Literature Review Outline: Fasting, Endothelial Dysfunction, and Autoimmune Diseases

Intermittent fasting (IF) has emerged as a promising non-pharmacological intervention to mitigate cardiovascular risk and systemic inflammation in patients with autoimmune diseases. This review explores the mechanistic links between IF and improved endothelial function, with a focus on oxidative stress reduction, immune modulation, and metabolic reprogramming. Evidence from in vitro, animal, and early-phase human studies indicates that IF enhances nitric oxide availability, reduces pro-inflammatory cytokines, and promotes vascular protection through ketone body production and autophagy. While benefits such as improved flow-mediated dilation and decreased markers of vascular inflammation have been observed, significant challenges remain regarding the variability of fasting protocols, individual response, and the scarcity of long-term randomized controlled trials. Tailored fasting strategies, supported by omics approaches and circadian alignment, may provide a valuable adjunct in managing cardiovascular complications in autoimmune populations. Further research is essential to clarify the safety, efficacy, and personalization of IF regimens in this context.