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Research article
Nuria Barbarroja
University of Cordoba
Corresponding Author
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Background:Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic diseases of childhood that often persists into adulthood and can result in significant long-term morbidity. As a long lasting chronic inflammatory disease, concern has been raised regarding the risk of premature development of cardiovascular disease (CVD) in JIA. This study aims to determine whether adults with JIA in clinical remission and medium-long duration of the disease display subclinical signs of CVD risk. Methods: This is a cross-sectional study including 25 patients diagnosed with JIA according to the International League of Associations for Rheumatology criteria (ILAR 2001) and 25 age- and sex-matched controls. Remission was determined by JADAS10<1 and according to Wallace criteria. The presence of traditional CVD risk factors was analyzed. An extensive clinical analysis including body mass index (BMI), lipid profile, homeostatic model assessment – insulin resistance (HOMA-IR) and arterial blood pressure was performed. Intima media thickness of the common carotid artery (cIMT) was measured as a marker of subclinical atherosclerosis. Several proinflammatory cytokines, molecules involved in the endothelial dysfunction and adipokines were quantified on serum by ELISA. In vitro studies were carried out in healthy peripheral mononuclear cells (PBMCs), adipocytes and endothelial cells which were treated with serum from JIA patients under sustained remission. The expression of inflammatory molecules, oxidative stress and endothelial activation markers and adipokines was analyzed. Results : Mean duration of the disease was 13.47 ± 5.47 years. Mean age was 25.11 ± 7.21. Time in remission was 3.52 ± 3.33 years. CVD risk factors were similar in JIA patients and controls. However, cholesterol levels were significantly elevated in JIA patients. Serum levels of adipocytokines, oxidative stress and endothelial activation markers were elevated in serum and PBMCs from JIA patients. Serum of those JIA patients induced the activation of adipocytes, endothelial cells and healthy PBMCs. Conclusions: Long-term JIA adult patients in remission might have subclinical signs of inflammation and CVD risk, showed by an increase in the levels of inflammatory cytokines, endothelial activation and oxidative stress markers and adipokines, molecules closely involved in the alteration of the vascular system. Thus, CVD risk assessment might be considered as part of routine clinical care in those patients.
Keywords
Juvenile Idiopathic Arthritis, Cardiovascular Risk, Clinical Remission
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View the published article at Pediatric Rheumatology.
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On 14 Apr, 2020
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Received 24 Feb, 2020
Reviewer #7 agreed
On 17 Feb, 2020
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Received 13 Feb, 2020
Review #5 received
Received 13 Feb, 2020
Reviewer #6 agreed
On 04 Feb, 2020
Reviewer #4 agreed
On 03 Feb, 2020
Reviewer #5 agreed
On 03 Feb, 2020
Review #1 received
Received 02 Feb, 2020
Review #2 received
Received 01 Feb, 2020
Reviewer #3 agreed
On 01 Feb, 2020
Review #3 received
Received 01 Feb, 2020
Reviewer #1 agreed
On 29 Jan, 2020
Reviewer #2 agreed
On 29 Jan, 2020
Reviewers invited
Invitations sent on 26 Jan, 2020
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On 13 Jan, 2020
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See the published version of this preprint at Pediatric Rheumatology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Nuria Barbarroja
University of Cordoba
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Pediatric Rheumatology.
No community comments so far
Editorial decision: Accept
On 15 Apr, 2020
Editor assigned
On 14 Apr, 2020
Submission checks complete
On 13 Apr, 2020
Editor invited
On 13 Apr, 2020
Version 1
Posted 17 Jan, 2020
No comments provided
Editorial decision: Major revision
On 14 Mar, 2020
Review #7 received
Received 02 Mar, 2020
Review #6 received
Received 24 Feb, 2020
Reviewer #7 agreed
On 17 Feb, 2020
Review #4 received
Received 13 Feb, 2020
Review #5 received
Received 13 Feb, 2020
Reviewer #6 agreed
On 04 Feb, 2020
Reviewer #4 agreed
On 03 Feb, 2020
Reviewer #5 agreed
On 03 Feb, 2020
Review #1 received
Received 02 Feb, 2020
Review #2 received
Received 01 Feb, 2020
Reviewer #3 agreed
On 01 Feb, 2020
Review #3 received
Received 01 Feb, 2020
Reviewer #1 agreed
On 29 Jan, 2020
Reviewer #2 agreed
On 29 Jan, 2020
Reviewers invited
Invitations sent on 26 Jan, 2020
Editor assigned
On 14 Jan, 2020
First submitted
On 13 Jan, 2020
Submission checks complete
On 13 Jan, 2020
Editor invited
On 13 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Pediatric Rheumatology.
Background:Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic diseases of childhood that often persists into adulthood and can result in significant long-term morbidity. As a long lasting chronic inflammatory disease, concern has been raised regarding the risk of premature development of cardiovascular disease (CVD) in JIA. This study aims to determine whether adults with JIA in clinical remission and medium-long duration of the disease display subclinical signs of CVD risk. Methods: This is a cross-sectional study including 25 patients diagnosed with JIA according to the International League of Associations for Rheumatology criteria (ILAR 2001) and 25 age- and sex-matched controls. Remission was determined by JADAS10<1 and according to Wallace criteria. The presence of traditional CVD risk factors was analyzed. An extensive clinical analysis including body mass index (BMI), lipid profile, homeostatic model assessment – insulin resistance (HOMA-IR) and arterial blood pressure was performed. Intima media thickness of the common carotid artery (cIMT) was measured as a marker of subclinical atherosclerosis. Several proinflammatory cytokines, molecules involved in the endothelial dysfunction and adipokines were quantified on serum by ELISA. In vitro studies were carried out in healthy peripheral mononuclear cells (PBMCs), adipocytes and endothelial cells which were treated with serum from JIA patients under sustained remission. The expression of inflammatory molecules, oxidative stress and endothelial activation markers and adipokines was analyzed. Results : Mean duration of the disease was 13.47 ± 5.47 years. Mean age was 25.11 ± 7.21. Time in remission was 3.52 ± 3.33 years. CVD risk factors were similar in JIA patients and controls. However, cholesterol levels were significantly elevated in JIA patients. Serum levels of adipocytokines, oxidative stress and endothelial activation markers were elevated in serum and PBMCs from JIA patients. Serum of those JIA patients induced the activation of adipocytes, endothelial cells and healthy PBMCs. Conclusions: Long-term JIA adult patients in remission might have subclinical signs of inflammation and CVD risk, showed by an increase in the levels of inflammatory cytokines, endothelial activation and oxidative stress markers and adipokines, molecules closely involved in the alteration of the vascular system. Thus, CVD risk assessment might be considered as part of routine clinical care in those patients.
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