Endothelial dysfunction in ankylosing spondylitis improves after tumor necrosis factor-alpha blockade.

Area of Science:

• Rheumatology
• Cardiovascular Medicine
• Immunology

Background:

• Chronic inflammation in ankylosing spondylitis (AS) is linked to vascular endothelial dysfunction.
• Infliximab is known to improve AS inflammatory activity, but its impact on endothelial dysfunction in AS patients remains uninvestigated.

Purpose of the Study:

• To evaluate the effect of infliximab on endothelial dysfunction in AS patients.
• To assess changes in inflammatory markers and disease activity following infliximab treatment.

Main Methods:

• Twelve anti-tumor necrosis factor (TNF) naive AS patients with high disease activity were treated with a single intravenous infusion of infliximab (5 mg/kg).
• Measurements included disease activity scores (BASDAI, BASFI), inflammatory markers (ESR, CRP), serum nitrite concentration, and brachial artery vasodilation (endothelium-dependent and independent) at baseline and 12 weeks.

Main Results:

• Infliximab significantly improved flow-mediated vasodilation (endothelium-dependent) from 9.81% to 26.93% (p < 0.001).
• No significant changes were observed in endothelium-independent vasodilation.
• Significant reductions in nitrite concentration, ESR, CRP, BASDAI, and BASFI scores were noted post-treatment.

Conclusions:

• Endothelial dysfunction appears to be an integral component of the ankylosing spondylitis disease process.
• Infliximab effectively improves both endothelial dysfunction and inflammatory disease activity in AS patients.