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Increased cardiovascular (CV) mortality due to accelerated atherosclerosis occurs in ankylosing spondylitis (AS) patients.1 ,2 Beneficial effects of antitumour necrosis factor (anti-TNF)-α agents on disease activity and endothelial cell activation were reported in AS.3 ,4 Dramatic reduction of insulin resistance (IR) and improvement of insulin sensitivity after infliximab administration were also described in non-diabetic AS patients.5
We aimed to assess, for the first time, whether infliximab administration in AS patients may alter levels of retinol-binding protein 4 (RBP-4), a protein released from adipocytes, considered as an emerging cardiometabolic risk factor, which correlates with IR in individuals with obesity, impaired glucose tolerance or type 2 diabetes, and in non-obese subjects with or without family history of type 2 diabetes.6–⇓8
RBP-4 serum levels were measured by ELISA (Phoenix Pharmaceuticals, EK-028-28) in 30 consecutive non-diabetic and mostly non-obese AS patients without history of CV events before and after an infliximab infusion. Local institutional committee approval and patients’ informed consent were obtained. Information on blood sample determinations in this cohort was previously reported.9 Infliximab was given as an intravenous infusion in saline solution over 120 min.5 Measurements were made in …
FG, RL-M and JAM-F all contributed equally. MAG-G and JL shared senior authorship in this study.
Acknowledgements The authors thank Mrs Susana Escandon and Isabel Castro-Fernandez, nurses from the Rheumatology Outpatient Clinic, and Ms Pilar Ruiz, a nurse from the Haematology Division, and the members of the Biochemistry Department from Hospital Xeral-Calde, Lugo, for their valuable help to undertake this study.
Contributors FG and RL-M performed the study, contributed to the elaboration of the protocol of study, helped in the interpretation of data and in the elaboration of the manuscript. JAM-F recruited patients for the study, contributed to the elaboration of the protocol of study, helped in the interpretation of data and the elaboration of the manuscript. BU and RO performed the ELISA studies and helped in the interpretation of data. BC-L, RB, JR-G, TP and CG-J helped in the interpretation of data and contributed to the elaboration of the manuscript. IG-A performed the statistical analysis, helped in the interpretation of data and contributed to the elaboration of the manuscript. JL contributed to the elaboration of the protocol of study, helped in the interpretation of data and the elaboration of the manuscript and performed the statistical analysis. MAG-G recruited patients for the study, contributed to the elaboration of the protocol of study, helped in the interpretation of data and was responsible of the final drafting and elaboration of the manuscript.
Funding This study was supported by grants from ‘Fondo de Investigaciones Sanitarias’ PI06/0024, PS09/00748 and PI12/00060 (Spain). This work was also partially supported by RETICS Program, RD08/0075 and RD12/0009/0013 (RIER) from ‘Instituto de Salud Carlos III’ (ISCIII) (Spain).
Competing interests None.
Patient consent Obtained.
Ethics approval Local institutional committee approval was obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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