Disease trends over time and CD4+CCR5+ T-cells expansion predict carotid atherosclerosis development in patients with systemic lupus erythematosus

A. Baragetti, G. A. Ramirez, M. Magnoni, K. Garlaschelli, L. Grigore, M. Berteotti, I. Scotti, E. Bozzolo, A. Berti, P. G. Camici, A. L. Catapano, A. A. Manfredi, E. Ammirati, G. D. Norata

Research output: Contribution to journalArticle

Abstract

Background and Aim Patients with Systemic Lupus Erythematosus (SLE) present increased cardiovascular mortality compared to the general population. Few studies have assessed the long-term development and progression of carotid atherosclerotic plaque in SLE patients. Our aim was to investigate the association of clinical and laboratory markers of disease activity and classical cardiovascular risk factors (CVRF) with carotid atherosclerosis development in SLE patients in a prospective 5-year study. Methods and results Clinical history and information on principal CVRFs were collected at baseline and after 5 years in 40 SLE patients (36 women, mean age 42 ± 9 years; 14.4 ± 7 years of mean disease duration) and 50 age-matched controls. Carotid Doppler ultrasonography was employed to quantify the atherosclerotic burden at baseline and at follow up. Clinimetrics were applied to assess SLE activity over time (SLEDAI). The association between basal circulating T cell subsets (including CD4+CCR5+; CD4+CXCR3+; CD4+HLADR+; CD4+CD45RA+RO, CD4+CD45RO+RA and their subsets) and atherosclerosis development was evaluated. During the 5-year follow up, 32% of SLE patients, developed carotid atherosclerosis compared to 4% of controls. Furthermore, considering SLEDAI changes over time, patients within the highest tertile were those with increased incidence of carotid atherosclerosis independently of CVRF. In addition, increased levels of CD4+CCR5+ T cells were independently associated with the development of carotid atherosclerosis in SLE patients. Conclusion Serial clinical evaluations over time, rather than a single point estimation of disease activity or CVRF burden, are required to define the risk of carotid atherosclerosis development in SLE patients. Specific T cell subsets are associated with long-term atherosclerotic progression and may further be of help in predicting vascular disease progression.

Original languageEnglish
Pages (from-to)53-63
Number of pages11
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Adaptive immunity
  • Carotid atherosclerosis
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

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    Baragetti, A., Ramirez, G. A., Magnoni, M., Garlaschelli, K., Grigore, L., Berteotti, M., Scotti, I., Bozzolo, E., Berti, A., Camici, P. G., Catapano, A. L., Manfredi, A. A., Ammirati, E., & Norata, G. D. (2018). Disease trends over time and CD4+CCR5+ T-cells expansion predict carotid atherosclerosis development in patients with systemic lupus erythematosus. Nutrition, Metabolism and Cardiovascular Diseases, 28(1), 53-63. https://doi.org/10.1016/j.numecd.2017.09.001