Effect of anti TNFalpha therapy on arterial diameter and wall shear stress and HDL cholesterol

• Published in: Atherosclerosis Vol. 177; no. 1; pp. 113 - 118
• Main Authors: Irace, Concetta, Mancuso, Gerardo, Fiaschi, Elio, Madia, Angela, Sesti, Giorgio, Gnasso, Agostino
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01-11-2004; Elsevier
• Subjects: Adult; Arteries - drug effects; Arteries - pathology; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - pathology; Arthritis, Rheumatoid - physiopathology; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood vessels and receptors; Blood. Blood coagulation. Reticuloendothelial system; Cardiology. Vascular system; Carotid artery; Cholesterol, HDL - blood; Female; Fundamental and applied biological sciences. Psychology; HDL-cholesterol; Humans; Inflammation; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Stress, Mechanical; Tumor Necrosis Factor-alpha - therapeutic use; Ultrasonic; Vasodilation; Vertebrates: cardiovascular system; NO; HDL-cholesterol; Inflammation; τP; Vasodilation; RA; HDL; TNFalpha; DAS; SPV; HAQ; ID; Carotid artery; FMD; Ultrasonic; Diseases of the osteoarticular system; Autoimmune disease; Cardiovascular disease; Inflammatory joint disease; Monoclonal antibody; Vascular disease; Vasomotricity; Infliximab; Cholesterol HDL; Anticytokine; Atherosclerosis; Human; Brachial artery; Vasoconstriction; Apolipoprotein; Immunomodulator; Common carotid; Chronic; Treatment; Nitric oxide; Rheumatoid arthritis; Shear stress; Immunosuppressive agent; Comparative study
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2004.04.031

It has been recently hypothesized that both TNFalpha and anti TNFalpha treatment have a stimulating effect on nitric oxide synthesis and release. Moreover, an in vitro experiment has demonstrated that HDL-cholesterol binds TNFalpha. Aims of our study were to investigate wall shear stress of peripheral arteries and endothelial function of brachial artery in subjects with Rheumatoid Arthritis (RA) at baseline and after infliximab. Moreover, we evaluated the effect of anti TNFalpha therapy on lipid profile. Ten patients with RA received infliximab therapy at weeks 0, 2 and 6. Lipids and vascular parameters were measured before and the day after each infusion. After the first treatment, FMD increased (3.7 ± 1.9% versus 17.5 ± 2.9%,
P < 0.01) and common carotid and brachial artery diameters decreased (5.9 ± 0.2
mm versus 5.5 ± 0.2
mm; 3.5 ± 0.4
mm versus 3.1 ± 0.4
mm, respectively,
P < 0.005). Common carotid and brachial artery wall shear stress increased (21.1 ± 1.1
dynes/cm
2 versus 23.9 ± 1.4
dynes/cm
2; 42.0 ± 4.7
dynes/cm
2 versus 51.6 ± 5.7
dynes/cm
2,
P < 0.01). Similar results were observed after the second and third infusion. All these parameters returned to pre-treatment level at the following infusion. HDL-cholesterol and apolipoprotein AI significantly decreased after each treatment (1st treatment: 1.4 ± 0.05
mmol/L versus 1.2 ± 0.06
mmol/L,
P < 0.01; 1.73 ± 0.05
g/L versus 1.57 ± 0.02
g/L,
P < 0.03).
The present data show vasoconstriction and an increase of wall shear stress in studied arteries after infliximab. HDL cholesterol is reduced by treatment and does not seem to influence FMD.