title: Interleukin 17 as a novel predictor of vascular function in rheumatoid arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is associated with enhanced cardiovascular (CV) risk and subclinical vascular disease. The proinflammatory milieu has been linked to premature atherosclerosis and endothelial dysfunction in RA. While interleukin 17 (IL-17) is considered pathogenic in RA, its role in determining vascular dysfunction in this disease has not been systematically assessed.
  
  
  OBJECTIVE
  To analyse candidate variables that might determine endothelial function in various vascular territories in a cohort of patients with RA receiving treatment with biological agents, with minimal traditional CV risk factors and low disease activity score.
  
  
  METHODS
  Patients with RA (n=50) receiving stable treatment with biological agents underwent measurement of conduit artery endothelial function by brachial artery flow-mediated dilatation; arterial compliance by pulse wave velocity (PWV) assessment; and endothelium-dependent microvascular testing with Endo-Pat2000 device to assess the reactive hyperaemia index (RHI). IL-17 was quantified by ELISA and disease activity was assessed by 28-joint count Disease Activity Score.
  
  
  RESULTS
  IL-17 was the main determinant of lower RHI in univariate and multivariate analysis. Traditional and non-traditional CV risk variables determined PWV, with a significant positive association with IL-17 in univariate and multivariate analysis. In contrast, conduit endothelial function was mainly determined by rheumatoid factor titres in univariate and multivariate analysis. Anti-cyclic citrullinated peptide titres, specific disease-modifying antirheumatic drugs or biological agents and disease activity did not determine vascular function.
  
  
  CONCLUSIONS
  In patients with RA treated with biological agents, IL-17 is a main predictor of microvascular function and arterial compliance. This study suggests that IL-17 may play a significant role in development of endothelial dysfunction and cardiovascular disease in RA.
authors: University of Michigan Medical School, Ann Arbor, Michigan 48109, USA.
authors: Wendy
authors: W
authors: Marder
authors: Shokoufeh
authors: S
authors: Khalatbari
authors: James D
authors: JD
authors: Myles
authors: Rita
authors: R
authors: Hench
authors: Srilakshmi
authors: S
authors: Yalavarthi
authors: Susan
authors: S
authors: Lustig
authors: Robert
authors: R
authors: Brook
authors: Mariana J
authors: MJ
authors: Kaplan
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity / Q000502:physiology; D001916:Brachial Artery / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000097:blood* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D011673:Pulsatile Flow / Q000502:physiology; D012217:Rheumatoid Factor / Q000097:blood; D014664:Vasodilation / Q000502:physiology
chemical_list: D018501:Antirheumatic Agents; D001323:Autoantibodies; D015415:Biomarkers; D020381:Interleukin-17; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor