Endothelial dysfunction in patients with ankylosing spondylitis

Abstract

Ankylosing spondylitis (AS) is associated with accelerated atherosclerosis and enhanced cardiovascular morbidity and mortality compared to the general population. The mechanisms and mediators of this phenomenon have not been fully explained, but an expanding body of evidence demonstrates that increased cardiovascular risk in AS is heralded by endothelial dysfunction. We performed a literature review using the PubMed database from the year 2006 up to 2018. In this article we review the epidemiology, current evidence for impaired endothelial function, potential mechanisms and markers controlling this dysfunction, and finally we summarize the data regarding the efficacy of pharmacotherapy in reducing endothelial dysfunction in patients suffering from AS.

Effects of ankylosing spondylitis on cardiovascular disease: aMendelian randomization study

“…We found a negative causal association between AS and peripheral atherosclerosis. The majority of studies reported that AS is associated with accelerated atherosclerosis and enhanced cardiovascular morbidity and mortality ( Łosińska et al, 2019 ). However, no Grade A evidence links atherosclerosis to AS because most studies are cross sectional and involve small patient samples and controls.Platelets have beenrecognized as crucial regulators of inflammatory processes undervarious pathophysiological conditions.Previous study suggested that platelet may contribute to the inflammationseverity and treatment outcomes in AS patients ( Qian et al, 2020 ).Stephan Zeibigreported that platelets contribute to increased tissueoxidized low-density lipoprotein in the aortic wall but not in peripheral blood, which may be the evidence of the negative causal association between AS and peripheral atherosclerosis ( Zeibig et al, 2019 ).…”

There is urgent need to treat atherosclerotic cardiovascular disease risk earlier, more intensively, and with greater precision: A review of current practice and recommendations for improved effectiveness

“…Many others [314] . Substance use* Tobacco [ 315 , 316 ], marijuana [317] , [318] , [319] , alcohol [320] , cocaine [321] Autoimmune disease* Rheumatoid arthritis [ 322 , 323 ], Systemic Lupus Erythematosus [324] , psoriasis and psoriatic arthritis [ 325 , 326 ], ankylosing spondylitis [327] , scleroderma [328] , inflammatory bowel disease [329] , probably others immunological disease and inflammation elsewhere in the body [ 82 , 159 ]; clonal hematopoiesis of indeterminate potential (CHIP) [160] , [161] , [162] , [163] ; neutrophil extracellular traps [164] , [165] , [166] , [167] These are not yet readily actionable and further research is needed. Genetic factors and social determinants of health Knowledge and applicability are developing rapidly, already useful for FH and some other genetic variants [330] , [331] , [332] , [333] , [334] Race/ethnicity (All people are complex genetic mixtures, but some genetic factors are alerted by ethnicity in some cases.…”

Global Proteomic Analyses Reveals Abnormal Immune Regulation in Patients With New Onset Ankylosing Spondylitis

“…The pathologic mechanism of AS remains largely unclear but is thought to be immune-mediated and has a strong genetic association with HLA-B27, a class I human leukocyte antigen ( 4 , 5 ). Studies on AS have revealed that there is a tendency for endothelial dysfunction ( 6 ), and inflammation plays an important role in endothelial dysfunction ( 7 ). However, the complexity of the inflammatory process in AS is still poorly understood.…”