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Atherosclerosis in Juvenile Idiopathic Arthritis

DOI: 10.1155/2012/714732

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Abstract:

Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE) or rheumatoid arthritis (RA). There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA). Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT) index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance. 1. Introduction Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process, in the form of ischaemic heart disease, disorders of cerebral circulation, or circulatory disorders of peripheral arteries occur in the adult population; however atherosclerotic changes have their beginning in childhood. The severity of atherosclerosis correlates with the number and intensity of risk factors such as body mass index (BMI), systolic and diastolic arterial blood pressure, total cholesterol, LDL, HDL, triglyceride concentrations, and passive and active cigarette smoking. At present, much significance is attached to the inflammatory aetiology of atherosclerosis, which makes it an inflammatory disease, a vascular wall response to injury. Proinflammatory cytokines, such as IL-1b, IL-6, IL-8, or TNF-α, play a significant role in the development and progression of atherosclerotic lesions. Elevation of the concentrations of acute phase proteins, such as CRP, is also a reflection of the inflammatory process. An elevated homocysteine concentration also increases the risk of developing cardiovascular diseases. Awareness of the fact that initiation of the atherosclerotic process takes place very early in life underscores the need for identifying these changes as early as

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