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Systemic Lupus Erythematosus and Endothelial Dysfunction: A Close Relationship

Edoardo Sciatti1, Ilaria Cavazzana2, Enrico Vizzardi1

  • 1Cardiology Unit, University and ASST Spedali Civili, Brescia, Italy.

Current Rheumatology Reviews
|November 27, 2018
PubMed

Insights

Systemic lupus erythematosus (SLE) patients experience accelerated atherosclerosis due to endothelial dysfunction, increasing cardiovascular disease risk. Early assessment and management of cardiovascular risk factors are crucial for these patients.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) is associated with a 6-fold higher incidence of accelerated atherosclerosis compared to the general population.
  • Accelerated atherosclerosis in SLE stems from complex interactions involving classical and non-classical cardiovascular risk factors.
  • Endothelial dysfunction and arterial stiffness are linked to subclinical and widespread atherosclerosis in SLE patients.

Purpose of the Study:

  • To review and analyze the association between systemic lupus erythematosus (SLE) and endothelial dysfunction.
  • To explore the mechanisms contributing to endothelial dysfunction in SLE.

Main Methods:

  • Literature review and meta-analysis of studies investigating SLE and atherosclerosis.
  • Analysis of proposed mechanisms for endothelial dysfunction in SLE, including immune cell activation and inflammatory markers.

Main Results:

  • Studies indicate a significant prevalence of subclinical accelerated atherosclerosis in SLE patients from childhood compared to controls.
  • Endothelial dysfunction is a key feature contributing to increased cardiovascular risk in SLE.

Conclusions:

  • Endothelial dysfunction in SLE is multifactorial, involving impaired apoptotic cell clearance, oxidative stress, autoantibodies, T cell subtypes, and cytokine cascades.
  • Multidisciplinary management is recommended for early assessment and periodic treatment of cardiovascular risk factors in SLE patients.
  • Further prospective studies are required to validate the benefits of proposed management strategies.
Abstract

Keywords:
Endothelial dysfunctionSLET lymphocytesangiogenic T cellsmicrovascularregulatory T cells.

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