compared with controls, early RA patients have higher cIMT and lower FMD%, denoting premature atherosclerosis. Our data suggest that early determination of FMD% and cIMT may be useful tools to assess cardiovascular risk even in early RA patients.
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López-Mejías R, García-Bermúdez M, González-Juanatey C, Castañeda S, Miranda-Filloy JA, Gómez-Vaquero C, Fernández-Gutiérrez B, Balsa A, Pascual-Salcedo D, Blanco R, González-Álvaro I, Llorca J, Martín J, González-Gay MA. Lack of association of IL6R rs2228145 and IL6ST/gp130 rs2228044 gene polymorphisms with cardiovascular disease in patients with rheumatoid arthritis. ACTA ACUST UNITED AC 2011; 78:438-41. [DOI: 10.1111/j.1399-0039.2011.01774.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Teruel M, Martin JE, González-Juanatey C, López-Mejias R, Miranda-Filloy JA, Blanco R, Balsa A, Pascual-Salcedo D, Rodriguez-Rodriguez L, Fernández-Gutierrez B, Ortiz AM, González-Alvaro I, Gómez-Vaquero C, Bottini N, Llorca J, González-Gay MA, Martin J. Association of acid phosphatase locus 1*C allele with the risk of cardiovascular events in rheumatoid arthritis patients. Arthritis Res Ther 2011; 13:R116. [PMID: 21767392 PMCID: PMC3239354 DOI: 10.1186/ar3401] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 06/09/2011] [Accepted: 07/18/2011] [Indexed: 01/14/2023] Open
Abstract
Introduction Acid phosphatase locus 1 (ACP1) encodes a low molecular weight phosphotyrosine phosphatase implicated in a number of different biological functions in the cell. The aim of this study was to determine the contribution of ACP1 polymorphisms to susceptibility to rheumatoid arthritis (RA), as well as the potential contribution of these polymorphisms to the increased risk of cardiovascular disease (CV) observed in RA patients. Methods A set of 1,603 Spanish RA patients and 1,877 healthy controls were included in the study. Information related to the presence/absence of CV events was obtained from 1,284 of these participants. All individuals were genotyped for four ACP1 single-nucleotide polymorphisms (SNPs), rs10167992, rs11553742, rs7576247, and rs3828329, using a predesigned TaqMan SNP genotyping assay. Classical ACP1 alleles (*A, *B and *C) were imputed with SNP data. Results No association between ACP1 gene polymorphisms and susceptibility to RA was observed. However, when RA patients were stratified according to the presence or absence of CV events, an association between rs11553742*T and CV events was found (P = 0.012, odds ratio (OR) = 2.62 (1.24 to 5.53)). Likewise, the ACP1*C allele showed evidence of association with CV events in patients with RA (P = 0.024, OR = 2.43). Conclusions Our data show that the ACP1*C allele influences the risk of CV events in patients with RA.
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Affiliation(s)
- María Teruel
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Avd, del Conocimiento s/n, 18010, Granada, Spain.
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Emanuele E. Prediction of genetic risk for cardiovascular disease in patients with rheumatoid arthritis: Present and promises. Atherosclerosis 2011; 216:21-2. [DOI: 10.1016/j.atherosclerosis.2010.10.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 10/07/2010] [Indexed: 01/31/2023]
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