Autoimmune, rheumatic diseases linked to deeper aortic inflammation and risk of aneursym.

Autoimmune, rheumatic diseases linked to deeper aortic inflammation and risk of aneursym.
Rheumatoid arthritis, lupus, and other inflammatory rheumatic diseases are associated with a high rate of death from heart disease. One explanation is a greater susceptibility to atherosclerosis. Although atherosclerosis is linked to inflammation in healthy individuals as well, the mechanism of inflammation and the reason for accelerated atherosclerosis in patients with inflammatory rheumatic disease remain unclear. Does atherosclerosis result from systemic inflammation, a hallmark of these rheumatic diseases, or from local inflammation of vessels?
To shed light on the link between chronic inflammation and atherosclerosis, a team of researchers in Norway and the United States, affiliated with the Cleveland Clinic Foundation and Brigham and Women’s Hospital in Boston, focused on the aortas of recent recipients of coronary artery bypass graft (CABG) surgery, comparing biopsy specimens from patients with inflammatory rheumatic disease to those from patients without it. Their study, presented in the June 2007 issue of Arthritis & Rheumatism, affirms inflammatory rheumatic disease and smoking as independent predictors of vessel wall inflammation. The vascular inflammation might be a factor that promotes atherosclerosis and the formation of aneurysms.
Aortic samples were obtained during CABG surgery, performed at two cardiac centers in Norway, from 66 patients with inflammatory rheumatic disease and 51 control patients. The inflammatory rheumatic disease group included patients with rheumatoid arthritis, psoriatic arthritis, lupus, ankylosing spondylitis, polymyalgia and other diseases. Age, body mass index, family history of heart disease, and other traditional cardiovascular risk factors were similar in both groups. All specimens were evaluated, by light microscope, for evidence of chronic inflammatory cell infiltration in the aortic wall. This was achieved by counting and measuring the mononuclear cell infiltrates (MCI) in the aorta, with particular attention to the adventitia, the deepest layer of vascular tissue. Using statistical analysis, the relationship between these inflammatory infiltrates and established lifestyle risk factors for heart disease was also assessed.
In the adventitia (the deepest layer of the blood vessel wall), MCIs occurred more frequently in patients with inflammatory rheumatic disease — 47 percent of this group, compared with 20 percent of the control group. Along with greater prevalence, these inflammatory cells were larger in size. In the middle layer of the vessel wall (the media), MCIs were detected only in patients with inflammatory rheumatic disease. What’s more, MCIs were observed in 6 of 7 patients with a history of aortic aneurysm. In addition to inflammatory rheumatic disease, current smoking was independently associated with more pronounced chronic inflammatory infiltration in the inner adventitia.
In summary, inflammatory rheumatic diseases (many of which involve autoimmune mechanisms) are associated with much higher white blood cell infiltration in the middle and deepest layers of the blood vessel walls, and cigarette smoking worsens inflammation in the inner adventitia. Despite the limitations of its small sample size, this groundbreaking study of aortic inflammation in patients with inflammatory rheumatic disease indicates the need for further investigation into an inflammatory process that may increase vulnerability to dying from a heart attack or aneurysm (Courtesy of EurekAlert!, a service of AAAS).

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MS, more common among women

MS, or multiple sclerosis, is a chronic inflammatory disease that affects the central nervous system. In 1940, two out of three with the condition were women but by the year 2000, that figure went up to four out of five. "We also need to ask the general questions about what women do differently than men, such as use of hair dye and cosmetics that may block vitamin D absorption," said Dr Gary Cutter, from the University of Alabama in Birmingham. In another study, researchers also found the largest increase in the ratio of women to men has been for those whose MS started at younger ages. MS can cause a variety of symptoms, including changes in sensation, visual problems, muscle weakness, depression, difficulties with coordination and speech, severe fatigue, cognitive impairment, problems with balance, overheating and pain. MS will cause impaired mobility and disability in more severe cases. MS is the most common disabling neurological condition affecting young adults; it is an autoimmune condition - meaning the immune system mistakes the body's own tissue for an infectious foreign body, and attacks it. MGP/SF/BGH
For more information on autoimmune diseases.
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