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2017 ; 8
(ä): 195
Nephropedia Template TP
gab.com Text
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English Wikipedia
Expansions of Cytotoxic CD4(+)CD28(-) T Cells Drive Excess Cardiovascular
Mortality in Rheumatoid Arthritis and Other Chronic Inflammatory Conditions and
Are Triggered by CMV Infection
#MMPMID28303136
Broadley I
; Pera A
; Morrow G
; Davies KA
; Kern F
Front Immunol
2017[]; 8
(ä): 195
PMID28303136
show ga
A large proportion of cardiovascular (CV) pathology results from immune-mediated
damage, including systemic inflammation and cellular proliferation, which cause a
narrowing of the blood vessels. Expansions of cytotoxic CD4(+) T cells
characterized by loss of CD28 ("CD4(+)CD28(-) T cells" or "CD4(+)CD28(null)
cells") are closely associated with cardiovascular disease (CVD), in particular
coronary artery damage. Direct involvement of these cells in damaging the
vasculature has been demonstrated repeatedly. Moreover, CD4(+)CD28(-) T cells are
significantly increased in rheumatoid arthritis (RA) and other autoimmune
conditions. It is striking that expansions of this subset beyond 1-2% occur
exclusively in CMV-infected people. CMV infection itself is known to increase the
severity of autoimmune diseases, in particular RA and has also been linked to
increased vascular pathology. A review of the recent literature on immunological
changes in CVD, RA, and CMV infection provides strong evidence that expansions of
cytotoxic CD4(+)CD28(-) T cells in RA and other chronic inflammatory conditions
are limited to CMV-infected patients and driven by CMV infection. They are likely
to be responsible for the excess CV mortality observed in these situations. The
CD4(+)CD28(-) phenotype convincingly links CMV infection to CV mortality based on
a direct cellular-pathological mechanism rather than epidemiological association.