Arterial stiffness and atherosclerosis in systemic lupus erythematosus patients

Dziedzic-Oleksy, Hanna; Mazurek, Adam; Bugała, Kamil; Perricone, Carlo; Drabik, Leszek; Płazak, Wojciech

doi:10.5114/reum.2022.117836

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…Lower proteinuria after statins was also shown in humans [ 81 ]. Statins in RA decrease arterial stiffness [ 82 , 83 ], improve endothelial function [ 84 ], and decrease disease activity measured by the DAS28 score [ 79 ]. On the other hand, simvastatin has been shown to produce lupus-like syndrome [ 85 ], and atorvastatin has been shown to produce dermato-polymyositis [ 86 ].…”

Section: Pharmacotherapy Of Endothelial Dysfunction In Slementioning

confidence: 99%

SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis

Płazak

Drabik

2023

Clin Rheumatol

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An increased risk of atherosclerotic and thrombotic complications characterizes connective tissue diseases. Endothelial dysfunction is the basis for the initiation and progression of atherosclerosis and thrombosis. We present systemic lupus erythematosus (SLE) as a model rheumatic disease with endothelial dysfunction and discuss its mechanisms, factors that influence the early onset and rapid progression of atherosclerosis, and the increased risk of thromboembolic events. We focus on established methods to improve endothelium function, including statins, antiplatelet, and antithrombotic therapy. Hypercoagulable and hypofibrinolitic states and a hyperinflammatory response characterize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several pathogenic mechanisms are typical for an acute phase of Covid-19 post-Covid syndrome and connective tissue diseases: endothelial dysfunction, elevated antiphospholipid antibody titer, activation of the complement system, and formation of extracellular neutrophil traps (NET). The current review discusses the mechanisms underlying SLE and the COVID-19 in the context of endothelial function, atherosclerosis, and thrombosis (Graphical abstract). Key Points• The pathophysiology of systemic lupus erythematosus (SLE) and Covid-19 shows some similarities, such as endothelial cell activation and dysfunction, the activation of complementary systems, the presence of antiphospholipid antibodies, and the formation of extracellular neutrophil traps.• Autoimmunity in both diseases creates the basis for hyperinflammatory, hypercoagulable, and hypofibrinolitic states and their thromboembolic complications.• This paper presents our perspective on the mechanisms behind the cardiovascular manifestations of SLE and COVID-19, with a particular emphasis on endothelial dysfunction. Graphical abstract Covid-19 and systemic lupus erythematosus—potential similarities in pathophysiology. Figures of the panel illustrate the clinical manifestations of endothelial dysfunction, atherosclerosis, and thromboembolism, including coronary artery disease ([A] coronary angiography with left anterior descending artery stenosis and [B] scintigraphy with reduced perfusion in the myocardial apical segments), stroke ([C] carotid angiography, left carotid artery occlusion) and pulmonary embolism ([D]computed tomography with thrombus in the right pulmonary artery).

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Section: Pharmacotherapy Of Endothelial Dysfunction In Slementioning

confidence: 99%

SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis

Płazak

Drabik

2023

Clin Rheumatol

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“…Nearly 10% of all patients with SLE have accelerated atherosclerosis development; inflammation in small, medium, and large vessels; and impaired endothelium-dependent relaxation compared with age-matched controls ( 3 , 42 – 46 ). Multiple clinical studies implicate dyslipidemia and clotting factors in the association between CVD and SLE ( 5 , 43 , 47 ). In a study published by Urowitz et al., both male and female patients with SLE had a 60% increased prevalence of dyslipidemia 3 years after study enrollment ( 48 ).…”

Section: Mechanisms Of Cvd Complications In Slementioning

confidence: 99%

Cardiac and vascular complications in lupus: Is there a role for sex?

et al. 2023

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Systemic lupus erythematosus (SLE) is a common systemic autoimmune disorder and is characterized by autoantibody formation and subsequent immune complex deposition into target organs. SLE affects nearly nine women to every one man worldwide. Patients with SLE are at an enhanced risk for cardiovascular disease (CVD) morbidity and mortality. CVD is the leading cause of death worldwide and includes heart and blood vessel disorders, cerebrovascular disease, and rheumatic heart disease. Specific mechanisms by which cardiac and vascular pathophysiology develops in patients with SLE are still not fully known. Not only do we not understand this correlation between SLE and CVD, but there is also a critical gap in scientific knowledge on the contribution of sex. In this review, we will discuss the cardiac and vascular pathological disease states that are present in some patients with SLE. More importantly, we will discuss the potential mechanisms for the role of sex and sex hormones in the development of CVD with SLE.

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Prognostic value and predictors of the alteration of the diffusing capacity of the lungs for carbon monoxide in systemic lupus erythematosus

Le Tallec,

Bourg,

Bouzillé

et al. 2023

Rheumatology

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Objectives SLE is a systemic autoimmune disease characterized by heterogeneous manifestations and severity, with frequent lung involvement. Among pulmonary function tests, the measure of the diffusing capacity of the lungs for carbon monoxide (DLCO) is a noninvasive and sensitive tool assessing pulmonary microcirculation. Asymptomatic and isolated DLCO alteration has frequently been reported in SLE, but its clinical relevance has not been established. Methods This retrospective study focused on 232 SLE patients fulfilling the 2019 EULAR/ACR classification criteria for SLE. Data were collected from the patient’s medical record, including demographic, clinical and immunological characteristics, while DLCO was measured when performing pulmonary function tests as part of routine patient follow-up. Results At the end of follow-up, DLCO alteration (<70% of predicted value) was measured at least once in 154 patients (66.4%), and was associated with a history of smoking as well as interstitial lung disease, but was also associated with renal and neurological involvement. History of smoking, detection of anti-nucleosome autoantibodies and clinical lymphadenopathy at diagnosis were independent predictors of DLCO alteration, while early cutaneous involvement with photosensitivity was a protective factor. DLCO alteration, at baseline or any time during follow-up, was predictive of admission in intensive care unit and/or of all-cause death, both mainly due to severe disease flares and premature cardiovascular complications. Conclusion This study suggests a link between DLCO alteration and disease damage, potentially related to SLE vasculopathy, and a prognostic value of DLCO on death or intensive care unit admission in SLE.

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Arterial stiffness and atherosclerosis in systemic lupus erythematosus patients

Cited by 3 publications

References 36 publications

SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis

SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis

Cardiac and vascular complications in lupus: Is there a role for sex?

Prognostic value and predictors of the alteration of the diffusing capacity of the lungs for carbon monoxide in systemic lupus erythematosus

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