Journalartikel

Jahr der Veröffentlichung: 2018

Seiten: 207-214

Zeitschrift: Aktuelle Rheumatologie

Bandnummer: 43

Heftnummer: 3

ISSN: 0341-051X

eISSN: 1438-9940

Open Access Status: Bronze

DOI Link: https://doi.org/10.1055/s-0043-121037

Verlag: Georg Thieme Verlag

Abstract: 
Obesity, metabolic syndrome (MetS) and other metabolic diseases such as diabetes play an important role in the onset and progression of rheumatic diseases. Hormones of the adipose tissue, e.g. adiponectin or leptin, as well as other metabolic factors including free fatty acids or cholesterol may influence the disease progression of patients with rheumatic diseases. For patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) as well as patients with the non-autoimmune disease osteoarthritis, obesity represents a risk factor with pathophysiological importance. The response to drugs is also affected by obesity. For example, in PsA patients on anti-TNF treatment, there is a negative correlation between the amount of abdominal fat and the likelihood of achieving minimal disease activity. Within the pathophysiology of rheumatic diseases, adipose tissue is one of the most important sources of IL-6 as it produces up to one third of systemic IL-6, and a reduction of body weight leads to a reduction of IL-6 serum levels. The interaction between the immune system and biologically active metabolic factors is bidirectional, which leads to a highly complex network of interactions. C-reactive protein (CRP), for example, an inflammatory marker protein, binds to leptin, thus inhibiting its signal transduction and effects on target cells. At the same time, leptin promotes the secretion of CRP in the liver. This mechanism is possibly one of many pathways by which inflammation and metabolism influence each other. In addition, CRP serum levels inversely correlate with HDL levels, and serum lipid profiles change significantly in case of acute or chronic inflammation. New therapeutic approaches with small molecules such as tofacitinib not only lower inflammation, but also affect parts of the metabolism. RA patients, for example, have significantly lower serum levels of total cholesterol, HDL-C, LDL-C and Apo-A1 compared with healthy individuals. However, these levels increase in response to tofacitinib treatment and approximate those of healthy individuals.

Harvard-Zitierstil: Huelser, M., Frommer, K. and Mueller-Ladner, U. (2018) The Role of Metabolism and Metabolically Relevant Factors in the Pathophysiology of Rheumatic Diseases, Aktuelle Rheumatologie, 43(3), pp. 207-214. https://doi.org/10.1055/s-0043-121037

APA-Zitierstil: Huelser, M., Frommer, K., & Mueller-Ladner, U. (2018). The Role of Metabolism and Metabolically Relevant Factors in the Pathophysiology of Rheumatic Diseases. Aktuelle Rheumatologie. 43(3), 207-214. https://doi.org/10.1055/s-0043-121037