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Tang J, Wang Z, Zhou C, Wang X, Ma F, Pan Z, Han S, Li B, Du L, Cheng G, Fang D. Mechanism of Jinteng Qingbi granules in the treatment of rheumatoid arthritis using metabolomics analysis. Biomed Chromatogr 2024; 38:e5886. [PMID: 38726863 DOI: 10.1002/bmc.5886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 06/20/2024]
Abstract
This study investigated the differential metabolites after rheumatoid arthritis (RA) rats were treated with Jinteng Qingbi granules. Collagen-induced arthritis rats were divided into three groups, namely normal group, model group, and Jinteng Qingbi granules group. Serum compounds were identified, annotated, and classified using metabolomics to explain the physicochemical properties and biological functions. The metabolites were screened using univariate and multivariate statistical analyses. There were differences in serum metabolites between RA and normal rats; Jinteng Qingbi granules improved RA and recovered the metabolite levels to normal. Compared to the normal group, 51 differential ions were screened, and 108 ions were changed in the Jinteng Qingbi granules group compared to the RA model. Eight metabolites were upregulated in the RA model group compared to the normal group, whereas 10 metabolites were downregulated. Treatment with Jinteng Qingbi granules increased the levels of 12 metabolites such as cinnamate and decreased the levels of 16 metabolites such as allamandin in the RA model. Differential ion enrichment was mainly related to the histidine metabolic pathway in amino acid metabolism. Jinteng Qingbi granules resulted in improvements in the RA model, which were mainly associated with lipids and lipid-like molecules, organic acids, and derivatives, providing a new possibility and basis for screening biomarkers for the diagnosis and treatment of RA.
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Affiliation(s)
- Jinyang Tang
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zongli Wang
- State Key Laboratory of Generic Manufacture Technology of Traditional Chinese Medicine, Lunan Pharmaceutical Group Co., Ltd., Linyi City, China
| | - Caiyun Zhou
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xin Wang
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fang Ma
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zheng Pan
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shuhua Han
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bin Li
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liyan Du
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guoliang Cheng
- State Key Laboratory of Generic Manufacture Technology of Traditional Chinese Medicine, Lunan Pharmaceutical Group Co., Ltd., Linyi City, China
| | - Dingya Fang
- Department of Rheumatology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Gasparotto M, Di Pierro G, Toffoli B, Grillo A, Bressan M, Fiorentin M, Di Luozzo L, Fischetti F, Zen M, Fabris B, Bernardi S, Tomietto P. Preliminary Study on Pulse Wave Changes in Patients with Inflammatory Arthropathies Treated with bDMARDs. J Clin Med 2024; 13:2684. [PMID: 38731213 PMCID: PMC11084438 DOI: 10.3390/jcm13092684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Patients with inflammatory arthropathies exhibit an increased cardiovascular disease (CVD) risk as compared to the general population, which is not fully quantified by the conventional CVD risk scores. Biotechnological disease-modifying drugs (bDMARDs) have proved beneficial to reduce the overall CVD risk in these patients, although CVD remains a major cause of increased mortality. Since it has been shown that pulse wave parameters and in particular carotid-femoral pulse wave velocity (cfPWV) are predictors of CVD risk, the aim of this study was to evaluate their changes in patients with inflammatory arthropathies before and after bDMARD therapy. Methods: Pulse wave parameters were evaluated with applanation tonometry in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), and rheumatoid arthritis (RA), before and after two years of bDMARD therapy. Results: At baseline, cfPWV was significantly associated with age (p < 0.001) and, among pulse wave parameters, the subendocardial viability ratio was negatively associated with C-reactive protein (CRP) (p = 0.04) and the HAQ-disability index (p = 0.03). At baseline, PsA patients showed a higher percentage of male subjects, higher CRP, and the highest cfPWV values (p = 0.048). After two years, pulse wave parameters improved in the AS and RA groups, but not in the PsA group. Conclusions: Our data confirm that pulse wave parameters are potentially reversible after bDMARD therapy, as they improved in AS and RA patients. In PsA patients, there were no changes, which may be due to the higher percentage of male subjects and higher baseline cfPWV values.
