title: High prevalence of anti-apolipoprotein/A-1 autoantibodies in maintenance hemodialysis and association with dialysis vintage.
abstract: Autoantibodies to apolipoprotein/A-1 (anti-ApoA-1 IgG) have pro-atherogenic properties in patients at high cardiovascular risk, but its prevalence in patients with end-stage kidney disease is unknown. The aims of this single-center, cross-sectional study were to assess the prevalence of anti-ApoA-1 antibodies in patients on maintenance hemodialysis (MHD), and to examine its correlation with inflammatory biomarkers related to atherosclerotic plaque vulnerability and dialysis vintage. To this purpose, anti-ApoA-1 IgG levels and the concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), metalloproteinase-9 (MMP-9), tumor necrosis factor-α, and C-reactive protein (CRP) were assessed in the sera of 66 MHD patients (mean age: 68 ± 14 years, 36% women, 32% diabetics). Anti-ApoA-1 IgG positivity (defined as a blood value ≥ 97.5(th) percentile of the normal distribution as assessed in healthy blood donors) was 20%. Circulating levels of anti-ApoA-1 IgG correlated positively with dialysis vintage, but not with cardiovascular risk factors or previous cardiovascular events; no significant correlations were found between the anti-ApoA1 IgG levels and circulating levels of IL-6, IL-8, MCP-1, MMP-9, CRP, or low-density lipoprotein-cholesterol. In multivariable linear regression, adjusted for age and sex, only dialysis vintage remained positively and independently associated with anti-ApoA-1 titers (β = 0.05, 95% CI: 0.006; 0.28, P = 0.049). In conclusion, the prevalence of anti-ApoA-1 IgG is raised in the MHD-population, and positively associated with dialysis vintage, a major determinant of cardiovascular outcome. Whether antiApoA-1 antibodies play a role in the pathophysiology of accelerated atherosclerosis in the MHD-population merits further study.
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, University Hospital Lausanne, Lausanne, Switzerland. mennopruijm@hotmail.com
authors.forename: Menno
authors.initials: M
authors.lastname: Pruijm
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidtko
authors.forename: Anthony
authors.initials: A
authors.lastname: Aho
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pagano
authors.forename: Pascale
authors.initials: P
authors.lastname: Roux-Lombard
authors.forename: Daniel
authors.initials: D
authors.lastname: Teta
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vuilleumier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000276:immunology*; D050197:Atherosclerosis / Q000276:immunology / Q000503:physiopathology*; D001323:Autoantibodies / Q000276:immunology*; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007249:Inflammation / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic / Q000276:immunology; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D016632:Apolipoprotein A-I; D001323:Autoantibodies; D015415:Biomarkers; D007074:Immunoglobulin G