Association of circulating endothelial cells with flow mediated vasodilation and disease activity in patients with systemic lupus erythematosus

Abstract

The aim of this study was to determine the correlation between CEC count and endothelial function, disease activity, and organ involvement in patients with SLE. Background: Premature atherosclerosis in patients with systemic lupus erythematosus (SLE) is not explained by traditional risk factors. Circulating endothelial cells (CEC) have been identified as a surrogate marker of endothelial dysfunction Methods: The present study included 30 premenopausal women with SLE and 20 age and sex matched healthy controls (HC). Endothelial function was studied by flow mediated vasodilation (FMD%) in the brachial artery. Serum levels of VCAM-1, ICAM-1 were measured. Results: FMD% was lower in patients with SLE than HC (3.5 ± 0.4 vs 9.7 ± 3.2, p < 0.001). CEC count was significantly elevated in patients with SLE compared to HC (38 ± 18 vs 7 ± 3, p < 0.001). CEC count correlated positively with systemic lupus activity score (r = 0.97), and negatively with FMD% (r = −0.94). Serum levels of VCAM-1 and ICAM-1 were significantly elevated in patients with SLE compared to HC (p < 0.001). There was a significant correlation between CEC count and vasculitic skin lesions (p < 0.01), renal involvement (p < 0.01), and VCAM-1 levels (p < 0.001). Conclusion: CEC is associated with endothelial dysfunction, disease activity and increased VCAM-1 levels in patients with SLE. These findings suggest a potential role of CEC in the pathophysiology of cardiovascular disease in these patients.

Keywords

• Circulating endothelial cells
• Systemic lupus erythematosus
• Flow mediated dilatation