Slot Marjan C, Kroon Abraham A, Damoiseaux Jan G M C, Theunissen Ruud, Houben Alfons J H M, de Leeuw Peter W, Tervaert Jan Willem Cohen
Department of Clinical and Experimental Immunology, University Hospital Maastricht, Maastricht, The Netherlands.
Department of Internal Medicine, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Rheumatol Int. 2017 May;37(5):791-798. doi: 10.1007/s00296-016-3643-8. Epub 2017 Jan 13.
Previous studies have suggested an increased risk for cardiovascular events in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). We analyzed the presence of atherosclerotic damage in patients with AAV in relation to the presence of CD4CD28 T cells and antibodies against cytomegalovirus (CMV) and human Heat-Shock Protein 60 (hHSP60). In this cross-sectional study, patients with inactive AAV were compared with healthy controls (HC). Carotid intima-media thickness (IMT) and aortic pulse-wave velocity (PWV) were measured. In addition, CD4CD28 T cells, anti-CMV, and anti-hHSP60 levels were determined. Forty patients with AAV were included. Patients' spouses were recruited as HC (N = 38). CD4CD28 T cells are present in patients with AAV in a higher percentage (median 3.1, range 0.01-85) than in HC (0.28, 0-36, P < 0.0001). No significant difference in IMT (mm) between patients and controls was detected (mean 0.77 ± standard deviation 0.15 and 0.73 ± 0.11, respectively, P = 0.20). PWV standardized for MAP was increased in AAV patients (9.80 ± 2.50 m/s, compared to 8.72 ± 1.68 in HC, P = 0.04). There was a strong association between a previous CMV infection and the presence and percentage of CD4CD28 T cells (0.33 vs 13.8, P < 0.001). There was no relationship between CD4CD28 T cells and/or a previous CMV infection and IMT or PWV. There was no relation between anti-hHSP60 and CD4CD28 T cells. Increased PWV values suggest atherosclerotic damage in patients with AAV. Plaque size, as determined by IMT, did not differ. CD4CD28 T cells are increased in AAV and related to the previous CMV infection.
既往研究提示抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）患者发生心血管事件的风险增加。我们分析了AAV患者动脉粥样硬化损伤的存在情况，及其与CD4CD28 T细胞、抗巨细胞病毒（CMV）抗体和抗人热休克蛋白60（hHSP60）抗体的关系。在这项横断面研究中，将病情缓解的AAV患者与健康对照（HC）进行比较。测量了颈动脉内膜中层厚度（IMT）和主动脉脉搏波速度（PWV）。此外，还测定了CD4CD28 T细胞、抗CMV抗体和抗hHSP60抗体水平。纳入了40例AAV患者。招募患者的配偶作为健康对照（n = 38）。与健康对照（0.28，范围0 - 36，P < 0.0001）相比，AAV患者中CD4CD28 T细胞的百分比更高（中位数3.1，范围0.01 - 85）。未检测到患者与对照之间IMT（mm）有显著差异（分别为平均值0.77 ± 标准差0.15和0.73 ± 0.11，P = 0.20）。校正平均动脉压（MAP）后的PWV在AAV患者中升高（9.80 ± 2.50 m/s，而健康对照为8.72 ± 1.68，P = 0.04）。既往CMV感染与CD4CD28 T细胞的存在及百分比之间存在强关联（0.33对13.8，P < 0.001）。CD4CD28 T细胞和/或既往CMV感染与IMT或PWV之间无关联。抗hHSP60抗体与CD4CD28 T细胞之间无关联。PWV值升高提示AAV患者存在动脉粥样硬化损伤。通过IMT测定的斑块大小无差异。AAV患者中CD4CD28 T细胞增加，且与既往CMV感染有关。
