Artritis reumatoide y riesgo cardiovascular

Cardiovascular disease (CVD) is the most frequent cause of premature death according to data from the American Heart Association and World Health Organization. Incidence and prevalence are on the rise. Rheumatoid Arthritis (RA) is the most common autoimmune disease. It is a chronic and systemic disease characterized by articular involvement with deformity ranging from persistent pain to premature disability. CVD is the most frequent cause of death in RA patients, even more than in diabetes mellitus 2 or chronic kidney disease. Multiple CVD risk scales have been tested in order to obtain a more accurate prediction of premature death by stroke or myocardial infarction in RA patients. Most of the scales, even those adjusted including RA features like inflammation and antibodies titles, have failed to properly predict the real CVD risk. Individually, RA specific autoantibodies have been related with increased CVD risk and multiple mechanistic explanations have arisen, generating even a new concept called “Autoimmune Atheromatosis”. Nevertheless, this association fails to give a full understanding of the accelerated and aggressive atheromatosis process that RA patients develop. New studies oriented to mechanistic explanations are necessary in order to develop new diagnostic targets and prevention strategies

Additional file 1: of LPS regulates the expression of glucocorticoid receptor α and β isoforms and induces a selective glucocorticoid resistance in vitro

LPS regulates the expression of GRα and GRβ isoforms in a epithelial cell line. HeLa cells were cultured with LPS for 24 h. The expression of GRα and GRβ was determined by Western blot. The median values of three different experiments, plotted as values relative to control are shown. * p < 0.05 and ** p < 0.01. (TIFF 128 kb

Variables associated with mortality in 103 patients with anti-neutrophil cytoplasmic antibodies associated vasculitis

Cumulative survival in patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (VAA) is 88 and 78% at 1 and 5 years, respectively. Despite this, mortality continues to be 2.7 times higher than the general population. Differences in the clinical profile of VAA in different ethnicities have been observed. Aim: To identify factors at the time of diagnosis, associated with mortality at one year of follow-up and to describe the clinical characteristics of these patients. Material and Methods: We identified in local databases and reviewed clinical records of patients with VAA with at least one year of follow up in a clinical hospital. Demographic and laboratory parameters and clinical activity scores were analyzed. Results: Of 103 patients with VAA identified, 65 met the inclusion criteria and were analyzed. Their age ranged from 45 to 63 years and 56% were women. Thirty-five patients (54%) were diagnosed as granulomatosis with Polyangiitis (GPA) and 30 patients (46%) with Microscopic Polyangiitis (MPA). The frequency of renal disease was 53% and pulmonary involvement occurred in 72%. At one year of follow-up 11 patients died resulting in a mortality of 17%. Seven patients died within three months after diagnosis. MPO ANCA were more common than PR3 ANCA. In the multivariate analysis, the presence of ophthalmological involvement, lung kidney syndrome and a Five Factor Score (FFS) of 1 or more were independent factors associated with mortality at one year. Conclusions: In these patients, pulmonary manifestations predominate. Lung kidney syndrome, ophthalmological involvement and a FFS score ≥ 1 were associated with mortality