ArticleRMD open2025
Molecular insights into the relationship between sustained CRP elevation and endothelial dysfunction in axial spondyloarthritis.
Article in RMD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Selected biomarkers of coagulation, inflammation, and vascular tone in young women with normal weight obesity.International journal of obesity (2005) · 2026Article
- Golimumab for the Treatment of Axial Spondyloarthritis: Integrating Clinical Outcomes with Real-World Patient Benefits.Advances in therapy · 2026Review
- Cardiovascular involvement in ankylosing spondylitis and axial spondyloarthritis: epidemiology, mechanisms, and clinical management.Frontiers in medicine · 2026Review
- Ankylosing spondylitis complicated by cervical spine fracture and cervicothoracic epidural hematoma: A case report.Medicine · 2025Article
- Association of C-reactive protein-triglyceride-glucose index with all-cause and cardiovascular mortality in postmenopausal women.Przeglad menopauzalny = Menopause review · 2025Article
- Clinical and molecular links between chronic systemic inflammation and structural damage in axial spondyloarthritis.Arthritis research & therapy · 2025Article
- From advanced imaging to molecular insights: the state of the art in omics for axial spondyloarthritis.Therapeutic advances in musculoskeletal disease · 2025Review
- Risk factors for hypoxemia during pediatric anesthesia: a logistic regression analysis.American journal of translational research · 2025Article
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the impact of sustained C reactive protein (CRP) elevation on cardiovascular (CV) risk factors, particularly endothelial dysfunction and atherosclerosis, in axial spondyloarthritis (axSpA) patients and to explore the underlying molecular mechanisms.
methods245 axSpA patients were enrolled. Carotid intima-media thickness (CIMT) and microvascular endothelial function (post-ischaemic reactive hyperaemia) were measured. Retrospective CRP measurements from the past 5 years classified patients as having sustained high CRP if >50% of readings were elevated. Serum levels of 184 inflammation and CV disease-related proteins were analysed using a proximity extension assay, and in vitro studies were conducted in human umbilical vein endothelial cells.
results40% of axSpA patients had sustained CRP elevation, showing increased metabolic comorbidities, higher prevalence of atherosclerotic plaques and worse microvascular endothelial function compared with those with intermittent CRP elevations. Proteomic analysis identified 10 altered proteins, with interleukin 6 (IL-6) and CUB domain-containing protein 1 (CDCP-1) linked to endothelial dysfunction, higher CIMT and metabolic disturbances. Paraoxonase 3 (PON-3), the only downregulated protein, showed anti-inflammatory, antioxidant and antiatherogenic properties, restoring endothelial function in vitro. CDCP-1 was associated with atherosclerotic plaques and promoted endothelial adhesion, oxidative stress and inflammation in vitro. Anti-TNF-α therapy reduced inflammatory markers, complement components and the atherogenic index, while increasing high density lipoprotein, apolipoprotein A and PON-3 levels and decreasing IL-6 and CDCP-1 levels.
conclusionsSustained CRP elevation in axSpA is strongly linked to increased CV risk, endothelial dysfunction and atherosclerosis. IL-6, CDCP-1 and PON-3 emerge as key mediators connecting inflammation to CV risk. Anti-tumour necrosis factor-α therapy improved the metabolic and inflammatory profile and modulated IL-6, CDCP-1 and PON-3 levels, supporting its role in managing CV risks in axSpA.
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