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Ann Rheum Dis doi:10.1136/ard.2008.092171

Anti-inflammatory therapy with TNFα inhibitors improves HDL-cholesterol anti-oxidative capacity in rheumatoid arthritis patients

  1. Calin Popa (c.popa{at}reuma.umcn.nl)
  1. Radboud University Nijmegen Medical Centre, Netherlands
    1. Lambertus J.H. van Tits
    1. Radboud University Nijmegen Medical Centre, Netherlands
      1. Pilar Barrera
      1. Radboud University Nijmegen Medical Centre, Netherlands
        1. Heidi L.M. Lemmers
        1. Radboud University Nijmegen Medical Centre, Sint Maartenskliniek Nijmegen, Netherlands
          1. Frank H.J. van den Hoogen
          1. Sint Maartenskliniek Nijmegen, Netherlands
            1. Piet L.C.M. van Riel
            1. Radboud University Nijmegen Medical Centre, Netherlands
              1. Timothy R.D.J. Radstake
              1. Radboud University Nijmegen Medical Centre, Netherlands
                1. Mihai G. Netea
                1. Radboud University Nijmegen Medical Centre, Netherlands
                  1. Mark Roest
                  1. University Medical Centre Utrecht, Netherlands
                    1. Anton F.H. Stalenhoef
                    1. Radboud University Nijmegen Medical Centre, Netherlands
                      • Published Online First 17 July 2008

                      Abstract

                      Objective: HDL anti-atherogenic functions seem to be diminished during inflammatory conditions such as rheumatoid arthritis (RA). The aim of this study was to investigate the effects of TNF inhibition on the anti-oxidative capacity of HDL in RA.

                      Methods: Plasma lipids and paraoxonase (PON)-1 activity were investigated in 45 RA patients, before and during 6 months of anti-TNF therapy. In addition, HDL was isolated and tested for its ability to inhibit copper induced oxidation of LDL in vitro.

                      Results Plasma HDL concentrations did not considerably change after 6 months of therapy. However, stable increases of PON-1 activities were observed throughout the same period (p<0.03). The increases were more obvious when related to HDL or apolipoprotein A-I concentrations. HDL total anti-oxidative capacity significantly improved 6 months after initiation of anti-TNF therapy (p = 0.015). The initial improvement of PON-1 activity paralleled a decrease of the inflammatory status, whereas specific TNF blockade was likely to be responsible for the long-term effects.

                      Conclusions: Anti-TNF therapy with infliximab has beneficial effects on lipids through changes in HDL anti-oxidative capacity, which might be clinical relevant and contribute to the reported protective effect of anti-TNF on cardiovascular morbidity in RA. This emphasizes the importance of HDL anti-atherogenic capacity for the cardiovascular risk in chronic inflammatory conditions.