Altered Flow-Mediated Vasodilatation, Low Paraoxonase-1 Activity, and Abnormal High-Density Lipoprotein Subclass Distribution in Takayasu's Arteritis

Abstract

Background: Takayasu's arteritis (TA) is an idiopathic chronic inflammatory disease that causes occlusion of large arteries, but little is known about whether affected patients are characterized by endothelial dysfunction, different high-density lipoproteins (HDL) subclasses and paraoxonase-1 (PON1) activity. Methods and Results:In the present study, 30 patients with TA, 30 age-and gender-matched volunteers (controls) and 15 patients with essential hypertension were studied. Flow-mediated vasodilation (FMD) and maximal blood flow velocity, assessed in the brachial artery by high-resolution ultrasound, were significantly lower in patients. HDL subclass distribution was determined by polyacrylamide gradient gel electrophoresis. HDL-cholesterol, HDL3b subclass and PON1 activity, assessed spectrophotometrically using phenylacetate as the substrate, were also lower in patients compared with controls. In a multiple regression analysis, the use of prednisone and systolic blood pressure were independent variables that predicted the FMD. Conclusions: A low FMD, abnormal size distribution of HDLs, and low PON1 activity are observed in TA patients. These abnormalities appear independently and constitute a cluster that may contribute to the vascular dysfunction of TA arteritis. (Circ J 2009; 73: 760 -766)

Assessment of Mechanical Properties of Common Carotid Artery in Takayasu's Arteritis Using Velocity Vector Imaging

“…In combination with endothelial dysfunction, these abnormalities are likely to be important in the accelerated atherosclerosis in TA. 18,19 In the present study the severity of luminal narrowing in carotid arteries was positively correlated with degree of dyssynchronous expansion. These findings could support the relationship between abnormal arterial mechanical property and luminal narrowing in patients with TA.…”

Assessment of Endothelial Function in Patients with Takayasu Arteritis by Measuring Flow-Mediated Vasodilation and Correlating it with Plasma Levels of Reactive Nitrogen Intermediates

“…Although most studies showed decreased FMD in systemic vasculitis patients, one study showed that there was an enhanced FMD in patients with systemic vasculitis (19) where they had postulated that continued endothelial activation, even when the disease was clinically quiescent, could have led to this response. Unlike the results reported by Espinola-Zavaleta et al, (20) endothelial function as measured by FMD was found to be similar between patients with TA and normal controls (p>0.05). Hoffmann et al (21) showed that the efficacy of infliximab in TA patients acts by inhibiting the action of TNF-β, thereby decreasing iNOS activity.…”

Antiplatelet Therapy for the Prevention of Arterial Ischemic Events in Takayasu Arteritis

“…3,28,29 Moreover, TA patients had more endothelial dysfunction, lower paroxonase-1 activity, a higher proportion of large HDL2b and lower levels of HDL3b than in hypertensive patients and controls. 30 In clinical practice, the search for risk factors for CVD should not be overlooked in TA patients. Even though corticosteroid and immunosuppressive therapy was not associated with a protection against ischemic events in the present study, we believe that the proper treatment of TA disease activity is also important for preventing ischemic events altogether with aspirin use and the management of risk factors for CVD.…”