Autoantibodies against oxidized low-density lipoprotein in cerebral small vessel disease.
OBJECTIVE
Oxidized low-density lipoprotein (oxLDL) induces endothelial dysfunction and antibody formation. Because endothelial dysfunction is involved in cerebral small vessel disease (CSVD) (dilated Virchow Robin spaces, lacunar infarcts, and white matter lesions), oxLDL antibodies could play a role in CSVD pathogenesis. Therefore, we studied oxLDL antibodies in patients with high prevalence of CSVD: lacunar stroke patients and essential hypertensive patients.


METHODS
A total of 158 lacunar stroke patients, 158 hypertensive patients, and 43 healthy controls were included. We determined levels of IgG and IgM against hypochlorite (HOCl) and malondialdehyde (MDA) oxLDL using ELISA (values in optical density).


RESULTS
Patients with CSVD had higher levels of IgG-HOCl-oxLDL (0.77 versus 0.70; P<0.01), as well as lower levels of IgM-MDA-oxLDL (0.55 versus 0.65; P<0.05) than patients without such lesions. Higher IgG-HOCl-oxLDL levels were only independently associated with higher numbers of Virchow Robin spaces at the level of the basal ganglia (β=0.218; P<0.001).


CONCLUSIONS
An autoinflammatory process with lower levels of IgM antibodies and higher levels of IgG antibodies against oxLDL may be involved in CSVD.
Rouhl
Rob P W
RP
Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands. R.Rouhl@mumc.nl
van Oostenbrugge
Robert J
RJ
Theunissen
Ruud O M F I H
RO
Knottnerus
Iris L H
IL
Staals
Julie
J
Henskens
Léon H G
LH
Kroon
Abraham A
AA
de Leeuw
Peter W
PW
Lodder
Jan
J
Tervaert
Jan-Willem Cohen
JW
Damoiseaux
Jan G M C
JG
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000276:immunology* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008077:Lipoproteins, LDL / Q000276:immunology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000209:etiology / Q000276:immunology / Q000503:physiopathology
D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein