Accelerated Atherosclerosis in Autoimmune Diseases

Atherosclerosis (AS) is a chronic inflammatory disease of arterial vessels, leading to chronic and acute ischemic damage or hemorrhages in virtually any organ. Atherosclerotic plaque formation is the result of inflammatory processes that mediate lymphocyte and macrophage infiltration, lipid intra- and inter-cellular deposition, and eventually smooth muscle cell migration/proliferation and fibrosis. Adaptive and innate immune responses against exogenous as well as self-antigens cooperate in triggering such processes. The atherogenic processes may be magnified and accelerated in patients with autoimmune rheumatic diseases (AIRDs) because of the underlying immune abnormalities, the consequent systemic inflammation and the effects of some concomitant chronic therapies. As a matter of fact, accelerated AS is responsible for increased mortality and morbidity in almost all AIRDs, nowadays. Diagnostic strategies to detect early atherosclerotic lesions and to apply preventive therapeutical approaches have been proposed in order to avoid complications related to accelerated AS in AIRDs.