Antiphospholipid antibodies and atherosclerosis: Insights from Rheumatoid arthritis – A five-year follow-up study

Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine lowering and blockade in rheumatoid arthritis patients

“…Folic acid depletion and subsequent HHcy-common in RA patients- partly explain this trend via excess immuno-inflammatory activation [ 7 , 11 , 12 , 38 , 45 ]. Furthermore, variations of plasma homocysteine may significantly predict atherosclerosis progression in RA patients [ 69 ]. Therefore, homocysteine-lowering strategies might be suitable to curtail the CVD ‘epidemic’ in RA populations.…”

“…Learning from general population and animal studies [ 55 – 57 ] and more than in the general population, folic acid supplements could reduce incident cerebrovascular events in the RA population as well if we consider their high propensity for HHcy and folate deficiency [ 55 – 57 ]. This hypothesis can be further supported by the central role of oxidative stress in HHcy-mediated cerebrovascular disease regardless of populations and species [ 4 , 7 , 52 – 54 ] together with the likelihood of folic acid to reverse oxidative stress both independently of and via homocysteine lowering [ 56 , 69 ]. However, it is questionable whether or not the likely impact of folate therapy on the cerebral microvasculature of RA patients extends to coronary and other peripheral vessels.…”

“…Notably, CIMT is a reliable marker of atherosclerosis progression and a strong predictor of future cardiovascular events including CHD in both general and RA populations [ 71 , 72 ]. Besides, RA patients are high CVD risk subjects [ 1 , 3 , 6 , 68 ] with higher baseline CIMT values [ 72 ] that steeply rise partly because of HHcy [ 69 ]. Thus, it can be speculated that folic acid supplementation may also significantly reduce or delay atherosclerosis progression, consequently preventing all-cause CVD in RA patients.…”

Atherogenesis, Inflammation and Autoimmunity - An Overview

“…Further data is emerging that IgG anti-oxLDL/ 2-GPI antibodies have been associated with proatherogenic functions, whereas IgM anti-oxLDL/ 2-GPI have been considered to be antiatherogenic (Narshi et al, 2011). In our recent study of 70 RA female patients, which were followed for 5.5 years, neither antibodies against 2-GPI, nor rheumatoid factor or CRP contributed to AS progression, as measured by carotid intima media thickness and number of plaques (Holc et al, 2011). The increased risk of AS in patients with autoimmune rheumatic diseases is explained only in part by traditional AS risk factors, such as those from the Framingham study (Lloyd-Jones et al, 2004;Tegos et al, 2001), for example autoimmune patients commonly have dislipidemias.…”

Association between antiphospholipid antibodies and arterial thrombosis in patients with rheumatoid arthritis

“…However, no significant association between the presence of aPL and APS manifestation in RA patients was found in previous studies. [15][16][17] However, these studies had the limitations of small sample sizes and incomplete compliance to the revised APS classification criteria. 18 Therefore, in the present study, we measured the aPL positivity in RA patients in precise accordance with the revised APS classification criteria and explored the association between aPL positivity and the development of thrombotic events.…”