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系统性红斑狼疮与动脉粥样硬化的新见解。

Novel Insights in Systemic Lupus Erythematosus and Atherosclerosis.

作者信息

Teixeira Vítor, Tam Lai-Shan

机构信息

Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon, Portugal.

Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Sha Tin, Hong Kong.

出版信息

Front Med (Lausanne). 2018 Jan 29;4:262. doi: 10.3389/fmed.2017.00262. eCollection 2017.

Abstract

INTRODUCTION

The systemic inflammatory nature of systemic lupus erythematosus (SLE) is well patent not only in the diverse clinical manifestations of the disease but also in the increased risk of premature atherosclerosis and cardiovascular events (CVE), making SLE one of the most complex diseases to study and manage in clinical practice.

AIM

To travel from old aspects to modern insights on the physiopathology, new molecular biomarkers, imaging methods of atherosclerosis assessment, and the potential treatments of atherosclerosis in SLE.

METHODS

We conducted a literature search using PubMed database and performed a critical review.

CONCLUSION/DISCUSSION: Several developments have taken place in the understanding of the relationship between SLE and premature atherosclerosis. Nevertheless, cardiovascular diseases are still the major cause of reduced life expectancy in SLE and the main cause of death. The lack of standardization methods for the imaging assessment of atherosclerosis in SLE and the multifactorial nature of the disease are well patriated in the difficulty of achieving consistent and reproducible results among studies that focus in cardiovascular risk assessment and prediction. A raising number of molecular biomarkers of atherosclerosis have been proposed, but the combination of several biomarkers and risk factors may better estimate cardiovascular disease risk. Moreover, the development of effective therapies to prevent progression of atherosclerosis and CVE shall address systemic inflammation.

摘要

引言

系统性红斑狼疮(SLE)的全身炎症性质不仅在该疾病的多种临床表现中明显可见,而且在过早发生动脉粥样硬化和心血管事件(CVE)的风险增加方面也很明显,这使得SLE成为临床实践中最难研究和管理的疾病之一。

目的

从旧的方面探讨到对SLE中动脉粥样硬化的生理病理学、新的分子生物标志物、动脉粥样硬化评估的成像方法以及潜在治疗方法的现代见解。

方法

我们使用PubMed数据库进行了文献检索并进行了批判性综述。

结论/讨论:在对SLE与过早动脉粥样硬化之间关系的理解方面已经取得了一些进展。然而,心血管疾病仍然是SLE患者预期寿命缩短的主要原因和主要死亡原因。SLE中动脉粥样硬化成像评估缺乏标准化方法以及该疾病的多因素性质,在专注于心血管风险评估和预测的研究中难以获得可重复的结果方面体现得很明显。已经提出了越来越多的动脉粥样硬化分子生物标志物,但几种生物标志物和风险因素的组合可能能更好地估计心血管疾病风险。此外,开发有效的疗法来预防动脉粥样硬化和CVE的进展应针对全身炎症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0fe/5796914/f35fa879943e/fmed-04-00262-g001.jpg

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