Atherosclerosis in systemic autoimmune diseases. Early markers and risk factor

PhD ceremony: Mr. H.L.A. Nienhuis, 11.00 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Atherosclerosis in systemic autoimmune diseases. Early markers and risk factor

Promotor(s): prof. C.G.M. Kallenberg

Faculty: Medical Sciences

Systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and granulomatosis with polyangiitis, are associated with an increased prevalence of cardiovascular disease (CVD), due to accelerated atherosclerosis. We studied early markers and potential risk factors for atherosclerosis in systemic autoimmune diseases. Pulse wave analysis (PWA) measures small artery elasticity (SAE) and was used as marker for EC function. SAE was decreased in patients with systemic autoimmune disease without overt atherosclerosis. Accumulation of advanced glycation end products (AGEs) was increased in patients with systemic autoimmune diseases and was related to SAE and intima media thickness, as marker for early atherosclerosis. Polymorphisms in the gene for the receptor for advanced glycation end products (RAGE) were associated with disease susceptibility for SLE and RA and were associated with cardiovascular disease and disease severity in RA. PWA is a sensitive method to detect early vascular changes in patients with systemic autoimmune diseases. AGEs and their receptor RAGE contribute to accelerated atherosclerosis in systemic autoimmune diseases. Prospective studies are necessary to establish whether decreased SAE is indeed an early marker for atherosclerosis and whether interventions to reduce accumulation of AGEs can suppress the development of atherosclerosis in patients with systemic autoimmune diseases.