Abstract
Background:Rheumatoid Arthritis (RA) is a chronic and inflammatory disease that affects about 1% of the world's population. Almost 70% of RA patients have a cardiovascular disease such as Systemic Arterial Hypertension (SAH). Inflammatory cytokines are clearly involved in the pathogenesis of RA and correlated with SAH.Objective:It is necessary to understand whether the antihypertensive drugs have a dual effect as immunomodulators and which one is the best choice for RA SAH patients.Methods:Peripheral Blood Mononuclear Cells (PBMCs) from 16 RA patients were purified and stimulated or not stimulated with anti-CD3 and anti-CD28 mAB and were treated with Enalapril, Losartan and Valsartan at 100μM. Patients were evaluated for clinical and laboratory variables including measures of disease activity by Clinical Disease Activity Index (CDAI) and Disease Activity Score (DAS28). Cytokines were quantified by ELISA sandwich.Results:Losartan was able to reduce levels of IFN-γ (p = 0.0181), IL-6 (p = 0.0056), IL-17F (0.0046) and IL-22 (p = 0.0234) in RA patients. In addition, patients in remission and mild score (DAS28<3.2 and CDAI<10) had a better response to treatment. On the other hand, patients in moderate and severe activity had poor response to Losartan in cytokine inhibition.Conclusion:PBMCs from RA patients are responsive in inhibiting proinflammatory cytokines using Losartan better than Enalapril and Valsartan and it could be a better antihypertensive choice for patients with RA and systemic arterial hypertension treatment.
Highlights
Rheumatoid Arthritis (RA) is a chronic and systemic disease that affects the joints, connective tissues, muscles, tendons and fibrous tissues, and in addition to pain, causing deformations in the bony-cartilaginous structure
Peripheral Blood Mononuclear Cells (PBMCs) from RA patients are responsive in inhibiting proinflammatory cytokines using Losartan better than Enalapril and Valsartan and it could be a better antihypertensive choice for patients with RA and systemic arterial hypertension treatment
Our results show that Losartan at 100μM could significantly reduce IFN-γ, IL-6, IL-17F, IL-22 cytokine levels secreted by PBMCs in RA cultures
Summary
Rheumatoid Arthritis (RA) is a chronic and systemic disease that affects the joints, connective tissues, muscles, tendons and fibrous tissues, and in addition to pain, causing deformations in the bony-cartilaginous structure. Cardiovascular disease (CVD) represents one of the most frequent comorbidities in RA patients, and it is responsible for increasing the mortality of this population up to twice [3, 4]. The prevalence of systemic arterial hypertension (SAH) is high in patients with RA, ranging from 53% -73% [5]. When comparing this percentage with the general population, this index is no more than 23% [5]. Rheumatoid Arthritis (RA) is a chronic and inflammatory disease that affects about 1% of the world's population. Almost 70% of RA patients have a cardiovascular disease such as Systemic Arterial Hypertension (SAH). Inflammatory cytokines are clearly involved in the pathogenesis of RA and correlated with SAH
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