Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Risk Factors Associated with Depletion of Endothelial Progenitor Cells in Rheumatoid Arthritis Patients and Effect of Anti-TNF Therapy On EPCs Restoration
Park1, Yun-Jung, Kim2, Ki-Jo, Kim3, Ji-Young, Choi4, Jin-Jung, Kim5, Wan-Uk, Cho6, Chul-Soo
Catholic University of Korea, South Korea
Catholic University of Korea, St. Mary's Hospital, Seoul, South Korea
Catholic univeristy of Korea, Seoul, South Korea
Bundang CHA General Hospital, CHA University, Bundang, South Korea
St. Vincent Hospital, Suwon, South Korea
St. Mary's Hospital, Seoul, South Korea
It has been shown that circulating endothelial progenitor cells (EPC) decreased in rheumatoid arthritis (RA) patients, but the precise factors linked to reduction of EPC remain elusive. In this study, we determined the circulating EPC number in RA patients and variables associated with its depletion, and compared the effects of anti-TNF therapy and disease modifying anti-rheumatic drugs (DMARD) on the restoration of EPC.
164 RA patients and 67 age-gender matched control subjects were included. Circulating EPC was quantified by flow cytometry based on expression of CD34 and KDR. 85 RA patients were randomly assigned in 24-week comparator-controlled study to receive anti-TNF therapy (n=59) and DMARD alone (n=26). Endothelial function assessed by flow-mediated dilatation (FMD) was measured before and after the completion of study.
The median EPC number was significantly reduced in RA patients than control subjects (44 vs 71 cells/ml, P<0.01). EPC number was significantly lower in RA patients with rheumatoid factor, anti-CCP antibody and bony erosion (p=0.04, p=0.01, and 0.03, respectively). The EPC number was inversely correlated with disease duration and cumulative C-reactive protein levels (p<0.01 for both). In multiple regression analysis, longer disease duration, cumulative CRP levels, and ESR were associated with EPC depletion. Compared to DMARD treatment, anti-TNF therapy led to further increase the EPC number and FMD change (p<0.05 for both). In parallel, patients in the highest tertile of EPC showed significantly higher FMD than the others at 24 weeks (p<0.05).
Circulating EPC was reduced in RA patients. Longer disease duration, inflammatory burden were associated with reduction of EPC. Anti-TNF therapy has beneficial effect on restoration of EPC depletion but also improving endothelial dysfunction.
To cite this abstract, please use the following information:
Park, Yun-Jung, Kim, Ki-Jo, Kim, Ji-Young, Choi, Jin-Jung, Kim, Wan-Uk, Cho, Chul-Soo; Risk Factors Associated with Depletion of Endothelial Progenitor Cells in Rheumatoid Arthritis Patients and Effect of Anti-TNF Therapy On EPCs Restoration [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1599