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Affiliation(s)
- Michela Gasparotto
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medicine, Padua University Hospital, University of Padua, 35122 Padova, Italy;
| | - Giuliano Di Pierro
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Barbara Toffoli
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Andrea Grillo
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Marco Bressan
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Marco Fiorentin
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Lorenzo Di Luozzo
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Fabio Fischetti
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Margherita Zen
- Department of Medicine, Padua University Hospital, University of Padua, 35122 Padova, Italy;
| | - Bruno Fabris
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Stella Bernardi
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Paola Tomietto
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
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3
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Ben Shimol J. Perimenopause in women with rheumatologic diseases: a spotlight on an under-addressed transition. Climacteric 2024; 27:115-121. [PMID: 37990992 DOI: 10.1080/13697137.2023.2276201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
Abundant research has been published describing the effects invoked during menopause across different organ systems. Changing levels of estrogen and progesterone result in bidirectional alterations of immune cell pathways. Overall, the net trend dampens immunoregulation and promotes inflammation. In paradigmatic rheumatologic diseases, the combined effect is far from predictable. While some features may abate during menopause, studies have shown a general increased frequency toward disease exacerbation. Similarly, while impossible to isolate the ramifications of menopause in women with fibromyalgia, a tendency toward enhanced symptoms is unquestionably apparent. Furthermore, the comorbidities accrued by increasing age and the consequences of long-term medication use may also confound this picture. Periodic rheumatologic visits are warranted, with clinical assessments directed toward a multi-disciplinary approach. Ultimately, while an arsenal of effective tools is available for caring for these women and their underlying conditions, more studies are needed to better clarify how the different stages surrounding perimenopause affect subpopulations with rheumatic diseases and fibromyalgia-related disorders so that clinical course can be predicted and addressed prior to the emergence of symptomatology.
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Affiliation(s)
- J Ben Shimol
- Department of Rheumatology, Barzilai University Medical Center, Ashqelon, Israel
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4
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Ikdahl E, Stensrud MJ. Re-evaluating the mythical divide between traditional and novel cardiovascular risk factors in rheumatoid arthritis. RMD Open 2024; 10:e003954. [PMID: 38428975 PMCID: PMC10910651 DOI: 10.1136/rmdopen-2023-003954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/16/2024] [Indexed: 03/03/2024] Open
Abstract
Cardiovascular (CV) risk factors for rheumatoid arthritis (RA) are conventionally classified as 'traditional' and 'novel'. We argue that this classification is obsolete and potentially counterproductive. Further, we discuss problems with the common practice of adjusting for traditional CV risk factors in statistical analyses. These analyses do not target well-defined effects of RA on CV risk. Ultimately, we propose a future direction for cardiorheumatology research that prioritises optimising current treatments and identifying novel therapeutic targets over further categorisation of well-known risk factors.
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Affiliation(s)
- Eirik Ikdahl
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Mats Julius Stensrud
- Department of Mathematics, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
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Seo JW, Jo SH, Kim SH, Choi BH, Cho H, Yoo JJ, Park SH. Application of Cartilage Extracellular Matrix to Enhance Therapeutic Efficacy of Methotrexate. Tissue Eng Regen Med 2024; 21:209-221. [PMID: 37837499 PMCID: PMC10825102 DOI: 10.1007/s13770-023-00587-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is characterized by chronic inflammation and joint damage. Methotrexate (MTX), a commonly used disease-modifying anti-rheumatic drug (DMARD) used in RA treatment. However, the continued use of DMARDs can cause adverse effects and result in limited therapeutic efficacy. Cartilage extracellular matrix (CECM) has anti-inflammatory and anti-vascular effects and promotes stem cell migration, adhesion, and differentiation into cartilage cells. METHODS CECM was assessed the dsDNA, glycosaminoglycan, collagen contents and FT-IR spectrum of CECM. Furthermore, we determined the effects of CECM and MTX on cytocompatibility in the SW 982 cells and RAW 264.7 cells. The anti-inflammatory effects of CECM and MTX were assessed using macrophage cells. Finally, we examined the in vivo effects of CECM in combination with MTX on anti-inflammation control and cartilage degradation in collagen-induced arthritis model. Anti-inflammation control and cartilage degradation were assessed by measuring the serum levels of RA-related cytokines and histology. RESULTS CECM in combination with MTX had no effect on SW 982, effectively suppressing only RAW 264.7 activity. Moreover, anti-inflammatory effects were enhanced when low-dose MTX was combined with CECM. In a collagen-induced arthritis model, low-dose MTX combined with CECM remarkably reduced RA-related and pro-inflammatory cytokine levels in the blood. Additionally, low-dose MTX combined with CECM exerted the best cartilage-preservation effects compared to those observed in the other therapy groups. CONCLUSION Using CECM as an adjuvant in RA treatment can augment the therapeutic effects of MTX, reduce existing drug adverse effects, and promote joint tissue regeneration.
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Affiliation(s)
- Jeong-Woo Seo
- Department of Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Sung-Han Jo
- Department of Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Seon-Hwa Kim
- Department of Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Byeong-Hoon Choi
- Department of Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea
| | - Hongsik Cho
- Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN, USA
- Research 151, Veterans Affairs Medical Center, Memphis, TN, USA
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sang-Hyug Park
- Department of Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, Republic of Korea.
- Major of Biomedical Engineering, Division of Smart Healthcare, College of Information Technology and Convergence, Pukyong National University, 45 Yongso-ro, Nam-gu, Busan, 48513, Republic of Korea.
