Accelerated Atherosclerosis in Rheumatoid Arthritis: Rationale for Mannose-binding Lectins?
Accelerated Atherosclerosis in Rheumatoid Arthritis: Rationale for Mannose-binding Lectins?
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DOI：
10.3899/jrheum.091364
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发表时间：
2010-03
期刊：
影响因子：
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通讯作者：
B. Nakken;P. Szodoray
中科院分区：
文献类型：
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作者：
B. Nakken;P. Szodoray
类风湿性关节炎（RA）以累及全身结缔组织的慢性炎症为特征，尤其是腹泻关节，最终导致关节破坏和身体残疾。与糜糜性关节炎同时发生的还有其他关节外表现，表现为免疫系统的全身性激活1，这通常与高死亡率有关2。动脉粥样硬化被认为是RA3的关节外表现。与健康受试者相比，公认的类风湿性关节炎会降低平均预期寿命4,5。总体而言，RA6地区的死亡率高出约40%。除了非甾体抗炎药（NSAID）引起的感染和胃肠道出血外，类风湿关节炎的心血管（CV）死亡率也增加。除了心血管疾病外，类风湿性关节炎的主要死亡原因是感染和恶性肿瘤，这也会导致死亡率增加7,8。RA患者动脉粥样硬化的加速表现为心血管发病率和死亡率的增加8 - 12。一般来说，在RA患者中，CV疾病平均使预期寿命减少5 - 10年。在类风湿性关节炎和动脉粥样硬化中，炎症免疫介导的过程都起着核心作用，这两种疾病有几个共同的致病机制14,16,17。除了常见的炎症途径外，RA本身也被认为是加速CV疾病的独立危险因素18,19。在一项基于超过10万名受试者的大型前瞻性女性队列研究中，与没有RA19的受试者相比，RA患者发生心肌梗死的风险显著增加。传统的CV风险…请与Szodoray博士联系；电子邮件:szodoray在}{gmail.com
Rheumatoid arthritis (RA) is characterized by chronic inflammation involving connective tissues throughout the body, particularly diarthrodial joints, eventually leading to joint destruction and physical disability1. In parallel with erosive arthritis, other extraarticular manifestations have been described in the disease, representing systemic activation of the immune system1, which is generally associated with excess mortality2. Atherosclerosis, among others, is considered an extraarticular manifestation of RA3. Well established RA reduces median life expectancy, compared to that of healthy subjects4,5. Overall, about 40% excess mortality has been shown in RA6. In addition to infections and gastrointestinal hemorrhage due to nonsteroidal antiinflammatory drugs (NSAID), cardiovascular (CV) mortality is increased in RA. Besides CV diseases, the leading causes of death in RA are infection and malignancies, which also contribute to increased mortality7,8. Accelerated atherosclerosis in RA is signified by increased CV morbidity and mortality8–12. Generally, in patients with RA, CV diseases reduce life expectancy by 5 to 10 years on average13–15. In both RA and atherosclerosis, inflammatory immune-mediated processes play central roles, and the 2 diseases share several common pathogenic mechanisms14,16,17. Besides the common inflammatory pathways, RA itself has been considered as an independent risk factor for accelerated CV disease18,19. In a large prospective cohort of women, based on over 100,000 subjects, participants with RA had a significantly increased risk of myocardial infarction compared to those without RA19. Traditional CV risk … Address correspondence to Dr. Szodoray; E-mail: szodoray{at}gmail.com