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Endothelial cell markers reflecting endothelial cell dysfunction in patients with mixed connective tissue disease.doc

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Endothelial cell markers reflecting endothelial cell dysfunction in patients with mixed connective tissue disease

Soltesz et al. Arthritis Research Therapy 2010, 12:R78 /content/12/3/R78 RESEARCH ARTICLE Open Access Endothelial cell markers reflecting endothelial cell Research article dysfunction in patients with mixed connective tissue disease Pal Soltesz1, Daniel Bereczki2, Peter Szodoray3, Maria T Magyar4, Henrietta Der1, Istvan Csipo1, Agota Hajas1, Gyorgy Paragh5, Gyula Szegedi1 and Edit Bodolay*1 Abstract Introduction: The aim of the present study was to investigate the association between cardiovascular risk factors and endothelial dysfunction in patients with mixed connective tissue disease (MCTD) and to determine which biomarkers are associated with atherosclerotic complications, such as cardiovascular disease. Methods: Fifty MCTD patients and 38 healthy age-matched and sex-matched controls were enrolled in this study. In order to describe endothelial dysfunction, we assessed flow-mediated dilation (FMD), nitrate-mediated dilation (NMD) and carotid artery intima-media thickness (IMT). We investigated FMD of the brachial artery after reactive hyperemia and NMD after sublingual nitroglycerin administration, while the IMT of the common carotid artery was determined by ultrasound. Anti-U1 ribonucleoprotein (anti-U1RNP) antibodies, anti-cardiolipin (anti-CL) antibodies, anti-endothelial cell antibody (AECA) and endothelial cell markers, such as soluble thrombomodulin (TM) and von Willebrand factor antigen (vWFAg), were assessed. Results: The endothelium-dependent vasodilation (FMD) was significantly impaired in patients with MCTD, as compared with controls (%FMD: 4.7 ± 4.2% vs. 8.7 ± 5.0%; P 0.001), while the percentage NMD did not differ (%NMD: 14.3 ± 6 .6 % vs. 17.1 ± 6 .7%; P = 0.073). Mean carotid IMT values were higher in patients than in controls (IMT: MCTD, 0.6 4 ± 0.13 mm vs. controls, 0.53 ± 0.14 mm; P 0.001). FMD negatively correlated with disease duration, the levels of apolipoprotein A1, the paraoxonase-1 activity, and systolic