RESEARCH - Endothelial dysfunction in RA is associated with a reduced number and impaired function of EPC

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Ann Rheum Dis. 2005 Jun 23; [Epub ahead of print]

Endothelial dysfunction in patients with rheumatoid arthritis is associated

with a reduced number and impaired function of endothelial progenitor cells.

Herbrig K, Haensel S, Oelschlaegel U, Pistrosch F, Foerster S, Passauer J.

Department of Nephrology / Internal Medicine III, Germany.

OBJECTIVE: Rheumatoid arthritis (RA) is associated with increased morbidity

and mortality attributable to accelerated atherosclerosis and cardiovascular

events. Endothelial progenitor cells (EPC) seem to play an important role in

the defence system against arteriosclerosis. METHODS: We studied number and

function of endothelial progenitor cells in young RA patients (n=13) with

low disease activity (DAS 28 3.5+/-0.3) and healthy control subjects (n=13).

Endothelial function was investigated by agonist-induced endothelium

dependent vasodilation measured by the forearm blood flow technique.

Migratory activity and adhesion of EPC to TNFa activated mature endothelial

cells and components of the extracellular matrix were tested in vitro.

Putative precursor populations (CD34+, CD34+/CD133+ and CD34+/KDR+

hematopoietic stem cells) were measured by flow cytometric analysis.

RESULTS: Acetylcholine-induced, endothelium- dependent vasodilation was

reduced by approximately 50% in RA patients indicating endothelial

dysfunction, while endothelium-independent vasodilation in response to

glyceryl-trinitrate was at control level. We found significantly reduced

numbers of EPC in these patients compared to control. Migratory activity of

EPC was decreased in RA patients. Adhesion to mature endothelial cells after

activation with TNF-a was enhanced only in control. The adhesion to matrix

proteins and the number of putative precursor cell lineages was comparable

in both groups.

CONCLUSION: This study demonstrates that endothelial dysfunction in RA

patients with low-grade inflammation is associated with a reduced number and

partial dysfunction of EPC. Further studies have to explore whether

interventions that potentially ameliorate the number and function of EPC

also result in an improvement of endothelial function in these patients.

PMID: 15975971

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5975971 & dopt=Abstract

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