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Endothelial dysfunction is associated with activation of the type I interferon
system and platelets in patients with systemic lupus erythematosus
#MMPMID29119007
Tydén H
; Lood C
; Gullstrand B
; Nielsen CT
; Heegaard NHH
; Kahn R
; Jönsen A
; Bengtsson AA
RMD Open
2017[]; 3
(2
): e000508
PMID29119007
show ga
OBJECTIVES: Endothelial dysfunction may be connected to cardiovascular disease
(CVD) in systemic lupus erythematosus (SLE). Type I interferons (IFNs) are
central in SLE pathogenesis and are suggested to induce both endothelial
dysfunction and platelet activation. In this study, we investigated the interplay
between endothelial dysfunction, platelets and type I IFN in SLE. METHODS: We
enrolled 148 patients with SLE and 79 sex-matched and age-matched healthy
controls (HCs). Type I IFN activity was assessed with a reporter cell assay and
platelet activation by flow cytometry. Endothelial dysfunction was assessed using
surrogate markers of endothelial activation, soluble vascular cell adhesion
molecule-1 (sVCAM-1) and endothelial microparticles (EMPs), and finger
plethysmograph to determine Reactive Hyperaemia Index (RHI). RESULTS: In patients
with SLE, type I IFN activity was associated with endothelial activation,
measured by high sVCAM-1 (OR 1.68,?p<0.01) and elevated EMPs (OR 1.40, p=0.03).
Patients with SLE with high type I IFN activity had lower RHI than HCs (OR 2.61,
p=0.04), indicating endothelial dysfunction.Deposition of complement factors on
platelets, a measure of platelet activation, was seen in patients with
endothelial dysfunction. High levels of sVCAM-1 were associated with increased
deposition of C4d (OR 4.57,?p<0.01) and C1q (OR 4.10, p=0.04) on platelets. High
levels of EMPs were associated with C4d deposition on platelets (OR 3.64,
p=0.03). CONCLUSIONS: Endothelial dysfunction was associated with activation of
platelets and the type I IFN system. We suggest that an interplay between the
type I IFN system, injured endothelium and activated platelets may contribute to
development of CVD in SLE.