当前位置： SCI文献检索 > CLINICAL AND EXPERIMENTAL IMMUNOLOGY期刊下所有文献 > Translational mini-review series on immunology of vascular disease: accelerated atherosclerosis in vasculitis.

Translational mini-review series on immunology of vascular disease: accelerated atherosclerosis in vasculitis.

Abstract：

:Premature atherosclerosis has been observed during the course of different systemic inflammatory diseases such as rheumatoid arthritis and sytemic lupus erythematosus. Remarkably, relatively few studies have been published on the occurrence of accelerated atherosclerosis in patients with vasculitis. In giant cell arteritis (GCA), mortality because of ischaemic heart disease is not increased. In addition, intima media thickness (IMT) is lower in patients with GCA than in age-matched controls. In contrast, IMT is increased significantly in Takayasu arteritis, another form of large vessel vasculitis occurring in younger patients. In Takayasu arteritis and in Kawasaki disease, a form of medium-sized vessel vasculitis, accelerated atherosclerosis has been well documented. In small vessel vasculitis because of anti-neutrophil cytoplasmic autoantibodies-associated vasculitis, cardiovascular diseases are a major cause of mortality. IMT measurements reveal conflicting results. During active disease these patients experience acceleration of the atherosclerotic process. However, when inflammation is controlled, these patients have atherosclerotic development as in healthy subjects. Several risk factors, such as diabetes and hypertension, are present more often in patients with vasculitis compared with healthy controls. In addition, steroids may be pro-atherogenic. Most importantly, many patients have impaired renal function, persistent proteinuria and increased levels of C-reactive protein, well-known risk factors for acceleration of atherosclerosis. Enhanced oxidation processes, persistently activated T cells and reduced numbers of regulatory T cells are among the many pathophysiological factors that play a role during acceleration of atherogenesis. Finally, autoantibodies that may be relevant for acceleration of atherosclerosis are found frequently in elevated titres in patients with vasculitis. Because patients have an increased risk for cardiovascular events, vasculitis should be treated with as much care as possible. In addition, treatment should be considered with angiotensin-converting-enzyme inhibitors and/or angiotensin receptor-1 blockers, statins and acetylsalicyl acid. Finally, classical risk factors for cardiovascular disease should be monitored and treated as much as possible.

journal_name

Clin Exp Immunol

journal_title

Clinical and experimental immunology

authors

Tervaert JW

doi

10.1111/j.1365-2249.2009.03885.x

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

377-85

issue

eissn

0009-9104

issn

1365-2249

pii

CEI3885

journal_volume

156

pub_type

杂志文章,评审

在线工具

Translational mini-review series on immunology of vascular disease: accelerated atherosclerosis in vasculitis.