title: Update on cardiovascular disease in lupus.
abstract: Atherosclerotic cardiovascular disease confers significant morbidity and mortality in patients with systemic lupus erythematosus (SLE) and cannot be fully explained by traditional cardiovascular risk factors. Recent immunologic discoveries have outlined putative pathways in SLE that may also accelerate the development of atherosclerosis.
  
  
  
  Aberrant innate and adaptive immune responses implicated in lupus pathogenesis may also contribute to the development of accelerated atherosclerosis in these patients. Defective apoptosis, abnormal lipoprotein function, autoantibodies, aberrant neutrophil responses, and a dysregulated type I interferon pathway likely contribute to endothelial dysfunction. SLE macrophages have an inflammatory phenotype that may drive progression of plaque.
  
  
  
  Recent discoveries have placed increased emphasis on the immunology of atherosclerotic cardiovascular disease. Understanding the factors that drive the increased risk for cardiovascular disease in SLE patients may provide selective therapeutic targets for reducing inflammation and improving outcomes in atherosclerosis.
authors.affiliation: Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Lewandowski
authors.forename: Mariana J
authors.initials: MJ
authors.lastname: Kaplan
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology; D017209:Apoptosis / Q000276:immunology; D050197:Atherosclerosis / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D002318:Cardiovascular Diseases / Q000276:immunology; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology; D007249:Inflammation / Q000276:immunology; D007370:Interferon Type I / Q000276:immunology; D008074:Lipoproteins / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008264:Macrophages / Q000276:immunology; D009504:Neutrophils / Q000276:immunology; D058226:Plaque, Atherosclerotic / Q000276:immunology*; D012307:Risk Factors
chemical_list: D001323:Autoantibodies; D007370:Interferon Type I; D008074:Lipoproteins