Roubille Camille, Martel-Pelletier Johanne, Haraoui Boulos, Tardif Jean-Claude, Pelletier Jean-Pierre
Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Notre-Dame Hospital, 1560 Sherbrooke Street East, Montreal, Quebec, Canada.
Antiinflamm Antiallergy Agents Med Chem. 2013;12(1):68-82. doi: 10.2174/1871523011312010009.
Patients with chronic inflammatory diseases such as rheumatoid arthritis have a higher risk of cardiovascular diseases and related mortality compared to the general population. This risk is first due to classical cardiovascular risk factors but also due to systemic inflammation which is independently involved, causing accelerated atherosclerosis, myocardial infarction, cerebrovascular disease and heart failure (HF). Pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1 and IL-6 could be major actors on this pathophysiology. Biologics are effective specific treatments in the management of inflammatory rheumatic and systemic diseases. In this review, beneficial and deleterious effects on the heart and vessels of the biologics used in the management of inflammatory arthritis and vasculitides will be discussed, focusing on TNF-alpha, IL-6 and IL-1 blockades, and anti-CD20. Noninflammatory cardiac conditions, such as heart failure, myocardial infarction, and cardiovascular conditions such as atherosclerosis, as well as inflammatory diseases including vasculitides will be discussed.
与普通人群相比，患有类风湿关节炎等慢性炎症性疾病的患者患心血管疾病及相关死亡的风险更高。这种风险首先归因于经典的心血管危险因素，也归因于独立起作用的全身炎症，后者会导致动脉粥样硬化加速、心肌梗死、脑血管疾病和心力衰竭（HF）。促炎细胞因子，如肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1和IL-6可能是这一病理生理过程的主要参与者。生物制剂是治疗炎性风湿性疾病和全身性疾病的有效特效药物。在本综述中，将讨论用于治疗炎性关节炎和血管炎的生物制剂对心脏和血管的有益和有害影响，重点关注TNF-α、IL-6和IL-1阻断剂以及抗CD20。还将讨论非炎性心脏疾病，如心力衰竭、心肌梗死，以及心血管疾病，如动脉粥样硬化，以及包括血管炎在内的炎性疾病。
