Servicio de Reumatología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
Servicio de Reumatología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
Med Clin (Barc). 2017 Aug 22;149(4):160-169. doi: 10.1016/j.medcli.2017.05.003. Epub 2017 Jun 12.
Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are 2 highly related autoimmune-rheumatic diseases associated with an increased risk of developing cardiovascular (CV) diseases. Despite the great progresses made in understanding the pathological mechanisms leading to CV diseases in those pathologies, there is still the unmet need to improve long term prognosis. CV diseases in SLE and APS is thought to happen as the result of a complex interaction between traditional CV risk factors, immune deregulation and disease activity, including the synergic effect of cytokines, chemokines, adipokines, proteases, autoantibodies, adhesion receptors, oxidative stress and a plethora of intracellular signalling molecules. Genomic and epigenomic analyses have further allowed the identification of specific signatures explaining the proathero-thrombotic profiles of APS and SLE patients. This review examines the complex role of these heterogeneous factors, and analyses new therapeutic approaches under study to reduce the CV risk in these autoimmune disorders.
系统性红斑狼疮（SLE）和抗磷脂综合征（APS）是两种高度相关的自身免疫性风湿病，与心血管疾病（CV）风险增加相关。尽管在理解这些疾病导致心血管疾病的病理机制方面取得了重大进展，但仍需要改善长期预后。SLE 和 APS 的 CV 疾病被认为是由传统 CV 危险因素、免疫失调和疾病活动之间的复杂相互作用引起的，包括细胞因子、趋化因子、脂肪因子、蛋白酶、自身抗体、黏附受体、氧化应激和大量细胞内信号分子的协同作用。基因组和表观基因组分析进一步确定了特定的特征，这些特征解释了 APS 和 SLE 患者的动脉粥样硬化血栓形成特征。本文综述了这些异质因素的复杂作用，并分析了正在研究中的新的治疗方法，以降低这些自身免疫性疾病的 CV 风险。
