Endothelial stem cell

Systemic inflammation

Cardiology

Endothelial activation

Endothelium

Biochemistry

Rheumatoid arthritis

Vasodilation

Endothelial dysfunction

Immunology

Vascular disease

In vitro

Arthritis

Inflammation

Internal medicine

Medicine

Chemistry

Disease

Nature Reviews Rheumatology

The systemic autoimmune disease rheumatoid arthritis (RA) is characterized by increased cardiovascular mortality and morbidity and is an independent cardiovascular risk factor. Cardiovascular diseases (CVDs) result from accelerated atherogenesis, which is a consequence of endothelial dysfunction in the early stages of the disease. Endothelial dysfunction is a functional and reversible alteration of endothelial cells and leads to a shift in the properties of the endothelium towards reduced vasodilation, a pro-inflammatory state, and proliferative and prothrombotic properties. In RA, endothelial dysfunction can occur in the large vessels (such as the conduit arteries) and in the small vessels of the microvasculature, which supply oxygen and nutrients to the tissue and control inflammation, repair and fluid exchange with the surrounding tissues. Growing evidence suggests that microvascular endothelial dysfunction contributes to CVD development, as it precedes and predicts the development of conduit artery atherosclerosis and associated risk factors. As such, numerous studies have investigated microvascular endothelial dysfunction in RA, including its link with disease activity, disease duration and inflammation, the effect of treatments on endothelial function, and possible circulating biomarkers of microvascular endothelial dysfunction. Such findings could have important implications in the cardiovascular risk management of patients with RA. Endothelial dysfunction is thought to be an important contributor to the increased risk of cardiovascular diseases seen in patients with rheumatoid arthritis. Microvascular endothelial dysfunction could be a useful predictive marker of cardiovascular events in early rheumatoid arthritis.

Microvascular endothelial dysfunction in rheumatoid arthritis