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Avagimyan A, Fogacci F, Pogosova N, Kakturskiy L, Jndoyan Z, Faggiano A, Bairamyan T, Agati L, Sattar Y, Mkrchyan L, Avetisyan G, Ginosyan K, Aznauryan A, Sahakyan K, Trofimenko A, Urazova O, Mikhaleva L, Vandysheva R, Kogan E, Demura T, Kc M, Shafie D, Nicola S, Brussino L, Cicero A, Biondi-Zoccai G, Sarrafzadegan N. Methotrexate & rheumatoid arthritis associated atherosclerosis: A narrative review of multidisciplinary approach for risk modification by the international board of experts. Curr Probl Cardiol 2024; 49:102230. [PMID: 38040221 DOI: 10.1016/j.cpcardiol.2023.102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
Rheumatoid arthritis (RA) is an idiopathic, autoimmune connective tissue disorder that primarily affects the synovial joints, causing symmetric, erosive-deforming polyarthritis. It is also associated with extra-articular manifestations, particularly cardiovascular (CV) diseases (CVD). CV risk modification in RA remains unsolved despite recent advances in the management of RA. RA is an independent risk factor for atherosclerosis. RA and atherosclerosis share similar pathophysiological features (such as the pro-inflammatory cascade activation including interleukin-6) and risk factors (such as microflora dysbacteriosis and smoking). Patients with RA experience an exacerbation of atherogenesis, with atheromas destabilization, endothelial dysfunction, vasculitis, and hypercytokinemia. Consequently, the inflammatory response associated with RA is the basis for CVD development. The treat-to-target strategy not only improved RA control but also had a favorable effect on the morpho-functional state of the CV system in patients living with RA. Thus, disease-modifying antirheumatic drugs (DMARDs) - in particular methotrexate - may have a beneficial effect on the prevention of CV events in RA. It must be mentioned that RA is a serious multi-system disease, not only because of a window period during which the course of RA can be reversed, but also due to early damage to the heart and blood vessels. For this reason, a thorough cardiological assessment must be performed for all patients with RA, regardless of sex, age, disease stage, and disease activity score.
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Affiliation(s)
- Ashot Avagimyan
- MD, PhD, Assistant Professor, Department of Anatomical Pathology and Clinical Morphology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
| | - Federica Fogacci
- MD, Research Fellow, Atherosclerosis and Metabolic Disorders Research Unit, University of Bologna, Bologna, Italy
| | - Nana Pogosova
- MD, PhD, Professor, Head of Laboratory of Preventive Cardiology, Deputy Director for Science and Preventive Cardiology, National Medical Research Center of Cardiology named after academician E. Chazov, Moscow, Russia
| | - Lev Kakturskiy
- MD, Ph.D, Scientific Director, A. P. Avtsyn Research Institute of Human Morphology of Petrovskiy NRCS, Moscow, Russia
| | - Zinaida Jndoyan
- MD, PhD, Head of Internal Diseases Propaedeutic Department, Head of Internal Medicine Unit of University Clinical Hospital, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Andrea Faggiano
- MD, PhD, Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; Department of Clinical Sciences and Community Health, University of Milano, Italy
| | - Tamara Bairamyan
- MD, PhD, Associate Professor, Department of Rheumatology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Luciano Agati
- MD, PhD, Head of Cardiology Unit Aziendo Umberto II, Department of Cardiology, La Sapienza University of Rome, Rome, Italy
| | - Yasar Sattar
- MD, Department of Cardiology, West Virginia University, Morgantown, WV, USA
| | - Lusine Mkrchyan
- MD, PhD, Associate Professor, Department of Cardiology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Gayane Avetisyan
- MD, PhD, Associate Professor, Department of Topographical Anatomy and Operative Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Knarik Ginosyan
- MD, PhD, Head of Rheumatology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Anahit Aznauryan
- PhD, Associate Professor, Histology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Karmen Sahakyan
- PhD, Professor, Head of Histology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Artem Trofimenko
- MD, PhD, Associate Professor, Department of Pathophysiology, Kuban State Medical University, Krasnodar, Russia
| | - Olga Urazova
- MD, PhD, Professor, Head of Pathophysiology Department, Siberian State Medical University, Tomsk, Russia
| | - Liudmila Mikhaleva
- MD, PhD, Director, A. P. Avtsyn Research Institute of Human Morphology of Petrovskiy NRCS, Moscow, Russia
| | - Rositsa Vandysheva
- MD, PhD, A. P. Avtsyn Research Institute of Human Morphology of Petrovskiy NRCS, Moscow, Russia
| | - Eugenia Kogan
- MD, PhD, Professor, Head of Anatomical Pathology Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Tatiana Demura
- MD, PhD, Professor, Director of Institute of Clinical Morphology and Digital Pathology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Manish Kc
