C-reactive protein: the underlying cause of microvascular dysfunction in rheumatoid arthritis

Galarraga, Bernat; Khan, Faisel; Kumar, Pradeep; Pullar, T; Belch, J. J. F.

doi:10.1093/rheumatology/ken386

Cited by 77 publications

(57 citation statements)

References 42 publications

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“…in a large, crosssectional study of 128 patients with ra, we reported that micro vascular endothelial dysfunction is directly correlated with CrP level and that this association is independent of other conventional vascular risk factors. 94 we have also reported that vascular function improves in patients who respond to therapy with anti-tnF agents or DmarDs, which suggests that, in the microcirculation at least, a reduction in inflammation, rather than choice of treatment per se, can be beneficial. 95 surrogate serological markers of cardiovascular risk such as coagulation abnormalities are more common or more pronounced in ra patients than in healthy controls, 96,97 as are markers of endothelial function or activation, or both.…”

Section: Assessment Of Endothelial Functionmentioning

confidence: 73%

The role of endothelial function and its assessment in rheumatoid arthritis

Khan

Galarraga²,

Belch

2010

Nat Rev Rheumatol

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Patients with rheumatoid arthritis (RA) have a reduced life expectancy when compared with the general population, largely attributable to cardiovascular disease. Factors that contribute to this increased cardiovascular risk include traditional risk factors, which account for only part of the excess, along with manifestations of the disease itself. RA is characterized by inflammation, which also is a key component in the development of atherosclerosis. Inflammation leads to the activation of endothelial cells, which, through an increase in the expression of leukocyte adhesion molecules, promotes a pro-atherosclerotic environment. Endothelial dysfunction is an early preclinical marker of atherosclerosis, and is commonly found in patients with RA. Several methods are available for the assessment of endothelial function, such as flow-mediated dilatation and laser Doppler flowmetry combined with iontophoresis, each with its own advantages and limitations. Studies have shown that endothelial dysfunction in RA is closely associated with inflammation, and therapeutic reduction of inflammation leads to improvements in endothelial function. As such, assessments of endothelial function could prove to be useful tools in the identification and monitoring of cardiovascular risk in patients with RA. Given the increase in cardiovascular mortality associated with RA, effective management must involve prevention of cardiovascular risk, in addition to control of disease activity and inflammation.

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Section: Assessment Of Endothelial Functionmentioning

confidence: 73%

The role of endothelial function and its assessment in rheumatoid arthritis

Khan

Galarraga²,

Belch

2010

Nat Rev Rheumatol

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“…Some clinical studies relating to endothelial function testing have utilized the cutaneous microvasculature. It has been established that there are implications for microvascular function in a range of diseases including diabetes (Khan et al, 2000;Morris et al, 1995), rheumatoid arthritis (Galarraga et al, 2008) and in patients with cardiovascular risk factors (Huang et al, 2007;Ijzerman et al, 2003;Khan et al, 2003). Therefore, it may prove to be potentially very useful to be able to measure early microvascular dysfunction in animal studies of these diseases, and also in mouse models in which the genotype has been altered.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal assessment of endothelial function in the microvasculature of mice in-vivo

Belch

Akbar

Alapati

et al. 2013

Microvascular Research

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“…On the contrary, better control of inflammation has been reported to lessen the risk of cardiovascular complications. 5,6 Subclinical process, however, may start quite early in disease, as studies show silently progressing micro vascular dysfunction in IMIDs correlating strongly with early inflammatory state. 7,8 Evaluation for early atherosclerosis, adoption of 'treat to target' concept for tight control of disease to bring down CRP or preferably high-sensitivity CRP (hs-CRP) level towards normal range are measures to keep CVS complications in abeyance in RA.…”

mentioning

confidence: 99%