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Pusztai A, Hamar A, Horváth Á, Gulyás K, Végh E, Bodnár N, Kerekes G, Czókolyová M, Szamosi S, Bodoki L, Hodosi K, Domján A, Nagy G, Szöllősi I, Lopez LR, Matsuura E, Prohászka Z, Szántó S, Nagy Z, Shoenfeld Y, Szekanecz Z, Szűcs G. Soluble Vascular Biomarkers in Rheumatoid Arthritis and Ankylosing Spondylitis: Effects of 1-year Antitumor Necrosis Factor-α Therapy. J Rheumatol 2020; 48:821-828. [PMID: 33323530 DOI: 10.3899/jrheum.200916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with cardiovascular disease. The treatment of arthritis by tumor necrosis factor-α (TNF-α) inhibitors may decrease the serum concentrations of vascular biomarkers. We determined circulating levels of oxidized low-density lipoprotein (oxLDL)/β2 glycoprotein I (β2-GPI) complexes, antibodies to 60 kDa heat shock protein (anti-Hsp60), soluble urokinase plasminogen activator receptor (suPAR), and B-type natriuretic peptide (BNP) fragment in sera of RA and AS patients undergoing anti-TNF treatment. METHODS Fifty-three patients with RA/AS were treated with etanercept or certolizumab pegol for 1 year. Circulating oxLDL/β2-GPI complex (AtherOx), anti-Hsp60 IgG, and BNP8-29 fragment levels were assessed by ELISA. suPAR levels were determined by suPARnostic Quick Triage test. Flow-mediated vasodilation (FMD), carotid intima-media thickness (CIMT), and arterial pulse wave velocity (PWV) were determined by ultrasound. RESULTS One-year anti-TNF treatment significantly decreased oxLDL/β2-GPI levels, as well as suPAR levels in patients with critically high suPAR levels at baseline. In RA, BNP levels were higher in seropositive vs seronegative patients. Serum levels of these vascular biomarkers variably correlated with lipids, anticitrullinated protein antibodies, rheumatoid factor, and C-reactive protein. CIMT positively correlated with BNP, and PWV with suPAR and anti-Hsp60, whereas FMD inversely associated with anti-Hsp60. In repeated measures ANOVA analysis, disease activity supported the effects of anti-TNF treatment on 12-month changes in oxLDL/β2-GPI. CIMT supported the effects of therapy on changes in anti-Hsp60 and suPAR. CONCLUSION These biomarkers may be involved in the pathogenesis of atherosclerosis underlying RA/AS. TNF inhibition variably affects the serum levels of oxLDL/β2-GPI, suPAR, and BNP.
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Affiliation(s)
- Anita Pusztai
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Hamar
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ágnes Horváth
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Katalin Gulyás
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Edit Végh
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nóra Bodnár
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - György Kerekes
- G. Kerekes, MD, PhD, Intensive Care Unit, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Monika Czókolyová
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Szilvia Szamosi
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Levente Bodoki
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Katalin Hodosi
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Domján
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Nagy
- G. Nagy, MD, PhD, I. Szöllősi, Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary
| | - Ibolya Szöllősi
- G. Nagy, MD, PhD, I. Szöllősi, Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary
| | - Luis R Lopez
- L.R. Lopez, MD, PhD, Corgenix Inc., Broomfield, Colorado, USA
| | - Eiji Matsuura
- E. Matsuura, MD, PhD, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Zoltán Prohászka
- Z. Prohászka, MD, PhD, Third Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Sándor Szántó
- S. Szántó, MD, PhD, Division of Rheumatology, Department of Medicine, and Department of Sports Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltán Nagy
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
| | - Yehuda Shoenfeld
- Y. Shoenfeld, MD, PhD, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Zoltán Szekanecz
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary;
| | - Gabriella Szűcs
- A. Pusztai, A. Hamar, MD, Á. Horváth, MD, K. Gulyás, MD, E. Végh, MD, N. Bodnár, MD, PhD, M. Czókolyová, S. Szamosi, MD, PhD, L. Bodoki, MD, PhD, K. Hodosi, A. Domján, Z. Nagy, MD, PhD, Z. Szekanecz, MD, PhD, G. Szűcs, MD, PhD, Division of Rheumatology, Department of Medicine, University of Debrecen, Debrecen, Hungary
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