- MD, North Alabama Medical Centre, Florence, Alabama, USA
| | - Davood Shafie
- MD, PhD, Director of Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Stefania Nicola
- MD, PhD, Immunology and Allergy Unit, AO Ordine Mauriziano di Torino and Department of Medical Sciences, University of Turin, Italy
| | - Luisa Brussino
- MD, PhD, Director of the Allergy and Immunology unit AO Ordine Mauriziano di Torino - Department of Medical Sciences, University of Turin, Italy
| | - Arrigo Cicero
- MD, PhD, Professor, Atherosclerosis and Metabolic Disorders Research Unit, University of Bologna, Bologna, Italy
| | - Giuseppe Biondi-Zoccai
- MD, PhD, Professor, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Nizal Sarrafzadegan
- MD, Professor, Director of Isfahan Cardiovascular Research Center (WHO Collaboration Center), Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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7
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Duruöz MT, Ataman Ş, Bodur H, Çay HF, Melikoğlu MA, Akgül Ö, Çapkın E, Gürer G, Çevik R, Göğüş FN, Kamanlı A, Yurdakul FG, Yağcı İ, Rezvani A, Altan L. Prevalence of cardiovascular diseases and traditional cardiovascular risk factors in patients with rheumatoid arthritis: a real-life evidence from BioSTAR nationwide registry. Rheumatol Int 2024; 44:291-301. [PMID: 38157014 DOI: 10.1007/s00296-023-05515-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities. The association of CV diseases (CVD) and traditional CV risk factors has been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA. A multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) in September 2022. Socio-demographic, clinical, and follow-up data were collected. Myocardial infarction, ischemic heart disease, peripheral vascular disorders, congestive heart failure, ischemic stroke, and transient ischemic attack were regarded as major adverse cardiovascular events (MACEs). CVD was defined as the presence of at least one clinical situation of MACE. Group 1 and Group 2 included patients with and without CVD. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD. An analysis of 724 patients with a mean age of 55.1 ± 12.8 years diagnosed with RA was conducted. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n = 33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in five, peripheral vascular disorders in three, and cerebrovascular events in three patients. The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p = 0.027, p < 0.001, and p = 0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR = 7.818, 95% CI 3.030-20.173, p < 0.001) and hypertension (HR = 4.570, 95% CI 1.567-13.328, p = 0.005) were the independent risk factors for CVD. The prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. Male sex and hypertension were the independent risk factors for developing CVD in patients with RA.
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Affiliation(s)
- Mehmet Tuncay Duruöz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Marmara University, İstanbul, Türkiye.
| | - Şebnem Ataman
- Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Hatice Bodur
- Department of Physical Medicine and Rehabilitaton, Ankara City Hospital, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Türkiye
| | - Hasan Fatih Çay
- Department of Physical Medicine Rehabilitation and Rheumatology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Türkiye
| | - Meltem Alkan Melikoğlu
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Atatürk University, Erzurum, Türkiye
| | - Özgür Akgül
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Manisa Celal Bayar University, Manisa, Türkiye
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitaton, School of Medicine, Karadeniz Technical University, Trabzon, Türkiye
| | - Gülcan Gürer
- Department of Physical Medicine Rehabilitation and Rheumatology, University School of Medicine, Adnan Menderes University, Aydın, Türkiye
| | - Remzi Çevik
- Department of Physical Medicine and Rehabilitaton, School of Medicine, Dicle University, Diyarbakır, Türkiye
| | - Feride Nur Göğüş
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Gazi University, Ankara, Türkiye
| | - Ayhan Kamanlı
- Department of Physical Medicine Rehabilitation and Rheumatology, School of Medicine, Sakarya University, Sakarya, Türkiye
| | - Fatma Gül Yurdakul
- Department of Physical Medicine and Rehabilitaton, Ankara City Hospital, University of Health Sciences, Ankara, Türkiye
| | - İlker Yağcı
- Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Marmara University, İstanbul, Türkiye
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitaton, Internatonal School of Medicine, İstanbul Medipol University, İstanbul, Türkiye
| | - Lale Altan
- Department of Physical Medicine Rehabilitation and Rheumatology, Faculty of Medicine, Uludağ University, Bursa, Türkiye
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8
