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Rheumatology Advance Access published online on January 19, 2009
Rheumatology, doi:10.1093/rheumatology/ken486
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Circulating endothelial cells and rheumatoid arthritis: relationship with plasma markers of endothelial damage/dysfunction

Will Foster1, Eduard Shantsila1, David Carruthers2, Gregory Y. H. Lip1 and Andrew D. Blann1

1University Department of Medicine and 2Department of Rheumatology, City Hospital, Birmingham, UK

Correspondence to: Andrew D. Blann, University Department of Medicine, City Hospital, Birmingham, B18 7QH, UK. E-mail: a.blann{at}bham.ac.uk


  Abstract

Objectives. RA is associated with endothelial cell dysfunction (ECD) and increased cardiovascular mortality and morbidity. Circulating endothelial cells (CECs) are a novel marker of severe endothelial damage. We hypothesized altered CECs in patients with RA compared with community controls (CCs) and hospital controls (HCs, with diabetes and hypertension) correlate with established plasma markers of inflammation and of ECD.

Methods. CECs (CD146-immunobeads), von Willebrand factor, soluble E-selectin, soluble intercellular adhesion molecule-1, soluble vascular endothelial adhesion molecule-1 (sVCAM, all ELISA) and C-reactive protein (CRP, immunonephelometry) were measured in 57 patients with RA, 45 CC and 23 HC patients.

Results. CECs in RA [median/interquartile range 8 (5–13.5) cells/ml] were elevated compared with either CC [4 (2–8.5) cells/ml] or HC [4 (1–8) cells/ml] (both P < 0.001). Levels of CECs did not correlate with other markers of ECD or of inflammation but did correlate inversely with sVCAM.

Conclusion. Evidence of endothelial damage in the form of mildly increased numbers of CECs is present in RA and is independent of plasma markers of inflammation and of ECD.

KEY WORDS: Rheumatoid arthritis, von Willebrand factor, C-reactive protein, Circulating endothelial cells, Soluble E selectin

Submitted 10 July 2008; revised version accepted 1 December 2008.
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