δείτε την πρωτότυπη σελίδα τεκμηρίου στον ιστότοπο του αποθετηρίου του φορέα για περισσότερες πληροφορίες και για να δείτε όλα τα ψηφιακά αρχεία του τεκμηρίου*
Ανοσοβιολογικοί παράγοντες στη θεραπεία των αυτοάνοσων ρευματικών νοσημάτων
Serelis, John
Σέρελης, Ιωάννης
Patients with Rheumatoid Arthritis (RA) are prone to aggressive atherosclerosis, resulting
to increased morbidity and mortality in comparison with the general population, mainly
due to cardiovascular disease. Increased cardiovascular risk in RA is the result of
interaction between traditional and disease-associated risk factors. In addition, active RA
is associated with changes of body composition (increase of the fat mass, reduction of
muscular and bone mass), which may relate to the increase of cardiovascular risk.
In both obesity and atherosclerotic disease, two conditions with a small load of
inflammation, serum concentration of adiponectin is low, while concentration of TNF-α
are relatively high. In RA there is high grade systemic inflammation and high
concentrations of TNF-α are detected on serum and synovium, while serum adiponectin
levels do not obey to suppression by TNF-α.
Since it is well known now, that RA responds to anti-TNF-α treatment, we have
tried to investigate the changes to adiponectin serum levels and body composition in
patients with RA. Ηn addition we investigated the influence of anti-TNF-α treatment on
cardiovascular disease incidence.
This thesis consists in 2 studies, one of which is prospective and the other is
retrospective. In the first study we investigated with DEXA-absorptiometry changes in
body composition, serum adiponectin concentrations and disease activity on 19 women
with RA, after one year of anti-TNF-α treatment. In the second study we investigated the
cardiovascular disease incidence on 325 patients with RA, who had follow-up at least 2
years and median follow-up of 10 years, and correlated the events with traditional and
disease associated risk factors, including TNF-α treatment.
The results have shown:
1. After one year of anti-TNF-α treatment, a rise on serum adiponectin
concentration was detected, eventhough there was no change of body
composition.
2. Cardiovascular disease incidence was not greater than that of the
average Greek population 3. Anti-TNF-α treatment conferred no extra protection from
cardiovascular disease in comparison with other treatments, provided
they were effective.
4. Risk factors for CVD incidence were late disease onset and high disease
activity after one year of treatment.
5. Among all risk factors hypertension had the dominant influence on
CVD development
In conclusion anti-TNF-alpha treatment increases serum adiponectin levels and in the
subset of the responders, is associated with reduction of CVD incidence.
Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ)
*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.
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