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Update on cardiovascular disease in lupus

Laura B Lewandowski1, Mariana J Kaplan

  • 1Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.

Current Opinion in Rheumatology
|May 27, 2016
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face high cardiovascular disease risk due to immune system dysregulation accelerating atherosclerosis. Understanding these immune pathways offers new therapeutic targets for improved patient outcomes.

Area of Science:

  • Immunology
  • Cardiovascular Science
  • Rheumatology

Background:

  • Atherosclerotic cardiovascular disease (ASCVD) causes significant mortality in systemic lupus erythematosus (SLE) patients.
  • Traditional cardiovascular risk factors do not fully explain the elevated ASCVD risk in SLE.
  • Emerging immunologic pathways in SLE are implicated in accelerated atherosclerosis.

Purpose of the Study:

  • To review the immunologic underpinnings of accelerated atherosclerosis in SLE.
  • To identify how aberrant immune responses in SLE contribute to cardiovascular disease.
  • To highlight potential therapeutic targets for managing ASCVD in SLE patients.

Main Methods:

  • Review of recent immunologic discoveries related to SLE and atherosclerosis.
  • Analysis of innate and adaptive immune responses in lupus pathogenesis.
  • Examination of specific cellular and molecular pathways involved in endothelial dysfunction and plaque progression.

Main Results:

  • Aberrant immune responses in SLE, including defective apoptosis and dysregulated type I interferon, contribute to endothelial dysfunction.
  • SLE macrophages exhibit an inflammatory phenotype that promotes atherosclerotic plaque progression.
  • Autoantibodies, abnormal lipoprotein function, and neutrophil responses are implicated.

Conclusions:

  • Immune dysregulation in SLE plays a critical role in accelerated atherosclerosis.
  • Targeting specific immune pathways may reduce cardiovascular risk and improve outcomes in SLE patients.
  • Further research into the immunology of ASCVD in SLE is warranted for developing novel therapies.
Abstract

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