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Guo Y, Chung W, Shan Z, Zhu Z, Costenbader KH, Liang L. Genome-Wide Assessment of Shared Genetic Architecture Between Rheumatoid Arthritis and Cardiovascular Diseases. J Am Heart Assoc 2023; 12:e030211. [PMID: 37947095 PMCID: PMC10727280 DOI: 10.1161/jaha.123.030211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
Background Patients with rheumatoid arthritis (RA) have a 2- to 10-fold increased risk of cardiovascular disease (CVD), but the biological mechanisms and existence of causality underlying such associations remain to be investigated. We aimed to investigate the genetic associations and underlying mechanisms between RA and CVD by leveraging large-scale genomic data and genetic cross-trait analytic approaches. Methods and Results Within UK Biobank data, we examined the genetic correlation, shared genetics, and potential causality between RA (Ncases=6754, Ncontrols=452 384) and cardiovascular diseases (CVD, Ncases=44 238, Ncontrols=414 900) using linkage disequilibrium score regression, cross-trait meta-analysis, and Mendelian randomization. We observed significant genetic correlations of RA with myocardial infarction (rg:0.40 [95% CI, 0.24-0.56), angina (rg:0.42 [95% CI, 0.28-0.56]), coronary heart diseases (rg:0.41 [95% CI, 0.27-0.55]), and CVD (rg:0.43 [95% CI, 0.29-0.57]) after correcting for multiple testing (P<0.05/5). When stratified by frequent use of analgesics, we found increased genetic correlation between RA and CVD among participants without aspirin usage (rg:0.54 [95% CI, 0.30-0.78] for angina; Pvalue=6.69×10-6) and among participants with paracetamol usage (rg:0.75 [95% CI, 0.20-1.29] for myocardial infarction; Pvalue=8.90×10-3), whereas others remained similar. Cross-trait meta-analysis identified 9 independent shared loci between RA and CVD, including PTPN22 at chr1p13.2, BCL2L11 at chr2q13, and CCR3 at chr3p21.31 (Psingle trait<1×10-3 and Pmeta<5×10-8), highlighting potential shared pathogenesis including accelerating atherosclerosis, upregulating oxidative stress, and vascular permeability. Finally, Mendelian randomization estimates showed limited evidence of causality between RA and CVD. Conclusions Our results supported shared genetic pathogenesis rather than causality in explaining the observed association between RA and CVD. The identified shared genetic factors provided insights into potential novel therapeutic target for RA-CVD comorbidities.
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Affiliation(s)
- Yanjun Guo
- Department of Occupational and Environmental Health, School of Public HealthTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Program in Genetic Epidemiology and Statistical Genetics, Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMAUSA
- Division of Preventive MedicineBrigham and Women’s HospitalBostonMA
- Harvard Medical SchoolBostonMA
| | - Wonil Chung
- Program in Genetic Epidemiology and Statistical Genetics, Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMAUSA
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulKorea
| | - Zhilei Shan
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMA
| | - Zhaozhong Zhu
- Program in Genetic Epidemiology and Statistical Genetics, Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Karen H. Costenbader
- Division of Preventive MedicineBrigham and Women’s HospitalBostonMA
- Division of Rheumatology, Inflammation and Immunity, Department of MedicineBrigham and Women’s HospitalBostonMA
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMAUSA
- Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonMA
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9
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Yan J, Yang S, Han L, Ba X, Shen P, Lin W, Li T, Zhang R, Huang Y, Huang Y, Qin K, Wang Y, Tu S, Chen Z. Dyslipidemia in rheumatoid arthritis: the possible mechanisms. Front Immunol 2023; 14:1254753. [PMID: 37954591 PMCID: PMC10634280 DOI: 10.3389/fimmu.2023.1254753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease, of which the leading cause of death is cardiovascular disease (CVD). The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) in RA decrease especially under hyperinflammatory conditions. It is conflictive with the increased risk of CVD in RA, which is called "lipid paradox". The systemic inflammation may explain this apparent contradiction. The increased systemic proinflammatory cytokines in RA mainly include interleukin-6(IL-6)、interleukin-1(IL-1)and tumor necrosis factor alpha(TNF-α). The inflammation of RA cause changes in the subcomponents and structure of HDL particles, leading to a weakened anti-atherosclerosis function and promoting LDL oxidation and plaque formation. Dysfunctional HDL can further worsen the abnormalities of LDL metabolism, increasing the risk of cardiovascular disease. However, the specific mechanisms underlying lipid changes in RA and increased CVD risk remain unclear. Therefore, this article comprehensively integrates the latest existing literature to describe the unique lipid profile of RA, explore the mechanisms of lipid changes, and investigate the impact of lipid changes on cardiovascular disease.
