title: Decreased levels of autoantibodies against apolipoprotein B-100 antigens are associated with cardiovascular disease in systemic lupus erythematosus.
abstract: Increased production of autoantibodies is a characteristic feature of systemic lupus erythematosus (SLE) and there is evidence that several of these autoantibodies may contribute to increased cardiovascular disease (CVD) in SLE. Autoantibodies against the apolipoprotein (apo) B-100 peptides p45 and p210 have been associated with a lower CVD risk in non-SLE cohorts. The aim of the present study was to investigate how SLE affects the occurrence of these potentially protective autoantibodies. The study cohort consisted of 434 SLE patients and 322 age- and sex-matched population controls. Antibodies against native and malondialdehyde (MDA)-modified p45 and p210 were measured by enzyme-linked immunosorbent assay (ELISA). SLE patients had significantly lower levels of p210 immunoglobulin (Ig)G and p45 IgM (both the native and malondialdehyde (MDA)-modified forms). SLE patients with manifest CVD (myocardial infarction, ischaemic cerebrovascular disease or peripheral vascular disease) had lower levels p210 IgG and p45 IgM than SLE patients without CVD. Decreased levels of these autoantibodies were also observed in SLE patients with permanent organ damage, as assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index (SDI). The present findings show that patients with SLE, a condition generally characterized by abundance of autoantibodies of multiple specificities, have reduced levels of antibodies against the apo B-100 antigens p45 and p210 and that the levels of these antibodies are reduced further in SLE patients with CVD. These observations suggest the possibility that an impaired antibody-mediated removal of damaged LDL particles may contribute to the development of vascular complications and organ damage in SLE.
authors.affiliation: Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Svenungsson
authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Engelbertsen
authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Wigren
authors.affiliation: Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Johanna T
authors.initials: JT
authors.lastname: Gustafsson
authors.affiliation: Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Iva
authors.initials: I
authors.lastname: Gunnarsson
authors.affiliation: Unit of Clinical Immunology, Department of Clinical Immunology and Transfusion Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Elvin
authors.affiliation: Department of Clinical Physiology, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Jensen-Urstad
authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Sweden.
authors.forename: Gunilla Nordin
authors.initials: GN
authors.lastname: Fredrikson
authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D053299:Apolipoprotein B-100 / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000276:immunology*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000276:immunology*; D008297:Male; D008315:Malondialdehyde / Q000276:immunology; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D053299:Apolipoprotein B-100; D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008315:Malondialdehyde
keywords: antibodies; human; systemic lupus erythematosus