Low Levels of IgM Antibodies against an Advanced Glycation Endproduct-Modified Apolipoprotein B100 Peptide Predict Cardiovascular Events in Nondiabetic Subjects.
Increased glucose levels are associated with the generation of advanced glycation endproduct (AGE) modifications. Interaction between AGE-modified plaque components and immune cells is believed to have an important role in the development of vascular complications in diabetes. Methylglyoxal (MGO) is one type of reactive aldehyde that gives rise to AGE modification. The present study analyzed whether autoantibodies against MGO-modified epitopes of the low-density lipoprotein apolipoprotein B (apoB) 100 predict cardiovascular events. A library consisting of 302 peptides comprising the complete apoB100 molecule was screened to identify peptides targeted by MGO-specific autoantibodies. Peptide (p) 220 (apoB amino acids 3286-3305) was identified as a major target. Baseline IgM and IgG against MGO-peptide 220 (p220) were measured in 700 individuals from the Malmö Diet and Cancer Cohort. A total of 139 cardiovascular events were registered during the 15-y follow-up period. Controlling for major cardiovascular risk factors demonstrated that subjects in the lowest tertile of MGO-p220 IgM had an increased risk for cardiovascular events (hazard ratio [95% confidence interval]: 2.07 [1.22-3.50]; p(trend) = 0.004). Interestingly, the association between MGO-p220 IgM and cardiovascular events remained and even tended to become stronger when subjects with prevalent diabetes were excluded from the analysis (2.51 [1.37-4.61]; p(trend) = 0.002). MGO-p220 IgM was inversely associated with blood glucose, but not with oxidized low-density lipoprotein. Finally, we demonstrate that anti-MGO-p220 IgM is produced by B1 cells. These data show that subjects with low levels of IgM recognizing MGO-modified p220 in apoB have an increased risk to develop cardiovascular events and that this association is present in nondiabetic subjects.
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Daniel
D
Engelbertsen
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Jenifer
J
Vallejo
Center for Oncology and Cell Biology, The Feinstein Institute for Medical Research, Manhasset, NY 11030.
Tâm Dan
TD
Quách
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Gunilla Nordin
GN
Fredrikson
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Ragnar
R
Alm
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Bo
B
Hedblad
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Harry
H
Björkbacka
Center for Oncology and Cell Biology, The Feinstein Institute for Medical Research, Manhasset, NY 11030.
Thomas L
TL
Rothstein
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and.
Jan
J
Nilsson
Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden; and Eva.Bengtsson@med.lu.se.
Eva
E
Bengtsson
D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood / Q000276:immunology; D053299:Apolipoprotein B-100 / Q000276:immunology*; D050197:Atherosclerosis / Q000503:physiopathology; D001323:Autoantibodies / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000276:immunology*; D016207:Cytokines / Q000097:blood; D003920:Diabetes Mellitus / Q000276:immunology; D005260:Female; D017127:Glycation End Products, Advanced / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood* / Q000276:immunology; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D011765:Pyruvaldehyde / Q000276:immunology* / Q000494:pharmacology; D012307:Risk Factors
D000906:Antibodies; D053299:Apolipoprotein B-100; D001323:Autoantibodies; D001786:Blood Glucose; D016207:Cytokines; D017127:Glycation End Products, Advanced; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D011765:Pyruvaldehyde