The Underlying Cause of Microvascular Disfunction in Rheumatoid
-
Upload
denata-prabhasiwi -
Category
Documents
-
view
223 -
download
0
Transcript of The Underlying Cause of Microvascular Disfunction in Rheumatoid
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
1/29
The Underlying Cause ofMicrovascular Disfunction
in Rheumatoid Arthritis
Denata prabhasiwi030 09 062
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
2/29
Why I choose this topic ????
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
3/29
CRP
RHEUMATOID
ARTHRITIS
NO
DISCUSSIOn
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
4/29
What is
rheumatoidarthritis
?????
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
5/29
\
INFLAMMATION
AUTOIMMUNE
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
6/29
EPIDEMIOLOGY
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
7/29
Multifactiorial factors1. Genetic factors HLA DR4 with Rheumatoid Arthritis type I
diabetes HLA DR2 with lupus2.Environment Infections Overexposure to pesticides and toxins Stress
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
8/29
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
9/29
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
10/29
sign and symptoms
Joint pain, typicallysymmetric
Morning joint stiffness (1hour)
Joint swelling
Articuler/classic
symptoms
Rheumatoid nodule
Cardiopulmonary disease
Eye disease Sjogrens syndrome
Neurologic syndrome
ekstrarticuler
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
11/29
Clinical manifestations
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
12/29
Rheumatoid nodule
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
13/29
DIAGNOSTIC CRITERIA OF RHEUMATOID
ARTHRITIS
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
14/29
WHAT ISCRP ??
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
15/29
CRP is a protein
that produced in
the liver as respon
from inflammatory
cytokines, but
based on recentstudies show that
CRP can also be
produced by
extrahepatic tissues
such as adipose
cells and vascularsmooth muscle
cells
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
16/29
Functions
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
17/29
WHAT IS
NO ??
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
18/29
efinition
Nitric Oxide is derived endhotelialreleasing factor (EDRF) that synthesized
and released by endothelial cells and serves
as a potent vasodilator.
the release of NO stimulated by bradykinin
synthesised from the amino acid L-arginine
by the endothelial isoform of nitric oxide
synthase
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
19/29
NOeNOS
nNOS
iNOS
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
20/29
an enzyme that has the properties dependent onCa, the enzyme is found in many types of cellsand are responsible for most of the NOproduction in healthy blood vessels and releasedcontinuously by arterial and venous endothelialcells and platelets.
Enzyme Endhotelial syntaseNO eNOS)
is a special form of eNOS function of nerves.Neuronal NO synthasenNOS)
can be induced by immunological stimuli bycytokines and endotoxin.
Inducible NO synthaseiNOS),
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
21/29
what isunderlying causeof microvascular
dysfunction inRA
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
22/29
C reactive
protein(CRP)
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
23/29
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
24/29
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
25/29
Rheumatoidarthritis
Release cytokinesinflammation IL6,TNFa, IL1)
IncreasingCRP
DecreasedNO
Triggersoxidation of
LDL
Inducecomplementactivation
Foam cell
Atheroscleroticplaque
Disturbendhotelialvasoreactivity
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
26/29
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
27/29
Prevention
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
28/29
Conclusion
Systemic inflammation CRP) is associated withmicrovascular dysfunction in patients with RA. Rheumatoidarthritis and atherosclerosis are strictly linked, this link is sostrong th t therosclerosis m y be considered n extr -articular m nifest tion of thedisease, leading to an increasedrisk of CVD.
To prevent the occurrence of atherosclerosis in patients withrheumatoid arthritis, the pateints can do traditional form likephysical exercise and for medikamentosa treatment can useanti inflamatory like methotrexate low dosage and TNF alfainhibitor
-
8/13/2019 The Underlying Cause of Microvascular Disfunction in Rheumatoid
29/29