An observational study of endothelial function in early arthritis

Eur J Clin Invest. 2012 May;42(5):510-6. doi: 10.1111/j.1365-2362.2011.02607.x. Epub 2011 Oct 10.


Background: Endothelial dysfunction is present in established rheumatoid arthritis, but it is not clear at what stage of the disease this abnormality develops. We set out to determine whether endothelial damage/dysfunction is present in a group of patients with early arthritis (EA) (new onset inflammatory arthritis, EA).

Materials and methods: Eighteen patients with EA, 48 healthy controls and 25 disease controls were recruited. Plasma was obtained for endothelial [von Willebrand factor (vWF) and soluble E-selectin] and angiogenesis markers (vascular endothelial growth factor and its receptor sFlt-1), adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1) and circulating endothelial cells (CECs, as a marker of endothelial damage). Microvascular endothelial function was assessed using laser Doppler perfusion imaging and macrovascular function using flow-mediated dilatation of the brachial artery.

Results: von Willebrand factor and CECs (both P < 0.05) were significantly elevated in EA suggesting endothelial dysfunction and damage but were unrelated to classical laboratory markers of inflammation C-reactive protein, erythrocyte sedimentation rate or IL6. No other biomarkers was elevated in EA. Microvascular and macrovascular abnormalities were confined to endothelium-independent (smooth muscle cell) responses.

Conclusions: Endothelial damage/dysfunction is present early in the course of inflammatory arthritis but is not directly related to inflammation markers.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / metabolism*
  • Arthritis, Rheumatoid / physiopathology
  • Biomarkers / metabolism
  • Case-Control Studies
  • E-Selectin / blood*
  • Endothelial Cells / metabolism*
  • Endothelium, Vascular / metabolism*
  • Female
  • Humans
  • Inflammation / metabolism
  • Laser-Doppler Flowmetry
  • Male
  • Middle Aged
  • Statistics as Topic
  • Time Factors
  • von Willebrand Factor / metabolism*


  • Biomarkers
  • E-Selectin
  • von Willebrand Factor