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Back to Conference Highlights
12/11/05 - 17/11/05, San Diego, USA
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Highlights of the American College of Rheumatology 70th Annual
Scientific Meeting - Nov. 12-17, San Diego, USA.
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 related discussion |
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Groundbreaking research reported at the annual meeting of
the American College of Rheumatology indicates that a certain
form of the normally "good" high density lipoprotein (HDL)
cholesterol linked to cardiovascular health plays a
counterproductive role in people with systemic lupus
erythematosus (SLE) and rheumatoid arthritis, promoting
atherosclerosis (hardening of the arteries) and heart disease in
many of these individuals.
The menacing HDL form is pro-inflammatory HDL (piHDL),
according to research by Bevra H. Hahn, MD, Maureen McMahon, MD,
and colleagues at the David Geffen School of Medicine at UCLA,
and it can easily be measured and, most importantly, treated.
Dr. Hahn is chief of the division of rheumatology, and Dr.
McMahon is an assistant clinical professor of rheumatology.
"Traditional risk factors for atherosclerosis--including high
blood pressure, increased cholesterol levels, diabetes mellitus,
older age and postmenopausal status--have proved ineffective for
predicting atherosclerosis in SLE patients," said Dr. Hahn,
whose research is funded by the Lupus Research Institute (LRI).
"Uncovering a potentially important role for pro-inflammatory
HDL in the development of atherosclerotic disease in patients
with SLE is an important first step toward developing strategies
to prevent cardiovascular morbidity and mortality in these
patients."
Dr. Hahn notes that "pro-inflammatory HDL, which is easily
measured, may provide just the sign, known as a biomarker, to
determine which patients are at increased risk. If this research
is successful, in two years or sooner a test may be available to
screen for piHD.
According to Dr. Hahn, women with lupus are about 7 to 10
times more likely than women without the disease to suffer a
heart attack or stroke--just a few of the myriad serious health
problems confronting the estimated 1.5 million Americans with
this chronic autoimmune disease. In lupus, the body attacks its
own healthy tissues and organs in a repetitive cycle of
flare-ups and remissions.
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Results Reported
In the study, Dr. Hahn measured the presence of pro-inflammatory
and HDL in samples of blood plasma from 154 women with SLE, 73
age matched controls, and 50 women with rheumatoid arthritis.
Compared to the control group, the HDL from those with SLE
contained significantly more piHDL. "We found that almost 50
percent of SLE patients, versus approximately 4 percent of
controls and 20 percent of rheumatoid arthritis patients, had
piHDL," said Dr. Hahn.
In addition, piHDL was found in 8 of the 10 individuals with
SLE determined to have actual atherosclerosis. The biomarker was
similarly high in half of the 12 subjects with SLE that had
suffered a stroke (cerebrovascular event).
"We can clearly see from these results that HDL function
fails to protect against cardiovascular disease in many SLE and
rheumatoid arthritis patients," Dr. Hahn concluded. "This
discovery may lead to an effective test [a fluorescence assay]
to identify those at increased risk for blockage of the coronary
arteries so that we can start them on preventive treatments like
cholesterol-lowering statins."
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