Microvascular endothelial dysfunction in rheumatoid arthritis

Abstract

The systemic autoimmune disease rheumatoid arthritis (RA) is characterized by increased cardiovascular mortality and morbidity and is an independent cardiovascular risk factor. Cardiovascular diseases (CVDs) result from accelerated atherogenesis, which is a consequence of endothelial dysfunction in the early stages of the disease. Endothelial dysfunction is a functional and reversible alteration of endothelial cells and leads to a shift in the properties of the endothelium towards reduced vasodilation, a pro-inflammatory state, and proliferative and prothrombotic properties. In RA, endothelial dysfunction can occur in the large vessels (such as the conduit arteries) and in the small vessels of the microvasculature, which supply oxygen and nutrients to the tissue and control inflammation, repair and fluid exchange with the surrounding tissues. Growing evidence suggests that microvascular endothelial dysfunction contributes to CVD development, as it precedes and predicts the development of conduit artery atherosclerosis and associated risk factors. As such, numerous studies have investigated microvascular endothelial dysfunction in RA, including its link with disease activity, disease duration and inflammation, the effect of treatments on endothelial function, and possible circulating biomarkers of microvascular endothelial dysfunction. Such findings could have important implications in the cardiovascular risk management of patients with RA.

Microvascular Disease and Small-Vessel Disease: The Nexus of Multiple Diseases of Women

“…38,39 There is no correlation between microvascular and macrovascular endothelial dysfunction in RA cohorts, suggesting a different underlying vascular pathology. 40 Despite the increased incidence of CAD in RA, patients with RA frequently have myocardial ischemia in the absence of obstructive CAD, highlighting the influence of CMD. 41 Such findings have important implications for the cardiovascular risk management of patients with RA, which is also a risk-enhancing factor in the 2018 Cholesterol Guidelines, 34 along with other inflammatory conditions.…”

Эндотелиотропные Эффекты Методжекта И Ритуксимаба У Больных Ревматоидным Артритом И Гипертонической Болезнью

“…Так же неясны сроки возникновения ГБ относительно начала заболевания РА. В некоторых источниках сообщается о повышенной атеросклеротической нагрузке у пациентов РА с длительностью заболевания менее года [4,8,11,12]. Эндотелиальная дисфункция (ЭД) является ранним индикатором атерогенеза.…”

Ubiquitin-based modifications in endothelial cell–cell contact and inflammation

“…The inner lining of all blood and lymphatic vessels is formed by a monolayer of vascular endothelial cells (ECs), which preserves integrity through dynamic but well-controlled cell-cell contacts. Loss of endothelial integrity, due to increased actomyosin-based contractility and reduced cell-cell contact, is among the first signs of inflammation and is associated with vascular pathology that accompanies chronic disorders, such as diabetes, atherosclerosis or rheumatoid arthritis (Bordy et al, 2018;Huveneers et al, 2015;Saharinen et al, 2017). Because of its clinical relevance, there is much interest in the mechanisms that govern endothelial integrity.…”