Foster Will, Shantsila Eduard, Carruthers David, Lip Gregory Y H, Blann Andrew D
University Department of Medicine, City Hospital, Birmingham, B18 7QH, UK.
Rheumatology (Oxford). 2009 Mar;48(3):285-8. doi: 10.1093/rheumatology/ken486. Epub 2009 Jan 19.
RA is associated with endothelial cell dysfunction (ECD) and increased cardiovascular mortality and morbidity. Circulating endothelial cells (CECs) are a novel marker of severe endothelial damage. We hypothesized altered CECs in patients with RA compared with community controls (CCs) and hospital controls (HCs, with diabetes and hypertension) correlate with established plasma markers of inflammation and of ECD.
CECs (CD146-immunobeads), von Willebrand factor, soluble E-selectin, soluble intercellular adhesion molecule-1, soluble vascular endothelial adhesion molecule-1 (sVCAM, all ELISA) and C-reactive protein (CRP, immunonephelometry) were measured in 57 patients with RA, 45 CC and 23 HC patients.
CECs in RA [median/interquartile range 8 (5-13.5) cells/ml] were elevated compared with either CC [4 (2-8.5) cells/ml] or HC [4 (1-8) cells/ml] (both P < 0.001). Levels of CECs did not correlate with other markers of ECD or of inflammation but did correlate inversely with sVCAM.
Evidence of endothelial damage in the form of mildly increased numbers of CECs is present in RA and is independent of plasma markers of inflammation and of ECD.
类风湿关节炎（RA）与内皮细胞功能障碍（ECD）相关，且心血管疾病死亡率和发病率增加。循环内皮细胞（CEC）是严重内皮损伤的一种新型标志物。我们假设与社区对照（CC）和医院对照（HC，患有糖尿病和高血压）相比，RA患者的CEC改变与既定的炎症和ECD血浆标志物相关。
对57例RA患者、45例CC患者和23例HC患者检测了CEC（CD146免疫磁珠法）、血管性血友病因子、可溶性E选择素、可溶性细胞间黏附分子-1、可溶性血管内皮黏附分子-1（sVCAM，均采用酶联免疫吸附测定法）和C反应蛋白（CRP，免疫比浊法）。
与CC组[4（2 - 8.5）个细胞/毫升]或HC组[4（1 - 8）个细胞/毫升]相比，RA患者的CEC[中位数/四分位间距为8（5 - 13.5）个细胞/毫升]升高（均P < 0.001）。CEC水平与ECD或炎症的其他标志物无相关性，但与sVCAM呈负相关。
RA患者存在以CEC数量轻度增加形式的内皮损伤证据，且独立于炎症和ECD的血浆标志物。
