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Studies from Maastricht University provide new data on takayasu arteritis risk factors
2009 JUN 1 - (NewsRx.com) -- Research findings, 'Translational mini-review series on immunology of vascular disease: accelerated atherosclerosis in vasculitis,' are discussed in a new report. "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," scientists in Maastricht, Netherlands report. "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," wrote Tervaert J.W Cohen and colleagues, Maastricht University. The researchers concluded: "Finally, classical risk factors for cardiovascular disease should be monitored and treated as much as possible." Cohen and colleagues published their study in Clinical & Experimental Immunology (Translational mini-review series on immunology of vascular disease: accelerated atherosclerosis in vasculitis. Clinical & Experimental Immunology, 2009;156(3):377-85). For additional information, contact J.W. Cohen Tervaert, Division of Clinical and Experimental Immunology, Dept. of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands. The publisher's contact information for the journal Clinical & Experimental Immunology is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: Netherlands, Maastricht, Takayasu Arteritis Risk Factors, Angiology, Arthritis, Atherosclerosis, Cardiology, Cardiovascular Disease, Giant Cell Arteritis, Heart Disease, Immunology, Inflammation, Lupus, Mucocutaneous Lymph Node Syndrome, Rheumatoid Arthritis, Takayasu Arteritis, Temporal Arteritis, Vascular Disease, Vasculitis. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.
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