The Risk Factors Of Vascular Endothelial Injury In Rheumatoid Arthritis

Objective:Rheumatoid arthritis is a systemic autoimmune disease characterized by symptoms and signs of chronic joint destruction. It also associates with high CVD morbidity and mortality, which can not be fully explained by the presence of traditional CVD risk factors. So we analyzed the levels of inflammatory mediators, autoantibodies, biomarkers of vascular endothelial injury in active and remissive RA patients and evaluated the correlation of the inflammatory mediators, ANCA with vascular endothelial injury, so as to demonstrate the pathogenesis of endothelial injury in RA and provide evidence for preventing RA patients from CVDMethods:The serum of106RA (including83active patients and23remissive patients) and55normal persons were collected. The concentrations of inflammatory mediators IL-1β, IL-6, IL-17, TNF-α and the biomarkers of vascular endothelial injury vWF,sICAM-1,sVCAM-1were detected with enzyme-linked immunosorbent assay. ANCA was detected with indirect immunof luorescence. The differences between the RA patients and the controls were analyzed. The correlation of the inflammatory mediators, ANCA with vascular endothelial injury was evaluated.Results:IL-6, TNF-α, vWF, sICAM-1and sVCAM-lwere higher in patients with act ive RA than in the controls (P<0.05); IL-6and vWF of the remissive RA patients were lower than those of the active patients (P<0.05),but vWF and sVCAM-1was still higher than those of the normal controls (P<0.01); In RA patients, IL-6, IL-1β and IL-17were correlated with the biomarkers of vascular endothelial injury. The positive rate of ANCA in the active RA patients(32.5%) was higher than in the normal controls (P<0.01). vWF was higher in the ANCA-positive RA patients than in the ANCA-negative group (P<0.05).Conclusions:RA patients, especially the active RA patients had vascular endothelial injury, which was correlated with the level of inflammatory mediators and the positive rate of ANCA.