Interleukin-17 effect on the pathogenesis and risks of cardiovascular diseases in spondylarthritis

E.A. Vasilenko¹, V.I. Mazurov¹, I.Z. Gaidukova¹, A.M. Dadalova¹, M.A. Korolev², E.K. Gaidukova³

¹North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg

²Research Institute of Clinical and Experimental Lymphology (NIIKEL), the branch of the Federal Research Center "Institute of Cytology and Genetics of the Siberian Department of the Russian Academy of Sciences", Novosibirsk

³Clinical Rheumatology Hospital No. 25, Saint-Petersburg

Background: the critical value of the IL-17 for the pathogenesis of spondyloarthritis (SpA) led to the emergence of new genetic engineering biological drugs that inhibit IL-17. At the same time, it is possible that IL-17 may have a certain value in modifying the risk of cardiovascular diseases in SpA.

Aim: to study the association of cardiovascular risks in patients with axial spondylitis (axial SpA) and genetic polymorphism responsible for IL-17 synthesis, assessed by various scales: Systematic COronary Risk Evaluation (SCORE), QRESEARCH Cardiovascular Risk Algorithm (QRISK3), Reynolds Risk Score (RRS).

Patients and Methods: 48 patients aged 25 to 69 years (74.6% men) were examined with confirmed axial SpA who met the ASAS (2009) criteria, including those with extra-skeletal lesions (psoriasis). Cardiovascular risks were assessed using the QRISK3, SCORE, and RRS scales. Genetic typing was performed according to IL17A-197 AG, IL17-F7 His/Arg, IL17F-11139 CG, and the concentration of highly sensitive C-reactive protein (hs-CRP) was determined.

Results: factor analysis revealed correlations between the risk of significant cardiovascular events, CRP level, and the carrier of various IL-17A and IL-17F alleles. The highest capacity and direct association with an increased risk of fatal cardiovascular outcomes was achieved in individuals homozygous for the AA IL-17A allele and heterozygous for the CG IL-17F allele. An inverse relationship was found in the presence of homozygous for the GG IL-17A and CC IL-17F alleles. In the course of the study, data were obtained on the presence of a direct association between an increase in cardiovascular risk and the CRP level.

Conclusion: increased cardiovascular risk in axial SpA may be associated with genetically determined altered secretion of IL-17 subtypes, which in the future may determine the validity of IL-17 blockade use in patients with axial SpA with a high cardiovascular risk.

Keywords: cardiovascular risk, axial spondyloarthritis, psoriatic arthritis, prevention of cardiovascular diseases, SCORE, QRISK, Reynolds Risk Score, interleukin-17.

For citation: Vasilenko E.A., Mazurov V.I., Gaidukova I.Z. et al. Interleukin-17 effect on the pathogenesis and risks of cardiovascular diseases in spondylarthritis. RMJ. 2020;11:39–42.