1
|
Arias de la Rosa I, Escudero-Contreras A, Ruiz-Ponce M, Román-Rodríguez C, Pérez-Sánchez C, Ábalos-Aguilera MDC, Ortega-Castro R, Alcaide J, Murri M, Font P, Calvo-Gutiérrez J, Luque-Tevar M, Patiño-Trives AM, Guzmán-Ruiz R, Malagón MDM, Tinahones FJ, Collantes-Estévez E, López-Pedrera C, Barbarroja N. Molecular Changes in the Adipose Tissue Induced by Rheumatoid Arthritis: Effects of Disease-Modifying Anti-Rheumatic Drugs. Front Immunol 2021; 12:744022. [PMID: 34721412 PMCID: PMC8549628 DOI: 10.3389/fimmu.2021.744022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/20/2021] [Accepted: 09/13/2021] [Indexed: 02/01/2023] Open
Abstract
Disease severity, progression and response to therapy might be worse in obese rheumatoid arthritis (RA) patients, but paradoxically, obesity also might protect from radiographic joint damage. Thus, the intricate relationship between obesity and RA needs urgent clarification. The aim of this study was to assess the influence of obesity on the onset and development of RA and to determine whether arthritis could modify the adipose tissue biology and whether conventional Disease Modifying Anti-Rheumatic Drugs (cDMARDs) can modulate these alterations. Two strategies were followed: (1) clinical profiling of two cohorts of RA: non-obese and obese patients; and (2) mechanistic studies carried out in both a collagen-induced arthritis (CIA) in an obese mouse model and 3T3-L1 adipocytes treated with cDMARDs (leflunomide, methotrexate, and hydroxychloroquine). In our cohort of RA patients with low-moderate disease activity, the presence of obesity was not related to a higher activity of the disease; actually, disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR) was reduced in the obese RA patients. However, the induction of arthritis promoted transcriptomic changes in the adipose tissue under obesity condition in the obese CIA model. Treatment with hydroxychloroquine reduced weight and insulin resistance, accompanied by beneficial metabolic effects in the adipose tissue. These molecular changes in adipose tissue were also observed after methotrexate administration. In sum, arthritis might affect directly the inflammatory burden and metabolic alterations associated with obesity in adipose tissue. Clinicians should be cautious measuring the activity of the disease in obesity and managing the best therapeutic options for the metabolic comorbidities of these patients, where the combination of hydroxychloroquine and methotrexate should be considered to improve adipose tissue dysfunction in obese RA.
Collapse
Affiliation(s)
- Iván Arias de la Rosa
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Miriam Ruiz-Ponce
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Cristóbal Román-Rodríguez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Carlos Pérez-Sánchez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - María Del Carmen Ábalos-Aguilera
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Rafaela Ortega-Castro
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Juan Alcaide
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex, Virgen de la Victoria, Malaga, Spain.,Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Mora Murri
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex, Virgen de la Victoria, Malaga, Spain.,Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Font
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Jerusalem Calvo-Gutiérrez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Maria Luque-Tevar
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Alejandra Maria Patiño-Trives
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Rocío Guzmán-Ruiz
- Department of Cell Biology, Physiology and Immunology, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Maria Del Mar Malagón
- Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Cell Biology, Physiology and Immunology, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Francisco José Tinahones
- Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex, Virgen de la Victoria, Malaga, Spain.,Centros de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Collantes-Estévez
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Service/Deparment of Medicine and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Reina Sofia Hospital, Cordoba, Spain
| |
Collapse
|
2
|
Ladehesa-Pineda ML, Arias de la Rosa I, López Medina C, Castro-Villegas MDC, Ábalos-Aguilera MDC, Ortega-Castro R, Gómez-García I, Seguí-Azpilcueta P, Jiménez-Gómez Y, Escudero-Contreras A, López Pedrera C, Barbarroja N, Collantes-Estévez E. Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis. Ther Adv Musculoskelet Dis 2021; 12:1759720X20982837. [PMID: 33447266 PMCID: PMC7780310 DOI: 10.1177/1759720x20982837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/29/2020] [Accepted: 11/26/2020] [Indexed: 12/16/2022] Open
Abstract
Aims To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10-0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.
Collapse
Affiliation(s)
| | - Iván Arias de la Rosa
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Clementina López Medina
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - María Del Carmen Castro-Villegas
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - María Del Carmen Ábalos-Aguilera
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Rafaela Ortega-Castro
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Ignacio Gómez-García
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Pedro Seguí-Azpilcueta
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Yolanda Jiménez-Gómez
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Chary López Pedrera
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Nuria Barbarroja
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | - Eduardo Collantes-Estévez
- Reina Sofia University Hospital/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC)/University of Córdoba, Cordoba, Spain
| | | |
Collapse
|