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Affiliation(s)
- Jiahui Yan
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Sisi Yang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Liang Han
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xin Ba
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Pan Shen
- Department of Rheumatology and Immunology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Weiji Lin
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Li
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ruiyuan Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ying Huang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yao Huang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Kai Qin
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yu Wang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Shenghao Tu
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zhe Chen
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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10
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Aslam B, Hussain A, Faisal MN, Sindhu ZUD, Khan RU, Alhidary IA, Naz S, Tufarelli V. Curcumin Co-Encapsulation Potentiates Anti-Arthritic Efficacy of Meloxicam Biodegradable Nanoparticles in Adjuvant-Induced Arthritis Animal Model. Biomedicines 2023; 11:2662. [PMID: 37893036 PMCID: PMC10604063 DOI: 10.3390/biomedicines11102662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to evaluate the anti-arthritic activity of curcumin and meloxicam co-loaded PLGA nanoparticles in adjuvant-induced arthritic rats. PLGA nanoparticles encapsulating curcumin (nCur) and meloxicam (nMlx) alone and in combination (nCur/Mlx) were used to characterize zeta size and potential, polydispersity index, encapsulation efficiency (%), compound-polymer interactions (FT-IR analysis), and surface morphology (SEM imaging). In vivo, Complete Freund's adjuvant-induced arthritic rats were intraperitoneally (i.p.) administered with curcumin, meloxicam, curcumin plus meloxicam, nCur, nMlx, and nCur/Mlx for 28 consecutive days. Results showed that nCur, nMlx, and nCur/Mlx significantly (p ≤ 0.05) reduced paw swelling and arthritic score, restored body weight and the immune organ index (thymus and spleen), as well as attenuated serum inflammatory markers (RF, CRP, and PGE2) and oxidative stress parameters (MDA, SOD, and CAT) in adjuvant-induced arthritic rats compared to free compounds. In addition, mono- and dual-compound-loaded nanoparticles significantly (p ≤ 0.05) down-regulated pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6), up-regulated anti-inflammatory cytokines (IL-4, IL-10, and IFN-γ), and modulated OPG and RANKL expressions in paw tissue. The aforementioned results were further confirmed through radiological and histopathological examinations. Furthermore, the anti-arthritic effect of nCur/Mlx was notably (p ≤ 0.05) enhanced compared to nCur or nMlx alone. In conclusion, the co-nanoencapsulation of curcumin could potentiate the anti-arthritic activity of meloxicam and could provide a novel therapeutic approach for the formulation of nanocarrier pharmaceutical products for the management of arthritis.
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Affiliation(s)
- Bilal Aslam
- Institute of Physiology and Pharmacology, University of Agriculture Faisalabad, Faisalabad 38040, Pakistan; (A.H.); (M.N.F.)
| | - Asif Hussain
- Institute of Physiology and Pharmacology, University of Agriculture Faisalabad, Faisalabad 38040, Pakistan; (A.H.); (M.N.F.)
- Department of Pharmacy, Riphah International University, Faisalabad 38000, Pakistan
| | - Muhammad Naeem Faisal
- Institute of Physiology and Pharmacology, University of Agriculture Faisalabad, Faisalabad 38040, Pakistan; (A.H.); (M.N.F.)
| | - Zia-ud-Din Sindhu
- Department of Parasitology, University of Agriculture Faisalabad, Faisalabad 38040, Pakistan;
| | - Rifat Ullah Khan
- College of Veterinary Sciences, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar 25130, Pakistan
| | - Ibrahim A. Alhidary
- Department of Animal Production, College of Food and Agriculture Sciences, King Saud University, Riyadh 11421, Saudi Arabia;
| | - Shabana Naz
- Department of Zoology, Government College University, Faisalabad 54000, Pakistan;
| | - Vincenzo Tufarelli
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePRe-J), Section of Veterinary Science and Animal Production, University of Bari ‘Aldo Moro’, s.p. Casamassima km 3, 70010 Valenzano, Italy;
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11
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Shao Y, Zhang H, Shi Q, Wang Y, Liang Q. Clinical prediction models of rheumatoid arthritis and its complications: focus on cardiovascular disease and interstitial lung disease. Arthritis Res Ther 2023; 25:159. [PMID: 37658422 PMCID: PMC10472585 DOI: 10.1186/s13075-023-03140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease of unknown etiology with erosive, symmetric polyarthritis as the main clinical manifestations. Its basic pathological changes are the formation of synovitis, and patients gradually develop destruction of articular cartilage destruction and bone erosion, which eventually leads to joint deformity, disability, and various extra-articular manifestations. Clinical prediction models (CPMs), also known as risk prediction models or risk scores, are mathematical formulas used to estimate the probability that a given individual will have a disease or an outcome in the future. The models are mainly divided into two categories: diagnostic models and prognostic models, which can be used to provide information on disease diagnosis or prognosis to help make better medical decisions. Currently, there is no cure for RA, but effective early diagnosis and treatment are crucial for limiting the severity of the disease and preventing the occurrence and development of complications. This paper reviews the CPMs associated with RA and its related complications, including cardiovascular disease (CVD) and interstitial lung disease (ILD), in order to provide reference and evidence for the early diagnosis and treatment of these diseases and personalized medicine for patients. In addition, the possible pathogenesis and risk factors of these comorbidities are summarized, and possible directions for future related research are prospected.
