title: Endothelial dysfunction in joint disease.
abstract: Inflammatory joint diseases and autoimmune diseases with joint manifestations are associated with premature and accelerated atherogenesis. Patients with rheumatoid arthritis (RA) have a 5- to 10-year decrease in life expectancy compared to the general population, and those exhibiting extraarticular manifestations have the greatest excess mortality. RA is now established as an independent cardiovascular risk factor. Complex interactions linking conventional cardiovascular risk factors, systemic inflammation, and vascular function may explain the increased cardiovascular risk among RA patients. Endothelial dysfunction is now recognized as both the key step in early atherogenesis and a contributor to atheroma plaque progression at later stages. Endothelial dysfunction is defined as impaired endothelium-dependent blood-vessel dilation in response to a stimulus. The underlying mechanisms remain speculative. Over the last decade, a role for endothelial dysfunction in the cardiovascular complications of inflammatory joint disease has been hypothesized and several maintenance drugs targeting this phenomenon have been tested, with promising results.
authors.affiliation: Service de Rhumatologie, CHRU de Besançon, Besançon, France; EA 4267 Fonctions et Dysfonctions Épithéliales, Université de Franche-Comté, Franche-Comté, France. Electronic address: praticlement@gmail.com.
authors.forename: Clément
authors.initials: C
authors.lastname: Prati
authors.affiliation: EA 4267 Fonctions et Dysfonctions Épithéliales, Université de Franche-Comté, Franche-Comté, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Demougeot
authors.affiliation: Service de Rhumatologie, CHRU de Besançon, Besançon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Guillot
authors.affiliation: Service de Rhumatologie, CHRU de Besançon, Besançon, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Godfrin-Valnet
authors.affiliation: Service de Rhumatologie, CHRU de Besançon, Besançon, France; EA 4266 Agents Pathogènes et Inflammation, Université de Franche-Comté, Franche-Comté, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
mesh_terms: D001168:Arthritis / Q000188:drug therapy / Q000503:physiopathology; D050197:Atherosclerosis / Q000150:complications / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology*; D003240:Connective Tissue Diseases; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000503:physiopathology*
keywords: Endothelial dysfunction; Lupus; Rheumatoid arthritis; Spondyloarthritis