Atherosclerosis in Rheumatoid Arthritis: Associations Between Anti-Cytomegalovirus IgG Antibodies, CD4+CD28null T-cells, CD8+CD28null T-cells and Intima-Media Thickness
Clinical and Experimental Rheumatology(2021)
摘要
Objective Patients with rheumatoid arthritis (RA) have an accelerated progression of atherosclerosis. The aims of this study were to study the associations between subsets of T-cells, subclinical atherosclerosis assessed by intima-media thickness (IMT) and serological status for CMV in patients with RA. Methods Patients with new-onset RA (n=79), aged <= 60 years at diagnosis, were included in a prospective study of atherosclerosis. Controls matched for age and sex were also included (n=44). Ultrasound measurement of IMT in the common carotid artery was undertaken at inclusion (T0), after 1.5 years (T1.5) and after 11 years (T11). At T11, flow-cytometry analysis was undertaken to investigate subsets of T-cells. Serological analysis for CMV was undertaken from samples collected at T0. Results At T0, 66% of the patients and controls were CMV immunoglobulin G-positive. CMV-IgG positive patients had a significantly more rapid increase in IMT at T1.5, compared with controls and CMV-IgG negative patients. CMV-IgG positive patients had a significantly higher percentage of T-cells lacking CD28 (both CD4(+)CD28null and CD8(+)CD28null T-cells) than CMV-IgG negative patients. Increased levels of CD4(+)CD28null and CD8(+)CD28null T-cells were significantly associated with IMT at T11, adjusted for systolic blood pressure. CX3CR1 was expressed in CD4(+) and CD8(+) CD28null T-cells, but CX3CR1 per se was not associated with increased IMT. Conclusion Presence of CMV IgG-antibodies in patients with RA is associated with altered T-cell-populations and an increased burden of atherosclerosis. A possible protective effect of antiviral treatment in CMV-positive patients with new-onset RA should be considered.
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关键词
rheumatoid arthritis,atherosclerosis,T-cells,CD28,cytomegalovirus
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