Cardiovascular risk in patients with spondyloarthritis

U chorych na spondyloaratropatie zapalne, w porównaniu z populacją ogólną, obserwuje się większą częstość występowania chorób układu sercowo-naczyniowego. Zwiększone ryzyko sercowo-naczyniowe ma związek nie tylko z tradycyjnymi czynnikami ryzyka sercowo-naczyniowego, ale również z czynnikami niekonwencjonalnymi, zależnymi od aktywności przewlekłej choroby zapalnej. Celem pracy jest przedstawienie dostępnych obecnie wyników obserwacji i badań, wskazujących na wpływ różnych czynników na ryzyko sercowo-naczyniowe u chorych na spondyloartropatie zapalne oraz możliwość wielokierunkowego działania profilaktycznego lub terapeutycznego, czego efektem powinna być poprawa rokowania chorych.Patients with spondyloarthritis have a higher prevalence of cardiovascular diseases compared to the general population. Increased cardiovascular risk is not only related to traditional cardiovascular risk factors but also to unconventional factors that depend on chronic inflammatory disease activity. This study aims to present currently available observation and research findings indicating the impact of various factors on cardiovascular risk in patients with spondyloarthritis and the possibility of multifaceted preventive or therapeutic action, which should result in an improved prognosis of patients

Antidiabetic effect of disease-modifying antirheumatic drugs

Leki modyfikujące przebieg choroby stanowią podstawę leczenia przewlekłych zapaleń stawów, hamują postęp choroby i mogą doprowadzić do stanu remisji. Większość z tych leków to preparaty o działaniu immunosupresyjnym oraz leki biologiczne. Pojawiają się doniesienia o dodatkowych, oprócz efektu przeciwzapalnego, działaniach tych preparatów, w tym o działaniu przeciwcukrzycowym. Celem pracy jest przedstawienie dostępnych obecnie wyników badań i obserwacji klinicznych, wskazujących na możliwość wielokierunkowego działania leków modyfikujących przebieg choroby, szczególnie efektu redukującego ryzyko rozwoju cukrzycy i zależnych od niej powikłań.Disease-modifying antirheumatic drugs (DMARDs) form the mainstay of treatment for chronic arthritis, slow down progression of the disease and can lead to a state of remission. Most of these drugs are immunosuppressive preparations and biologics. There are reports on effects of these preparations in addition to their anti-inflammatory effect, including antidiabetic effect. This paper aims to present the currently available results of studies and clinical observations indicating the potential for multidirectional effects of DMARDs, particularly a risk-reducing effect on the development of diabetes and diabetes-dependent complications

Obesity, Fat Mass and Immune System: Role for Leptin

Obesity is an epidemic disease characterized by chronic low-grade inflammation associated with a dysfunctional fat mass. Adipose tissue is now considered an extremely active endocrine organ that secretes cytokine-like hormones, called adipokines, either pro- or anti-inflammatory factors bridging metabolism to the immune system. Leptin is historically one of most relevant adipokines, with important physiological roles in the central control of energy metabolism and in the regulation of metabolism-immune system interplay, being a cornerstone of the emerging field of immunometabolism. Indeed, leptin receptor is expressed throughout the immune system and leptin has been shown to regulate both innate and adaptive immune responses. This review discusses the latest data regarding the role of leptin as a mediator of immune system and metabolism, with particular emphasis on its effects on obesity-associated metabolic disorders and autoimmune and/or inflammatory rheumatic diseases.OG is Staff Personnel of Xunta de Galicia (Servizo Galego de Saude, SERGAS) through a research-staff stabilization contract (ISCIII/SERGAS). VF is a “Sara Borrell” Researcher funded by ISCIII and FEDER. RG is a “Miguel Servet” Researcher funded by Instituto de Salud Carlos III (ISCIII) and FEDER. OG, MG-G, and RG are members of RETICS Program, RD16/0012/0014 (RIER: Red de Investigación en Inflamación y Enfermedades Reumáticas) via Instituto de Salud Carlos III (ISCIII) and FEDER. The work of OG and JP (PIE13/00024 and PI14/00016, PI17/00409), and RG (PI16/01870 and CP15/00007) was funded by Instituto de Salud Carlos III and FEDER. OG is a beneficiary of a project funded by Research Executive Agency of the European Union in the framework of MSCA-RISE Action of the H2020 Program (Project No. 734899). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript

