Decreased circulating endothelial progenitor cells as an early risk factor of subclinical atherosclerosis in systemic lupus erythematosus

Castejón, Raquel; Jimenez-Ortiz, C; Valero-González, Sara; Rosado, Silvia; Mellor, Susana; Yebra-Bango, M

doi:10.1093/rheumatology/ket367

Cited by 38 publications

(32 citation statements)

References 31 publications

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“…The role of EPC in relation with cardiovascular disease is well established and in patients with a chronic inflammatory disorder such as systemic lupus erythematosus and rheumatoid arthritis, EPC has been demonstrated to be related to subclinical atherosclerosis. 14,21 The present study extends these finding by showing that among all subtypes of EPC, CD34 + EPC is most correlated with arterial stiffness in patients with psoriasis. Although the reason is uncertain, this could be explained by the ability of CD34 + EPC to differentiate into multiple cell types including hematopoietic stem cells, smooth muscle and endothelial cells.…”

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 95%

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Relation between endothelial progenitor cells and arterial stiffness in patients with psoriasis

Liu

Chen

Zhen

et al. 2015

The Journal of Dermatology

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Patients with psoriasis are prone to premature atherosclerosis. We hypothesize that depletion of circulating endothelial progenitor cells (EPC) is related to patients with psoriasis and can contribute to the development of atherosclerosis. Thirty-five plaque-type psoriasis patients (41.9 ± 5.5 years, 30 men) and 20 age- and sex-matched controls were studied. Four subpopulations of EPC, namely, CD34(+) EPC, CD133(+) EPC, CD34(+) /kinase insert domain-containing receptor (KDR)(+) EPC and CD133(+) /KDR(+) EPC were measured by flow cytometry. Arterial stiffness in psoriasis patients was assessed by heart to ankle pulse wave velocity (haPWV), augmentation index (AI) and carotid intima media thickness (IMT). Patients with psoriasis had a lower level of CD34(+) EPC (7.85 ± 2.49% vs 6.26 ± 2.13%, P = 0.02) compared with healthy controls. In patients with psoriasis, level of CD34(+) EPC was negatively related with haPWV (r = -0.43 P = 0.01) and Psoriasis Area and Severity Index (r = -0.39 P = 0.02). Multivariate regression analysis further demonstrated that haPWV was independently associated with level of CD34(+) EPC. Each percentage decrease in CD34(+) EPC accounted for an increase in haPWV of +0.02 m/s. The result demonstrated that patients with psoriasis had reduced CD34(+) EPC compared with controls. Importantly, CD34(+) EPC was independently related with haPWV in these patients. This finding suggests that EPC reduction is associated with the development of arterial stiffness in patients with psoriasis.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 95%

Relation between endothelial progenitor cells and arterial stiffness in patients with psoriasis

Liu

Chen

Zhen

et al. 2015

The Journal of Dermatology

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“…Metabolic syndrome is accelerated in SLE patients and has been receiving increased attention . Multiple pathways might be involved in SLE endothelial dysfunction, such as neutrophil extracellular traps , interleukin‐10 , type I interferon , decreased circulating endothelial progenitor cells , and proinflammatory cytokines . Our findings suggest a statistically consistent relationship between increased morbidity in SLE patients and any smoking exposure.…”

Section: Discussionmentioning

confidence: 55%

Smoking and Its Association With Morbidity in Systemic Lupus Erythematosus Evaluated by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index: Preliminary Data and Systematic Review

Montes

Mocarzel

Lanzieri

et al. 2016

Arthritis & Rheumatology

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Objective. Due to the increased availability of effective treatments, patients with systemic lupus erythematosus (SLE) now have longer survival times, and factors involved in cumulative chronic damage in SLE need to be better understood. This study was undertaken to evaluate the relationship between smoking and cumulative chronic damage in SLE patients.Methods. A cross-sectional study of SLE patients was performed to investigate the possible association between smoking exposure (ever [previous or current, active or secondhand smokers] or never) and cumulative chronic damage as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). A systematic review of the literature was conducted by cross-searching Medline for the terms lupus and smoking.Results. We enrolled 105 patients with SLE (96% female), with a mean 6 SD age of 40.7 6 11.4 years and a mean followup time of 8.98 years. Of the 105 patients, 74 had an SDI score of 1-10, and 31 had an SDI score of 0. The difference between smoking exposure and no smoking exposure was significant (P 5 0.02 by chi-square test in contingency table analysis), and SLE patients who were never exposed to smoking had 0.78 times the risk of progressing toward a cumulative damage status (SDI score of > 0) (95% confidence interval 0.16-0.98) throughout the followup period compared to those who were ever exposed. In the systematic review of the literature, we found only a small number of articles that addressed some aspects of the relationship between smoking exposure and cumulative damage in SLE patients.Conclusion. Our findings indicate that smoking exposure is associated with cumulative chronic damage, as determined by the SDI score, in patients with SLE. Smoking exposure may have deleterious effects on lupus morbidity, and more detailed studies of this association are needed.

