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Combination of Azathioprine and Aminosalicylate Treatment Prevent Risk of Cardiovascular Disease in Women with Ulcerative Colitis by Reducing Inflammation.

dos Santos LC, Costa AV, Lopes LG, Leonel AJ, Aguilar EC, Noviello Mde L, Ferrari Mde L, Alvarez-Leite JI - Med. Sci. Monit. (2015)

Bottom Line: Framingham scores showed higher risk of CVD in UC groups.UC groups were compared and women treated with azathioprine showed reduction of total protein, globulin, ESR, and lymphocytes, with increased IL-6, TNF, IL-10, and TGF-β.Our data suggest that women with UC in clinical remission have a higher risk for development of atherosclerosis and CVD when compared to the control group, while women treated with azathioprine seem more protected than those treated only with aminosalicylates, due to better regulation of the inflammatory process.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.

ABSTRACT

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with involvement of the immune system. Chronic inflammatory diseases have been associated with increased risk of cardiovascular disease (CVD) but few studies have assessed this risk in patients with UC and the influence of drug treatment. Thus, we evaluated the risk of development of CVD in women with UC in clinical remission, considering the drug treatment.

Material and methods: Twenty-one women with UC participated in this study: 12 used aminosalicylates (ASA group) and 9 used azathioprine added to aminosalicylates (AZA+ASA group). The healthy control group was matched for age. We evaluated blood pressure, body composition, and biochemical and immunological parameters.

Results: Compared to the respective control group, the UC groups showed expansion of body fat and less lean body mass. Blood pressure, pro-inflammatory cytokines, nitric oxide, C reactive protein, erythrocyte sedimentation rate (ESR), and anti-oxidized LDL antibodies were higher in UC groups. Only AZA+ASA group showed increased anti-inflammatory cytokines (IL-10 and TGF-β). Framingham scores showed higher risk of CVD in UC groups. UC groups were compared and women treated with azathioprine showed reduction of total protein, globulin, ESR, and lymphocytes, with increased IL-6, TNF, IL-10, and TGF-β.

Conclusions: Our data suggest that women with UC in clinical remission have a higher risk for development of atherosclerosis and CVD when compared to the control group, while women treated with azathioprine seem more protected than those treated only with aminosalicylates, due to better regulation of the inflammatory process.

No MeSH data available.


Related in: MedlinePlus

Markers of inflammation in women treated with aminosalicylates (ASA) or azathioprine+aminosalicylates (AZA+ASA) and their controls. (A) Total protein; (B) albumin; (C) globulin; (D) erythrocyte sedimentation rate; (E) fibrinogen; (F) C-reactive protein.
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f1-medscimonit-21-2305: Markers of inflammation in women treated with aminosalicylates (ASA) or azathioprine+aminosalicylates (AZA+ASA) and their controls. (A) Total protein; (B) albumin; (C) globulin; (D) erythrocyte sedimentation rate; (E) fibrinogen; (F) C-reactive protein.

Mentions: Body weight, BMI, waist circumference, and traditional risk factors for CVD such as glycemia, triglyceridemia, total cholesterol, and its fractions were similar between groups (Tables 1, 2), while body fat was increased and fat-free mass was reduced in ASA group (Table 1). ASA patients also showed increased total proteins due to increase in globulin, with the concomitant decreased on albumin fraction (Figure 1). Diastolic and systolic blood pressures another important risk factor for CVD, and hsCRP and ESR were higher in ASA patients (Table 1, Figure 1). Inflammatory markers such as IL-6 and CCL2 were also increased in the ASA group (Figure 2). Nitrite concentration (indicating nitric oxide status) and IgG anti-oxLDL (an indicator of oxLDL concentration) were increased in women in the ASA group (Figure 3), suggesting an increased risk of atherosclerosis in these patients. The Framingham scores showed that ASA patients have a higher 10-year risk for CVD, considering lipid profile or BMI. Similar results were obtained when assessing the 30-year risk of CVD, showing higher relative risk of CVD in the ASA group (Figure 4). Together, changes in blood pressure and inflammation markers show that patients with UC in clinical remission and treated with aminosalicylates have higher risk of CVD when compared to healthy subjects.


