title: The role of endothelial cell reactive antibodies in peripheral arterial disease.
abstract: OBJECTIVE
  It is hypothesised that endothelial cell reactive antibodies (ECRA) play a role in the progression of PAD through activation of endothelial cells and the release of inflammatory cytokines. We aimed to test this hypothesis by assessing levels of ECRA, E-selectin and IL-6 in patients with PAD of varying severity in a case controlled study. DESIGN, MATERIALS, METHODS: Patients were assessed clinically and with ankle-brachial pressure indices. Patients with critical ischaemia (CI, n=30), stable claudicants (SC, n=30), and age-matched controls (AMC, n=20) were studied. Antibody, E-selectin and IL-6 levels were measured using ELISA.
  
  
  RESULTS
  ECRA levels were significantly raised in the CI group over AMC. IL-6 levels were significantly elevated in both SC and CI over the control group and in CI over SC. There were no significant differences in E-selectin levels between the AMC, SC and CI.
  
  
  CONCLUSIONS
  Our findings support the hypothesis that autoantibodies play a role in promoting PAD by elevating IL-6. The absence of an elevation in E-selectin in this study may be due to its short half-life, and casts doubt on its value as a marker of inflammation in atherosclerosis.
authors.affiliation: The Vascular Surgical Unit, The General Infirmary at Leeds, Leeds, UK. jdarmitage@doctors.net.uk
authors.forename: J D
authors.initials: JD
authors.lastname: Armitage
authors.forename: N J
authors.initials: NJ
authors.lastname: Lindsey
authors.forename: S
authors.initials: S
authors.lastname: Homer-Vanniasinkam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D018450:Disease Progression; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007383:Intermittent Claudication / Q000276:immunology; D007511:Ischemia / Q000276:immunology; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000276:immunology*; D053482:beta 2-Glycoprotein I
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D019040:E-Selectin; D006023:Glycoproteins; D015850:Interleukin-6; D053482:beta 2-Glycoprotein I