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Affiliation(s)
- Yubo Shao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- School of Graduate, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Key Laboratory of Ministry of Education of Theory and Therapy of Muscles and Bones, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Hong Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- Key Laboratory of Ministry of Education of Theory and Therapy of Muscles and Bones, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Qi Shi
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- Key Laboratory of Ministry of Education of Theory and Therapy of Muscles and Bones, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Yongjun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
- Key Laboratory of Ministry of Education of Theory and Therapy of Muscles and Bones, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
| | - Qianqian Liang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
- Key Laboratory of Ministry of Education of Theory and Therapy of Muscles and Bones, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
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12
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Riitano G, Recalchi S, Capozzi A, Manganelli V, Misasi R, Garofalo T, Sorice M, Longo A. The Role of Autophagy as a Trigger of Post-Translational Modifications of Proteins and Extracellular Vesicles in the Pathogenesis of Rheumatoid Arthritis. Int J Mol Sci 2023; 24:12764. [PMID: 37628944 PMCID: PMC10454292 DOI: 10.3390/ijms241612764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease, characterized by persistent joint inflammation, leading to cartilage and bone destruction. Autoantibody production is directed to post-translational modified (PTM) proteins, i.e., citrullinated or carbamylated. Autophagy may be the common feature in several types of stress (smoking, joint injury, and infections) and may be involved in post-translational modifications (PTMs) in proteins and the generation of citrullinated and carbamylated peptides recognized by the immune system in RA patients, with a consequent breakage of tolerance. Interestingly, autophagy actively provides information to neighboring cells via a process called secretory autophagy. Secretory autophagy combines the autophagy machinery with the secretion of cellular content via extracellular vesicles (EVs). A role for exosomes in RA pathogenesis has been recently demonstrated. Exosomes are involved in intercellular communications, and upregulated proteins and RNAs may contribute to the development of inflammatory arthritis and the progression of RA. In RA, most of the exosomes are produced by leukocytes and synoviocytes, which are loaded with PTM proteins, mainly citrullinated proteins, inflammatory molecules, and enzymes that are implicated in RA pathogenesis. Microvesicles derived from cell plasma membrane may also be loaded with PTM proteins, playing a role in the immunopathogenesis of RA. An analysis of changes in EV profiles, including PTM proteins, could be a useful tool for the prevention of inflammation in RA patients and help in the discovery of personalized medicine.
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Affiliation(s)
| | | | | | | | | | | | - Maurizio Sorice
- Department of Experimental Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (G.R.); (S.R.); (A.C.); (V.M.); (R.M.); (T.G.); (A.L.)
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13
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Atzeni F, La Corte L, Cirillo M, Giallanza M, Galloway J, Rodríguez-Carrio J. Metabolic Syndrome and Its Components Have a Different Presentation and Impact as Cardiovascular Risk Factors in Psoriatic and Rheumatoid Arthritis. J Clin Med 2023; 12:5031. [PMID: 37568433 PMCID: PMC10420311 DOI: 10.3390/jcm12155031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Patients with chronic inflammatory arthritis have a higher cardiovascular (CV) risk than the general population. Traditional CV risk factors are clearly implicated, while the impact of metabolic syndrome (MetS) is less defined. The aim of this study was to compare MetS prevalence and impact on the CV risk in psoriatic arthritis (PsA) versus rheumatoid arthritis (RA). A retrospective analysis of real-world data of PsA and RA patients referred to a rheumatology clinic was conducted. The following data were extracted and compared: demographic data; clinical data; presence of traditional CV risk factors and MetS. Univariate and multivariate models were used to compare the impact of MetS and its components in patients with PsA versus RA. Overall, 170 patients were included (PsA: 78; RA; 92). The two groups differed significantly in mean age, disease duration, and presence of MetS, while other variables were comparable. Univariate and multivariate analysis identified distinct predictors of MetS in PsA (hypertension) and RA (dyslipidemia). The history of CV events was similar in the two groups. Predictors of CV events were MetS and most of its components in PsA, while dyslipidemia was the strongest predictor in RA. These associations were stronger in PsA than in RA. In conclusion, the impact of MetS and its components is different in PsA and RA. The association of these risk factors with CV events is stronger in PsA than in RA. This suggests the implication of different mechanisms, which may require distinct strategies for the prevention of CV events in PsA and RA.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Laura La Corte
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Mariateresa Cirillo
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Manuela Giallanza
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98125 Messina, Italy
| | - James Galloway
- Centre for Rheumatic Disease, Kings College London, London WC2R 2LS, UK
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Spain;
- Instituto de Investigacíon Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
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14
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Barkhane Z, Zaree A, Zulfiqar S, Qudoos A, Vaidhyula S, Jaiprada F, Dar S, Ali N. Comparison of Cardiovascular Outcomes in Patients With and Without Rheumatoid Arthritis: A Meta-Analysis of Observational Studies. Cureus 2023; 15:e40348. [PMID: 37456442 PMCID: PMC10339149 DOI: 10.7759/cureus.40348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
The aim of this meta-analysis was to determine the risk of incident cardiovascular disease (CVD) in patients with rheumatoid arthritis compared to patients without rheumatoid arthritis. We conducted a thorough search of online databases, including PubMed, EMBASE, and Web of Science, to identify English-language publications examining cardiovascular outcomes in patients with rheumatoid arthritis from January 1, 2005, to May 15, 2023. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed using relevant keywords such as "rheumatoid arthritis," "cardiovascular diseases," and "risk," along with their synonyms. Medical subject heading (MeSH) terms and Boolean operators (AND, OR) were employed to optimize the search. Outcomes assessed in this study included composite cardiovascular events (as defined by individual studies), myocardial infarction, and stroke (including ischemic and hemorrhagic stroke). Overall, 14 studies met the inclusion criteria and were included in the present meta-analysis. We found that the risk of composite CVD was higher in patients with rheumatoid arthritis compared to patients without rheumatoid arthritis. We also found a higher risk of myocardial infarction and stroke in rheumatoid arthritis patients compared to their counterparts. This study demonstrates the elevated risk of CVD in patients with rheumatoid arthritis and highlights the importance of incorporating cardiovascular management and assessment into the care of these patients.
