Kukuy Olga, Livneh Avi, Mendel Liran, Benor Ariel, Giat Eitan, Perski Oleg, Feld Olga, Kassel Yonatan, Ben-Zvi Ilan, Lidar Merav, Holtzman Eliezer J, Leiba Adi
Heller Institute of Medical Research; and Institute of Nephrology and Hypertension, Sheba Medical Center, Tel Hashomer, Israel.
Heller Institute of Medical Research; Rheumatology Unit; and Department of Medicine F, Sheba Medical Center, Tel Hashomer; and Sackler Faculty of Medicine, Tel Aviv University, Israel.
Clin Exp Rheumatol. 2017 Nov-Dec;35 Suppl 108(6):32-37. Epub 2017 Feb 9.
Familial Mediterranean fever (FMF) is an autoinflammatory disorder with episodic and persistent inflammation, which is only partially suppressed by continuous colchicine treatment. While chronic inflammation is considered an important cardiovascular risk factor in many inflammatory disorders, its impact in FMF is still disputed. We measured arterial stiffness, a marker of atherosclerotic cardiovascular disease, in a group of FMF patients, in order to evaluate the cardiovascular consequences of inflammation in FMF and the role of colchicine in their development.
Eighty colchicine treated FMF patients, without known traditional cardiovascular risk factors, were randomly enrolled in the study. Demographic, genetic, clinical and laboratory data were retrieved from patient files and examinations. Arterial stiffness was measured using pulse wave velocity (PWV). The recorded values of PWV were compared with those of an age and blood pressure adjusted normal population, using internationally endorsed values.
FMF patients displayed normal PWV values, with an even smaller than expected proportion of patients deviating from the 90th percentile of the reference population (5% vs. 10%, p=0.02). The lowest PWV values were recorded in patients receiving the highest dose of colchicine (≥2 mg vs. 0-1 mg, p=0.038), and in patients of North African Jewish origin, whose disease was typically more severe than that of patients of other ethnicities; both observations supporting an ameliorating colchicine effect (p=0.043).
Though subjected to chronic inflammation, colchicine treated FMF patients have normal PWV. Our findings provide direct evidence for a cardiovascular protective role of colchicine in FMF.
家族性地中海热（FMF）是一种伴有发作性和持续性炎症的自身炎症性疾病，连续使用秋水仙碱治疗只能部分抑制这种炎症。虽然慢性炎症在许多炎症性疾病中被认为是重要的心血管危险因素，但其在FMF中的影响仍存在争议。我们对一组FMF患者测量了动脉僵硬度（动脉粥样硬化性心血管疾病的一个标志物），以评估FMF中炎症的心血管后果以及秋水仙碱在其发展中的作用。
80名接受秋水仙碱治疗且无已知传统心血管危险因素的FMF患者被随机纳入研究。从患者档案和检查中获取人口统计学、遗传学、临床和实验室数据。使用脉搏波速度（PWV）测量动脉僵硬度。使用国际认可的值，将记录的PWV值与年龄和血压调整后的正常人群的值进行比较。
FMF患者的PWV值正常，偏离参考人群第90百分位数的患者比例甚至低于预期（5%对10%，p = 0.02）。接受最高剂量秋水仙碱（≥2毫克对0 - 1毫克，p = 0.038）的患者以及北非犹太裔患者记录到最低的PWV值，这些患者的疾病通常比其他种族患者更严重；这两个观察结果均支持秋水仙碱有改善作用（p = 0.043）。
尽管受到慢性炎症影响，但接受秋水仙碱治疗的FMF患者PWV正常。我们的研究结果为秋水仙碱在FMF中的心血管保护作用提供了直接证据。
