Abstract | OBJECTIVE: METHODS: In 92 AS patients, lipid levels and their association with the inflammation markers C-reactive protein (CRP), erythrocyte sedimentation rate, and SAA were evaluated serially during 3 months of etanercept treatment. HDL composition and its relationship to inflammation markers was determined in a subgroup of patients, using surface-enhanced laser desorption/ionization time-of-flight analysis. RESULTS: With anti-TNF treatment, levels of all parameters of inflammation decreased significantly, whereas total cholesterol, HDL-c, and apolipoprotein A-I ( Apo A-I) levels increased significantly. This resulted in a better total cholesterol:HDL-c ratio (from 3.9 to 3.7) (although the difference was not statistically significant), and an improved Apo B: Apo A-I ratio, which decreased by 7.5% over time (P=0.008). In general, increases in levels of all lipid parameters were associated with reductions in inflammatory activity. In addition, SAA was present at high levels within HDL particles from AS patients with increased CRP levels and disappeared during treatment, in parallel with declining plasma levels of SAA. CONCLUSION: Our results show for the first time that during anti-TNF therapy for AS, along with favorable changes in the lipid profile, HDL composition is actually altered whereby SAA disappears from the HDL particle, increasing its atheroprotective ability. These findings demonstrate the importance of understanding the role of functional characteristics of HDL-c in cardiovascular diseases related to chronic inflammatory conditions.
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Authors | I C van Eijk, M K de Vries, J H M Levels, M J L Peters, E E Huizer, B A C Dijkmans, I E van der Horst-Bruinsma, B P C Hazenberg, R J van de Stadt, G J Wolbink, M T Nurmohamed |
Journal | Arthritis and rheumatism
(Arthritis Rheum)
Vol. 60
Issue 5
Pg. 1324-30
(May 2009)
ISSN: 0004-3591 [Print] United States |
PMID | 19404933
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Apolipoprotein A-I
- Apolipoproteins B
- Cholesterol, HDL
- Immunoglobulin G
- Receptors, Tumor Necrosis Factor
- Serum Amyloid A Protein
- Tumor Necrosis Factor-alpha
- C-Reactive Protein
- Etanercept
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Topics |
- Adult
- Apolipoprotein A-I
(blood)
- Apolipoproteins B
(blood)
- Blood Sedimentation
- C-Reactive Protein
(analysis)
- Cardiovascular Diseases
(blood)
- Cholesterol, HDL
(blood)
- Cohort Studies
- Etanercept
- Female
- Humans
- Immunoglobulin G
(pharmacology)
- Male
- Prospective Studies
- Receptors, Tumor Necrosis Factor
- Serum Amyloid A Protein
(analysis)
- Spondylitis, Ankylosing
(blood)
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
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