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“…Disease activity, duration, specific manifestations or organ damage have been shown to increase the possibility of developing CVD. Dysfunctional immune and inflammatory response including the complement depletion, role of interferon, inflammatory cytokines and impaired endothelial function were revealed to contribute to the premature atherosclerosis development in patients with SLE …”

Section: Introductionmentioning

confidence: 99%

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

et al. 2019

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multiple organ involvement. 1 Since the strategies of treatment with glucocorticoids (GC) and immunosuppressive agents have been established, mortality risk has decreased in patients with SLE. 2 Infection and cardiovascular events are regarded as the most common causes of death in SLE. Cardiovascular diseases (CVD) are 5-10 times more common in patients with SLE than in the general population. 3-6 CVD in SLE occurs earlier than the general population and is affected by traditional risk factors such as obesity, diabetes, smoking and hypertension. 7,8 Disease Abstract Aim: Patients with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular disease owing to an immunological abnormality, along with traditional risk factors. We found that carotid artery intima-media thickness (cIMT) and plaque were associated with age, body mass index (BMI) and disease activity in a previous study 4 years ago. Our aim was to identify risk factors associated with progression of subclinical atherosclerosis in SLE. Methods:We assessed cIMT and plaque using Doppler ultrasonography in 61 Korean women with SLE who were enrolled in the previous study 4 years ago. Results:The mean cIMT of the patients was 0.39 ± 0.09 mm; 11 patients had carotid plaques, which was similar to the results of the previous study. Twenty-one patients had increased cIMT, and new carotid plaque had developed in seven patients. Patients with increased cIMT had a lower BMI and took fewer non-steroidal anti-inflammatory drugs and higher 4 year cumulative glucocorticoid dose than patients without increased cIMT. The 4 year cumulative glucocorticoid dose was higher in patients with carotid plaque than in those without. On multivariate regression analysis, BMI (odds ratio [OR] = 0.67, P = 0.034) was associated with increased cIMT, and the 4 year cumulative glucocorticoid dose was associated with increased cIMT (OR = 6.994, P = 0.025) and carotid plaque (OR = 5.651, P = 0.031). Conclusion:This prospective follow-up study on cIMT and plaque in patients with SLE showed that low BMI and 4 year cumulative glucocorticoid dose were associated with the progression of subclinical atherosclerosis. K E Y W O R D S atherosclerosis, body mass index, carotid artery, disease activity, glucocorticoid, systemic lupus erythematosus | 1411 JUNG et al. activity, duration, specific manifestations or organ damage have been shown to increase the possibility of developing CVD. Dysfunctional immune and inflammatory response including the complement depletion, role of interferon, inflammatory cytokines and impaired endothelial function were revealed to contribute to the premature atherosclerosis development in patients with SLE. 9-12An assessment of the risk for CVD can be established using various methods, including carotid artery Doppler ultrasound, coronary artery calcium score and pulse wave velocity. Several studies assessing the risk of CVD in SLE have used different methods. 13,14 Carotid artery int...

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Decreased circulating endothelial progenitor cells as an early risk factor of subclinical atherosclerosis in systemic lupus erythematosus

Abstract: Patients with a reduced percentage of EPCs showed pathological arterial stiffness and association with certain CV risk factors, suggesting that the measurement of circulating EPCs can be used as a biological marker to determine subclinical atherosclerosis in SLE.

Cited by 38 publications

References 31 publications

Relation between endothelial progenitor cells and arterial stiffness in patients with psoriasis

Relation between endothelial progenitor cells and arterial stiffness in patients with psoriasis

Smoking and Its Association With Morbidity in Systemic Lupus Erythematosus Evaluated by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index: Preliminary Data and Systematic Review

Body mass index and glucocorticoid dose contribute to subclinical atherosclerosis in Korean patients with systemic lupus erythematosus: A prospective 4 year follow‐up study

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