Research

Child-parent screening for familial hypercholesterolaemia: screening strategy based on a meta-analysis

BMJ 2007; 335 doi: http://dx.doi.org/10.1136/bmj.39300.616076.55 (Published 20 September 2007) Cite this as: BMJ 2007;335:599

Re: Child-parent screening for familial hypercholesterolaemia: screening strategy based on a meta-analysis

There is a link between diffuse endothelial dysfunction , a predictor of atherosclerosis closely to vasculitis .There is a mechanism of endothelial damage and low density lipoprotein oxidation, promoted by the inflammatory microenvironment [1].Anti-endothelial cell antibodies found in vasculitis , systemic lupus erythematosus and the antiphospholipid syndrome have also been shown both to activate and precipitate endothelial dysfunction [2][3].Antinuclear antibody positivity is associated with decreased carotid elasticity in women [4].Several invasive and non-invasive techniques may be useful in endothelial dysfunction and arterial stiffness .Monitoring IMT( intima – medial thickness) is an excellent evaluation of risk stratification.
Reference:
1. Ross R. Atherosclerosis –an inflammatory disease.N Eng J Med 1999; 340:115-26.
2.Del Papa N,Guidali L,Sirani M,Schoenfield Y,Mantovani A,Tincani A et al.Anti-endothelial cell IgG antibodies from patient with Wegener’s Granulomatosis bind to human endothelial cells in vitro and inducer adhesion molecule expression and cytokine secreation.Arthritis Rheum 1996;39:758-66.
3.Savage CO,Pottinger PE,Gaskin G, Lockwood CM,Pusey CD,Pearson JD.Vascular damage in Wegener’s Granulomatosis and microscopic polyarteritis: Presence of antiendithelial antibodies and their relation to anti-neutrophil cytoplasm antibodies.Clin Exp Immunol 1991;85:14 -19 .
4.Pertovaara M,Kakonen M,Juonala M et al . Autoimmunity and atherosclerosis : the presence of antinuclear antibodies is associated with decreased carotid elasticity in young women .Tha cardiovascular risk in Young Finns study.Rheumatology 2009 ;48:1553 -6.

Competing interests: No competing interests

24 December 2012
Kaushik Sanyal
Department of Rheumatology
East Surrey Hospital
Redhill, Surrey , UK
Click to like:
16