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Cafaro G, Petito E, Bistoni O, Falcinelli E, Cipriani S, Borghi MC, Bonifacio AF, Giglio E, Alunno A, Perricone C, Gerli R, Gresele P, Bartoloni E. Methotrexate improves endothelial function in early rheumatoid arthritis patients after 3 months of treatment. Arthritis Res Ther 2022; 24:236. [PMID: 36280849 PMCID: PMC9590167 DOI: 10.1186/s13075-022-02930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Endothelial dysfunction contributes to increased cardiovascular (CV) disease in rheumatoid arthritis (RA). Angiogenic T cells (Tang) are a key regulator of vascular function via their interaction with endothelial progenitor cells (EPCs). Methotrexate (MTX) has been associated to reduced CV disease risk, but its effects on endothelial homeostasis have been poorly explored. We investigated MTX effects on endothelial homeostasis in early, treatment-naïve RA patients. Methods Fifteen untreated, early RA patients and matched healthy controls (HC) were enrolled. RA patients with long-standing disease in remission or low disease activity treated with MTX for at least 6 months were selected as controls. Circulating CD28+ and CD28null Tang cell, endothelial microparticle (EMP), EPC and soluble vascular cell adhesion molecule (sVCAM)-1 levels were measured. Results Tang percentage was higher in early RA than in HCs and significantly increased after 3-month MTX treatment. Tang cells in RA were characterized by higher percentage of CD28null and lower CD28-positive cells than HCs. MTX restored a Tang cell phenotype similar to HCs. Altered sVCAM-1, EMP and EPC were restored to levels similar to HCs after a 3-month MTX. Biomarker levels after 3 months of MTX were not different to those of patients with long-standing treatment. Conclusions MTX has a positive effect on Tang, sVCAM-1, EPCs and EMPs in RA. Restoration of imbalance between CD28 + and CD28null Tang by MTX may be one of the mechanisms underlying its favourable effects on endothelial dysfunction. These effects seem to be long-lasting and independent from systemic inflammation reduction, suggesting a direct effect of MTX on the endothelium.
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Affiliation(s)
- Giacomo Cafaro
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Eleonora Petito
- grid.9027.c0000 0004 1757 3630Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Onelia Bistoni
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Emanuela Falcinelli
- grid.9027.c0000 0004 1757 3630Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Sabrina Cipriani
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Maria Chiara Borghi
- grid.9027.c0000 0004 1757 3630Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Angelo F. Bonifacio
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Elisa Giglio
- grid.9027.c0000 0004 1757 3630Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alessia Alunno
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy ,grid.158820.60000 0004 1757 2611Internal Medicine and Nephrology Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Carlo Perricone
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Roberto Gerli
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
| | - Paolo Gresele
- grid.9027.c0000 0004 1757 3630Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Bartoloni
- grid.9027.c0000 0004 1757 3630Rheumatology Unit, University of Perugia, Perugia, Italy
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Busà E, Borghi MC, Marsili M, Martelli R, Mazzoccone A, Nucera M, Tanganelli R, Boncinelli S. [Ambulatory intravenous anesthesia in elderly patients: comparison of 2 techniques]. Minerva Anestesiol 1991; 57:632-3. [PMID: 1798515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- E Busà
- Servizio Universitario di Anestesia e Rianimazione 2, Firenze
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