RESUMEN
Rheumatoid Arthritis (RA), Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are the systemic autoimmune diseases (SADs) most associated with an increased risk of developing cardiovascular (CV) events. Cardiovascular disease (CVD) in SADs results from a complex interaction between traditional CV-risk factors, immune deregulation and disease activity. Oxidative stress, dyslipidemia, endothelial dysfunction, inflammatory/prothrombotic mediators (cytokines/chemokines, adipokines, proteases, adhesion-receptors, NETosis-derived-products, and intracellular-signaling molecules) have been implicated in these vascular pathologies. Genetic and genomic analyses further allowed the identification of signatures explaining the pro-atherothrombotic profiles in RA, SLE and APS. However, gene modulation has left significant gaps in our understanding of CV co-morbidities in SADs. MicroRNAs (miRNAs) are emerging as key post-transcriptional regulators of a suite of signaling pathways and pathophysiological effects. Abnormalities in high number of miRNA and their associated functions have been described in several SADs, suggesting their involvement in the development of atherosclerosis and thrombosis in the setting of RA, SLE and APS. This review focusses on recent insights into the potential role of miRNAs both, as clinical biomarkers of atherosclerosis and thrombosis in SADs, and as therapeutic targets in the regulation of the most influential processes that govern those disorders, highlighting the potential diagnostic and therapeutic properties of miRNAs in the management of CVD.
Asunto(s)
Enfermedades Autoinmunes/complicaciones , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/metabolismo , MicroARNs/metabolismo , Síndrome Antifosfolípido/complicaciones , Artritis Reumatoide/complicaciones , Aterosclerosis/etiología , Biomarcadores , Enfermedades Cardiovasculares/genética , Regulación de la Expresión Génica , Humanos , Lupus Eritematoso Sistémico/complicaciones , MicroARNs/genética , Estrés Oxidativo , Factores de Riesgo , Transducción de Señal/genética , Trombosis/etiologíaRESUMEN
BACKGROUND: Systemic lupus erythematosus (SLE) is a common systemic autoimmune disease with a complex genetic inheritance. Genome-wide association studies (GWAS) have significantly increased the number of significant loci associated with SLE risk. To date, however, established loci account for less than 30% of the disease heritability and additional risk variants have yet to be identified. Here we performed a GWAS followed by a meta-analysis to identify new genome-wide significant loci for SLE. METHODS: We genotyped a cohort of 907 patients with SLE (cases) and 1524 healthy controls from Spain and performed imputation using the 1000 Genomes reference data. We tested for association using logistic regression with correction for the principal components of variation. Meta-analysis of the association results was subsequently performed on 7,110,321 variants using genetic data from a large cohort of 4036 patients with SLE and 6959 controls of Northern European ancestry. Genetic association was also tested at the pathway level after removing the effect of known risk loci using PASCAL software. RESULTS: We identified five new loci associated with SLE at the genome-wide level of significance (p < 5 × 10- 8): GRB2, SMYD3, ST8SIA4, LAT2 and ARHGAP27. Pathway analysis revealed several biological processes significantly associated with SLE risk: B cell receptor signaling (p = 5.28 × 10- 6), CTLA4 co-stimulation during T cell activation (p = 3.06 × 10- 5), interleukin-4 signaling (p = 3.97 × 10- 5) and cell surface interactions at the vascular wall (p = 4.63 × 10- 5). CONCLUSIONS: Our results identify five novel loci for SLE susceptibility, and biologic pathways associated via multiple low-effect-size loci.
Asunto(s)
Sitios Genéticos/genética , Estudio de Asociación del Genoma Completo/métodos , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/genética , Estudios de Cohortes , Variación Genética/genética , HumanosRESUMEN
El lupus inducido por fármacos (LIF) es un síndrome que comparte síntomas y características de laboratorio con el lupus eritematoso sistémico (LES) idiopático y que se presenta tras la exposición a ciertos fármacos (AU)
Drug-induced lupus (DIL) is syndrome characterised by the occurrence of lupus-like symptoms and serological findings, following exposure to certain drugs. A substantial number of drugs can induce the positivity of antinuclear antibodies (ANA) but the diagnosis of DIL cannot be done in the absence of clinical features (AU)