Działanie przeciwcukrzycowe leków modyfikujących przebieg choroby

Leki modyfikujące przebieg choroby stanowią podstawę leczenia przewlekłych zapaleń stawów, hamują postęp choroby i mogą doprowadzić do stanu remisji. Większość z tych leków to preparaty o działaniu immunosupresyjnym oraz leki biologiczne. Pojawiają się doniesienia o dodatkowych, oprócz efektu przeciwzapalnego, działaniach tych preparatów, w tym o działaniu przeciwcukrzycowym.Celem pracy jest przedstawienie dostępnych obecnie wyników badań i obserwacji klinicznych, wskazujących na możliwość wielokierunkowego działania leków modyfikujących przebieg choroby, a w szczególności efektu redukującego ryzyko rozwoju cukrzycy i zależnych od niej powikłań

Serum Amyloid A as a Marker of Persistent Inflammation and an Indicator of Cardiovascular and Renal Involvement in Patients with Rheumatoid Arthritis

Objectives. Rheumatoid arthritis (RA) is a systemic, inflammatory disease. Serum amyloid A (SAA) is an acute-phase protein, involved in pathogenesis of atherosclerosis. The aim of the study was to assess serum concentration of SAA in RA patients, with reference to other inflammatory parameters and markers of extra-articular involvement. Methods. The study population consisted of 140 RA patients, low/moderate disease activity (L/MDA) in 98 (70%) patients and high disease activity (HDA) in 42 (30%). Comprehensive clinical and laboratory assessment was performed with evaluation of electrocardiogram and carotid intima-media thickness. Results. The mean SAA concentration [327.0 (263.4) mg/L] was increased highly above the normal value, even in patients with L/MDA. Simultaneously, SAA was significantly higher in patients with HDA versus L/MDA. The mean SAA concentration was significantly higher in patients treated with glucocorticoids, was inversely associated with QTc duration, and was markedly higher in patients with atherosclerotic plaques, emphasizing increased CV risk. SAA was significantly higher in patients with increased cystatin-C level. Conclusions. In RA patients, high serum SAA concentration was strongly associated with activity of the disease and risk of CV and renal involvement. Recurrent assessment of SAA may facilitate searching patients with persistent inflammation and risk of extra-articular complications

Metabolic Syndrome and Rheumatoid Arthritis Activity: An Analysis of Clinical, Laboratory, and Ultrasound Parameters

(1) Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with an increased incidence of metabolic syndrome (MetS). The aim of this study was to determine if there is an association between MetS and parameters of RA activity, as well as between metabolic parameters and indices of RA activity. (2) Methods: This study involved 65 patients with RA. MetS was diagnosed according to the 2009 IDF/AHA/NHLBI criteria. The comparative analysis was conducted between RA patients with MetS (RA (MetS (+)) and without MetS (RA (MetS (−)). The activity of RA was assessed using clinical, laboratory, and ultrasound (US) parameters. (3) Results: Compared with RA MetS (−) patients, RA MetS (+) patients were characterized by higher disease activity, according to Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI). RA MetS (+) patients had significantly higher tender and swollen joint counts, and values of erythrocyte sedimentation rate, C-reactive protein, and US parameters (grey-scale (GSUS), power Doppler (PDUS)). Significant correlations were found between metabolic parameters (waist circumference, cholesterol and glucose concentrations) and indices of RA activity. (4) Conclusion: The results of this study show that, in patients with RA, the presence of MetS is associated with higher disease activity, based on several clinical, laboratory, and US parameters