Anti TNF-Alpha Treatment Improves Microvascular Endothelial Dysfunction in Rheumatoid Arthritis Patients

• Published in: International journal of molecular sciences Vol. 25; no. 18; p. 9925
• Main Authors: Caraba, Alexandru, Stancu, Oana, Crișan, Viorica, Georgescu, Doina
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.09.2024; MDPI
• Subjects: Adult; Aged; Angiogenesis; Antirheumatic Agents - pharmacology; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - drug therapy; Atherosclerosis; Blood Sedimentation; Blood vessels; C-Reactive Protein - analysis; C-Reactive Protein - metabolism; Case-Control Studies; Complications and side effects; Cytokines; Disease; Dosage and administration; Drug therapy; Drugs; Endothelium; Endothelium, Vascular - drug effects; Endothelium, Vascular - metabolism; Female; Flow velocity; Humans; Male; Microcirculation disorders; Microscopic Angioscopy; Microvessels - drug effects; Microvessels - pathology; Middle Aged; Mortality; Nitric oxide; Pathogenesis; Rheumatoid arthritis; Risk factors; Tumor necrosis factor inhibitors; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-TNF; Romania; anti TNF-alpha therapy; microvascular endothelial dysfunction; rheumatoid arthritis; nailfold capillaroscopy
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms25189925

Nailfold capillaroscopy is a non-invasive investigation, which allows for the study of the microvasculature (anatomical and functional). Rheumatoid arthritis (RA) is associated with a high risk of cardiovascular atherosclerotic diseases, with endothelial dysfunction (macrovascular and microvascular) representing the first step in atherosclerosis development. The aim of this study is represented by the assessment of microvascular endothelial dysfunction in RA patients by means of nailfold capillaroscopy and to assess its evolution after a period of 12 months of anti TNF-alpha treatment. The study included 70 consecutive patients with RA and 70 healthy subjects, matched for age and gender, as the control group. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies, serum TNF-α, C reactive protein, and erythrocytes sedimentation rate were evaluated in all patients, but in controls, only rheumatoid factor, serum TNF-α, C reactive protein, and erythrocytes sedimentation rate were measured. The RA activity was measured by DAS28. Nailfold capillaroscopy was carried out in all patients and controls, determining the baseline nailfold capillary density (Db), nailfold capillary density during reactive hyperemia (Dh), and nailfold capillary density after venous congestion (Dc). Data were presented as mean ± standard deviation. Statistical analysis was performed using ANOVA and Pearson’s correlation, with p < 0.05 being statistically significant. Db, Dh, and Dc were lower in RA patients than in controls (p < 0.0001), correlating with RA activity and TNF-α (p < 0.05). After 12 months of anti TNF-α treatment, microvascular endothelial dysfunction improved (p < 0.0001). Microvascular endothelial dysfunction can be assessed by nailfold capillaroscopy, with anti TNF-α medication contributing to its improvement.