Orlacchio Antonio, Bruce Ian N, Rahman Proton, Kawarai Toshitaka, Bernardi Giorgio, St George-Hyslop Peter H, Gladman Dafna D, Urowitz Murray B
Laboratorio di Neurogenetica, CERC-IRCCS Santa Lucia, Rome, Italy and Dipartimento di Neuroscienze, Università di Roma "Tor Vergata", Rome, Italy.
Med Sci Monit. 2008 May;14(5):CR233-237.
Systemic lupus erythematosus (SLE) is a highly prevalent autoimmune disease and coronary artery disease (CAD) is a complication of SLE which is often crucial for the patient's prognosis. It is hypothesized that apolipoprotein E (Apo E), which is involved in cholesterol metabolism, might play a role in this process.
MATERIAL/METHODS: Patients with SLE registered at the University of Toronto Lupus Clinic who had DNA available for study had their Apo E genotype determined. Each case was assessed for the presence of CAD, and Apo E allele frequencies in patients with SLE were compared with data from the general population. Age at onset and disease duration of CAD were also recorded and compared between groups.
DNA was stored from 152 patients, of whom 38 (25%) had CAD. There was no difference in the frequencies of the Apo E isoforms between SLE patients and the general population. Patients with the E2 allele developed CAD after a mean +/-SD of 6.0+/-1.9 yrs compared with 14.5+/-5.4 yrs in those with E3/3 (p<0.01).
The distribution of Apo E genotypes in SLE is not significantly different from that of the North American population. In SLE, Apo E2 was associated with a more rapid development of CAD. Therefore, Apo E2 might interact with other disease-related factors to accelerate the onset of CAD in some patients with SLE and as such might be an additional marker of risk in this population.
系统性红斑狼疮（SLE）是一种高度流行的自身免疫性疾病，冠状动脉疾病（CAD）是SLE的一种并发症，通常对患者的预后至关重要。据推测，参与胆固醇代谢的载脂蛋白E（Apo E）可能在此过程中发挥作用。
材料/方法：在多伦多大学狼疮诊所登记的、有可用于研究的DNA的SLE患者，测定其Apo E基因型。评估每个病例是否存在CAD，并将SLE患者的Apo E等位基因频率与普通人群的数据进行比较。还记录并比较了CAD患者的发病年龄和病程。
从152例患者中提取了DNA，其中38例（25%）患有CAD。SLE患者和普通人群之间Apo E亚型的频率没有差异。携带E2等位基因的患者发生CAD的平均时间为6.0±1.9年，而携带E3/3等位基因的患者为14.5±5.4年（p<0.01）。
SLE中Apo E基因型的分布与北美人群没有显著差异。在SLE中，Apo E2与CAD的更快发展相关。因此，Apo E2可能与其他疾病相关因素相互作用，加速一些SLE患者CAD的发病，因此可能是该人群中一个额外的风险标志物。
