ABSTRACT
Infl ammatory, progressive, systemic and chronic rheumatic diseases lead to cardiovascular events beyond traditional cardiac risk factors. Infl ammatory risk factors, including C-reactive protein, homocysteine, folate defi ciency, lipoprotein (a), anti-phospholipid antibodies, antibodies to oxidized low-density lipoprotein and heat shock proteins, all contribute to the atherosclerotic process that underlies infl ammatory rheumatic diseases. An understanding of how systemic infl ammation accelerates atherosclerosis should guide therapeutic targets to minimize endothelial dysfunction, and may lead to insights into the infl ammatory mechanisms related to homocysteine (Hcy). Hyperhomocysteinemia (HHcy) has attracted great interest as a recognized independent risk factor for atherothrombosis. It is a vasculotoxic amino acid, altered levels leading to endothelial dysfunction. It can also affect both endothelial and immune system cells, that leads to an increase in the interaction of neutrophils, monocytes and
1Gazi University, Faculty of Medicine, 06500, Besevler, Ankara, Turkey. E-mail: asepicidincel@gmail.com 2Gazi University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Division of Rheumatology, 06500, Besevler, Ankara, Turkey. E-mail: feride_g@yahoo.com *Corresponding author
T-cells with endothelial cells and subsequent increase in infl ammatory cytokine production. As elevated Hcy levels are associated with poorer functional status in rheumatic diseases, Hcy levels can be used as a biomarker for susceptibility of future cardiovascular complications.
