Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus.
Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus.
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DOI：
10.1155/2014/178721
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发表时间：
2014
影响因子：
--
通讯作者：
Kow NY
中科院分区：
文献类型：
--
作者：
Mak A;Kow NY
系统性红斑狼疮（SLE）患者的动脉粥样硬化加速，并导致这些患者过多的心血管并发症。尽管对心血管疾病的认识有所提高，临床诊断也出现了，但大多数患者的动脉粥样硬化形成过程在临床上保持沉默，直到出现心血管并发症的症状和体征。有证据表明，在狼疮患者临床上明显的心血管疾病发展之前，血管损伤已经发生，在动脉粥样硬化形成的临床前阶段进行干预是合理的。事实上，内皮功能障碍，动脉粥样硬化形成的最早阶段之一，已被证明发生在狼疮患者，即使他们是初治心血管疾病。目前已知的"内皮毒性"因子包括1型干扰素、促炎性细胞因子、炎性细胞、免疫复合物、共刺激分子、嗜中性粒细胞胞外陷阱、狼疮相关自身抗体、氧化应激和血脂异常，以及对血管修复至关重要的内皮祖细胞（EPC）的异常功能，这可能会使平衡向内皮功能障碍和狼疮患者发生心血管疾病的倾向倾斜。在这篇综述中，内皮细胞的生理改变，因素导致扰动血管修复狼疮EPC和促动脉粥样硬化因子对内皮细胞的影响，这可能会导致动脉粥样硬化狼疮患者将进行讨论。
Atherosclerosis is accelerated in patients with systemic lupus erythematosus (SLE) and it leads to excessive cardiovascular complications in these patients. Despite the improved awareness of cardiovascular disease and advent of clinical diagnostics, the process of atherogenesis in most patients remains clinically silent until symptoms and signs of cardiovascular complications develop. As evidence has demonstrated that vascular damage is already occurring before clinically overt cardiovascular disease develops in lupus patients, intervention at the preclinical stage of atherogenesis would be plausible. Indeed, endothelial dysfunction, one of the earliest steps of atherogenesis, has been demonstrated to occur in lupus patients even when they are naïve for cardiovascular disease. Currently known “endothelium-toxic” factors including type 1 interferon, proinflammatory cytokines, inflammatory cells, immune complexes, costimulatory molecules, neutrophils extracellular traps, lupus-related autoantibodies, oxidative stress, and dyslipidemia, coupled with the aberrant functions of the endothelial progenitor cells (EPC) which are crucial to vascular repair, likely tip the balance towards endothelial dysfunction and propensity to develop cardiovascular disease in lupus patients. In this review, altered physiology of the endothelium, factors leading to perturbed vascular repair contributed by lupus EPC and the impact of proatherogenic factors on the endothelium which potentially lead to atherosclerosis in lupus patients will be discussed.
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