Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Asturias, Spain.
Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Ann Rheum Dis. 2015 May;74(5):921-7. doi: 10.1136/annrheumdis-2013-204250. Epub 2014 Jan 7.
The mechanisms underlying the increased cardiovascular risk (CVR) of rheumatoid arthritis (RA) patients remain unclear. Since the recently discovered angiogenic T cells (Tang) could have a role in endothelial repair through cooperating with endothelial progenitor cells (EPC), the main aim of this study was to analyse the Tang and EPC populations in relation to disease-specific features and traditional CVR factors.
Tang (CD3(+)CD31(+)CXCR4(+)) and EPC (CD34(+)VEGFR2(+)CD133(+)) populations were quantified by flow cytometry in peripheral blood samples from 103 RA patients and 18 matched healthy controls (HC). Clinical features and traditional CVR factors were obtained from clinical records, and 28-joint Disease Activity Score was used for measuring disease activity. Interferon (IFN) α serum levels were measured by immunoassays.
Tang and EPC were strongly decreased in RA patients. In HC, but not in patients, both populations were positively correlated and inversely related to low density lipoprotein- and total-cholesterol levels. Sex, diabetes, dyslipidaemia, hypertension or obesity did not significantly influence Tang in patients, although detected in smokers. However, Tang were closely related to disease activity, autoantibody positivity and IFNα levels. Multiple regression analysis adjusted for traditional CVR factors confirmed that only disease activity, age at diagnosis, antinuclear antibody positivity and smoking habit could predict Tang frequency. Finally, patients who had suffered a CV event since their RA diagnosis presented higher Tang decrease and IFNα levels than those who were CV event-free.
Disease-specific parameters, including disease activity, autoantibody profiles and IFNα levels, are associated with Tang decrease in RA, thus probably accounting for CVR.
类风湿关节炎（RA）患者心血管风险（CVR）增加的机制尚不清楚。由于最近发现的血管生成 T 细胞（Tang）可能通过与内皮祖细胞（EPC）合作在血管内皮修复中发挥作用，因此本研究的主要目的是分析 Tang 和 EPC 群体与疾病特异性特征和传统 CVR 因素的关系。
通过流式细胞术定量检测 103 例 RA 患者和 18 例匹配的健康对照者（HC）外周血样本中的 Tang（CD3(+)CD31(+)CXCR4(+)）和 EPC（CD34(+)VEGFR2(+)CD133(+)）群体。临床特征和传统 CVR 因素从临床记录中获得，28 关节疾病活动评分用于衡量疾病活动度。通过免疫测定法测量干扰素（IFN）α血清水平。
RA 患者的 Tang 和 EPC 明显减少。在 HC 中，但在患者中，这两种群体呈正相关，与低密度脂蛋白和总胆固醇水平呈负相关。性别、糖尿病、血脂异常、高血压或肥胖症并未显著影响患者中的 Tang，尽管在吸烟者中检测到。然而，Tang 与疾病活动度、自身抗体阳性和 IFNα水平密切相关。经传统 CVR 因素调整的多元回归分析证实，只有疾病活动度、诊断时年龄、抗核抗体阳性和吸烟习惯才能预测 Tang 频率。最后，与无心血管事件的患者相比，自 RA 诊断以来发生过心血管事件的患者 Tang 减少和 IFNα 水平更高。
包括疾病活动度、自身抗体谱和 IFNα 水平在内的疾病特异性参数与 RA 中 Tang 的减少有关，从而可能导致 CVR。