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Affiliation(s)
- Zineb Barkhane
- Medicine and Pharmacy, University of Hassan II Casablanca, Casablanca, MAR
| | - Amna Zaree
- Medicine, Shalimar Medical and Dental College, Lahore, PAK
| | - Sualeha Zulfiqar
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Ahmed Qudoos
- Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | - Santhoshi Vaidhyula
- Medicine, Dr. Nandamuri Taraka Rama Rao (NTR) University of Health Sciences, Vijayawada, IND
| | - Fnu Jaiprada
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Saleha Dar
- Adult Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Neelum Ali
- Internal Medicine, University of Health Sciences, Lahore, PAK
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15
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Qian Y, Fei Z, Nian F. The Association Between Rheumatoid Arthritis and Atrial Fibrillation: Epidemiology, Pathophysiology and Management. Int J Gen Med 2023; 16:1899-1908. [PMID: 37223618 PMCID: PMC10202215 DOI: 10.2147/ijgm.s406926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia with a significant increase in morbidity and mortality worldwide. Rheumatoid arthritis (RA), as a systemic inflammatory disease, affecting 0.5-1.0% of the adult population, is associated with increased incidence of cardiac arrhythmias such as AF. Several epidemiologic studies find that the risk of AF is increased in RA when compared with the general population. Other studies are inconsistent. Considering that inflammation plays an important role in AF, RA may be involved in the occurrence and development of AF. This review summarizes the epidemiology, pathophysiology, and management of AF in patients with RA.
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Affiliation(s)
- Yezhou Qian
- Department of Cardiology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Zhangli Fei
- Department of Rheumatology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Feige Nian
- Department of Rheumatology, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
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16
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Atzeni F, Alciati A. Cardiovascular Risk in Systemic Inflammatory Arthritis. J Clin Med 2023; 12:jcm12082779. [PMID: 37109115 PMCID: PMC10141337 DOI: 10.3390/jcm12082779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
In recent years, several papers have been published on cardiovascular (CV) involvement, risk, management, and treatment in systemic inflammatory arthritis (SIA), including rheumatoid arthritis, (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) [...].
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98122 Messina, Italy
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Villa S. Benedetto Menni, 22032 Albese con Cassano, Italy
- Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy
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17
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Wu D, Luo Y, Li T, Zhao X, Lv T, Fang G, Ou P, Li H, Luo X, Huang A, Pang Y. Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment. Front Immunol 2022; 13:1051082. [PMID: 36618407 PMCID: PMC9817137 DOI: 10.3389/fimmu.2022.1051082] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
As a systemic autoimmune disease, rheumatoid arthritis (RA) usually causes damage not only to joints, but also to other tissues and organs including the heart, kidneys, lungs, digestive system, eyes, skin, and nervous system. Excessive complications are closely related to the prognosis of RA patients and even lead to increased mortality. This article summarizes the serious complications of RA, focusing on its incidence, pathogenesis, clinical features, and treatment methods, aiming to provide a reference for clinicians to better manage the complications of RA.
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Affiliation(s)
- Di Wu
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Yehao Luo
- School of Second Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Tong Li
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Xinyi Zhao
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Ting Lv
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Gang Fang
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Peiqi Ou
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Hongyi Li
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Xiaofan Luo
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - An Huang
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China,*Correspondence: An Huang, ; Yuzhou Pang,
| | - Yuzhou Pang
- Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China,*Correspondence: An Huang, ; Yuzhou Pang,
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18
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Dessein PH, Gonzalez-Gay MA. Management of Cardiovascular Disease Risk in Rheumatoid Arthritis. J Clin Med 2022; 11:jcm11123487. [PMID: 35743556 PMCID: PMC9225346 DOI: 10.3390/jcm11123487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Patrick H. Dessein
- Departments of Medicine and Physiology, Faculty of Health Sciences, Universtiy of Witwatersrand, Johannesburg 2000, South Africa
- Correspondence:
| | - Miguel A. Gonzalez-Gay
- Division of Rheumatology and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marques de Valdecilla, Instituto de Investigacion Marques de Valdecilla (IDIVAL), 39011 Santander, Spain;
- Department of Medicine and Psychiatry, Universidad de Cantabria, 39011 Santander, Spain
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