Background Certain chemokines and TNF-α family cytokines participate in the development of atherosclerosis and in the pathogenesis of rheumatoid arthritis (RA). Early-onset and severe atherosclerosis is responsible for high incidence of cardiovascular diseases in RA patients.
Objectives To investigate the impact of low-cholesterol diet and statin treatment on serum concentration of selected chemokines: CX3CL1 (Fraktalkine), CCL2 (MCP-1), CCL5 (RANTES) and TNF-α family cytokines: TNF-α, CD40-ligand, FAS-ligand, in patients with RA and hypercholesterolaemia.
Methods 74 mostly female (93.2%) RA patients, age 59.4±7.3 years, disease duration 8.9±8.4 years, anti-CCP positive 69.8%, disease activity score (DAS28) 3.63±1.15, with serum total cholesterol (TCh) above 200 mg/dl (mean 246±33 mg/dl) were included in the study. All patients participated in a recommended low-cholesterol diet therapy and 36 patients (48.7%) received additional atorvastatin treatment (10 mg daily), according to the ATP III guidelines . Atherogenicity index (AI = TCh/HDL-cholesterol) was calculated and serum concentration of CX3CL1, CCL2, CCL5, TNF-α, CD40-ligand, and FAS-ligand was measured using ELISA (R&D Systems) before and after 4 months of treatment. Statistical analysis was performed using general linear models (SAS System v. 9.3).
Results Statistically significant AI decrease after 4 months (4.70 vs 3.63) was observed in the group treated with atorvastatin, but not in the patients with dietary treatment only (3.32 vs 3.76, p<0.001 for interaction effect). CCL5 concentration decreased similarly in both groups during the study (p<0.0001 for time effect). CD40-ligand concentration increased significantly only in the diet group, but in the atorvastatin group it remained unchanged during the trial (p<0.0001 for interaction effect). No differences were observed in the serum concentrations of CX3CL1, CCL2, TNF-α, FAS-ligand before and after the treatment in both groups.
Conclusions Atorvastatin treatment influencing serum lipids and lowering atherogenicity index in patients with RA, simultaneously decreases serum level of pro-atherogenic chemokine CCL5 and prevents increase of CD40-ligand concentration. Diet treatment alone does not seem to influence pro-atherogenic factors in RA.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel III). Circulation 2002; 106: 3143.
Disclosure of Interest None Declared