Combination of Azathioprine and Aminosalicylate Treatment Prevent Risk of Cardiovascular Disease in Women with Ulcerative Colitis by Reducing Inflammation.

dos Santos LC, Costa AV, Lopes LG, Leonel AJ, Aguilar EC, Noviello Mde L, Ferrari Mde L, Alvarez-Leite JI - Med. Sci. Monit. (2015)

Markers of inflammation in women treated with aminosalicylates (ASA) or azathioprine+aminosalicylates (AZA+ASA) and their controls. (A) Total protein; (B) albumin; (C) globulin; (D) erythrocyte sedimentation rate; (E) fibrinogen; (F) C-reactive protein.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4532194&req=5

f1-medscimonit-21-2305: Markers of inflammation in women treated with aminosalicylates (ASA) or azathioprine+aminosalicylates (AZA+ASA) and their controls. (A) Total protein; (B) albumin; (C) globulin; (D) erythrocyte sedimentation rate; (E) fibrinogen; (F) C-reactive protein.
Mentions: Body weight, BMI, waist circumference, and traditional risk factors for CVD such as glycemia, triglyceridemia, total cholesterol, and its fractions were similar between groups (Tables 1, 2), while body fat was increased and fat-free mass was reduced in ASA group (Table 1). ASA patients also showed increased total proteins due to increase in globulin, with the concomitant decreased on albumin fraction (Figure 1). Diastolic and systolic blood pressures another important risk factor for CVD, and hsCRP and ESR were higher in ASA patients (Table 1, Figure 1). Inflammatory markers such as IL-6 and CCL2 were also increased in the ASA group (Figure 2). Nitrite concentration (indicating nitric oxide status) and IgG anti-oxLDL (an indicator of oxLDL concentration) were increased in women in the ASA group (Figure 3), suggesting an increased risk of atherosclerosis in these patients. The Framingham scores showed that ASA patients have a higher 10-year risk for CVD, considering lipid profile or BMI. Similar results were obtained when assessing the 30-year risk of CVD, showing higher relative risk of CVD in the ASA group (Figure 4). Together, changes in blood pressure and inflammation markers show that patients with UC in clinical remission and treated with aminosalicylates have higher risk of CVD when compared to healthy subjects.

Bottom Line: Framingham scores showed higher risk of CVD in UC groups.UC groups were compared and women treated with azathioprine showed reduction of total protein, globulin, ESR, and lymphocytes, with increased IL-6, TNF, IL-10, and TGF-β.Our data suggest that women with UC in clinical remission have a higher risk for development of atherosclerosis and CVD when compared to the control group, while women treated with azathioprine seem more protected than those treated only with aminosalicylates, due to better regulation of the inflammatory process.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.

ABSTRACT

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with involvement of the immune system. Chronic inflammatory diseases have been associated with increased risk of cardiovascular disease (CVD) but few studies have assessed this risk in patients with UC and the influence of drug treatment. Thus, we evaluated the risk of development of CVD in women with UC in clinical remission, considering the drug treatment.

Material and methods: Twenty-one women with UC participated in this study: 12 used aminosalicylates (ASA group) and 9 used azathioprine added to aminosalicylates (AZA+ASA group). The healthy control group was matched for age. We evaluated blood pressure, body composition, and biochemical and immunological parameters.

Results: Compared to the respective control group, the UC groups showed expansion of body fat and less lean body mass. Blood pressure, pro-inflammatory cytokines, nitric oxide, C reactive protein, erythrocyte sedimentation rate (ESR), and anti-oxidized LDL antibodies were higher in UC groups. Only AZA+ASA group showed increased anti-inflammatory cytokines (IL-10 and TGF-β). Framingham scores showed higher risk of CVD in UC groups. UC groups were compared and women treated with azathioprine showed reduction of total protein, globulin, ESR, and lymphocytes, with increased IL-6, TNF, IL-10, and TGF-β.

Conclusions: Our data suggest that women with UC in clinical remission have a higher risk for development of atherosclerosis and CVD when compared to the control group, while women treated with azathioprine seem more protected than those treated only with aminosalicylates, due to better regulation of the inflammatory process.

No MeSH data available.


Related in: MedlinePlus