An observational study of endothelial function in early arthritis

• Published in: European journal of clinical investigation Vol. 42; no. 5; pp. 510 - 516
• Main Authors: Foster, Will, Lip, Gregory Y. H., Raza, Karim, Carruthers, David, Blann, Andrew D.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2012; Wiley-Blackwell
• Subjects: Adult; Aged; Arthritis, Rheumatoid - metabolism; Arthritis, Rheumatoid - physiopathology; Biological and medical sciences; Biomarkers - metabolism; Case-Control Studies; Circulating endothelial cells; Diseases of the osteoarticular system; E-Selectin - blood; early arthritis; Endothelial Cells - metabolism; endothelium; Endothelium, Vascular - metabolism; Female; General aspects; Humans; Inflammation - metabolism; Laser-Doppler Flowmetry; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Statistics as Topic; Time Factors; vascular endothelial growth factor; vascular function; von Willebrand factor; von Willebrand Factor - metabolism; vascular function; Endothelial cell; Observational study; Diseases of the osteoarticular system; early arthritis; Arthritis; Endothelium; Medicine; Vascular endothelium growth factor; Blood vessel; vascular endothelial growth factor; von Willebrand factor; Early; Circulating endothelial cells; Circulatory system; Willebrand factor
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1111/j.1365-2362.2011.02607.x

Eur J Clin Invest 2012; 42 (5): 510–516 Background  Endothelial dysfunction is present in established rheumatoid arthritis, but it is not clear at what stage of the disease this abnormality develops. We set out to determine whether endothelial damage/dysfunction is present in a group of patients with early arthritis (EA) (new onset inflammatory arthritis, EA). Materials and methods  Eighteen patients with EA, 48 healthy controls and 25 disease controls were recruited. Plasma was obtained for endothelial [von Willebrand factor (vWF) and soluble E‐selectin] and angiogenesis markers (vascular endothelial growth factor and its receptor sFlt‐1), adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1) and circulating endothelial cells (CECs, as a marker of endothelial damage). Microvascular endothelial function was assessed using laser Doppler perfusion imaging and macrovascular function using flow‐mediated dilatation of the brachial artery. Results  von Willebrand factor and CECs (both P < 0·05) were significantly elevated in EA suggesting endothelial dysfunction and damage but were unrelated to classical laboratory markers of inflammation C‐reactive protein, erythrocyte sedimentation rate or IL6. No other biomarkers was elevated in EA. Microvascular and macrovascular abnormalities were confined to endothelium‐independent (smooth muscle cell) responses. Conclusions  Endothelial damage/dysfunction is present early in the course of inflammatory arthritis but is not directly related to inflammation markers.