抗载脂蛋白A-I、高密度脂蛋白和C反应蛋白的抗体与系统性红斑狼疮患者的疾病活动相关。
Antibodies to apolipoprotein A-I, high-density lipoprotein, and C-reactive protein are associated with disease activity in patients with systemic lupus erythematosus.
作者信息
O'Neill Sean G, Giles Ian, Lambrianides Anastasia, Manson Jessica, D'Cruz David, Schrieber Leslie, March Lyn M, Latchman David S, Isenberg David A, Rahman Anisur
机构信息
University College London, London, UK.
出版信息
Arthritis Rheum. 2010 Mar;62(3):845-54. doi: 10.1002/art.27286.
OBJECTIVE
Inflammatory disease activity in patients with systemic lupus erythematosus (SLE) may affect the development of atherosclerosis, contributing to their increased risk of cardiovascular disease (CVD). This process may be mediated by anti-apolipoprotein A-I (anti-Apo A-I), anti-high-density lipoprotein (anti-HDL), and anti-C-reactive protein (anti-CRP) autoantibodies. We undertook this study to examine whether levels of these antibodies rise in association with increased SLE disease activity.
METHODS
IgG anti-Apo A-I, anti-HDL, and anti-CRP levels were measured in serum from the following groups: 39 patients with persistently high disease activity (British Isles Lupus Assessment Group [BILAG] A or B score) over the previous 2 years, 42 patients with persistently low disease activity (no BILAG A or B scores) over the previous 2 years, 34 healthy controls, 25 individual patients from whom paired samples (at time of disease flare and quiescence) were obtained and compared, 16 patients with newly diagnosed lupus nephritis from whom multiple samples were obtained and who were followed up prospectively for up to 2 years, and 24 patients with SLE who had experienced CVD events.
RESULTS
Serum levels of IgG anti-Apo A-I, anti-HDL, and anti-CRP were higher in patients with SLE than in controls. Anti-Apo A-I and anti-HDL levels, but not anti-CRP levels, were higher in patients with persistently high disease activity than in those with low disease activity. Mean levels of the 3 autoantibodies in patients who had experienced CVD events lay between the mean levels in the high and low disease activity groups. Only levels of anti-Apo A-I were significantly higher in samples obtained from individual patients during disease flares than in samples obtained during disease quiescence. In the lupus nephritis patients, anti-Apo A-I and anti-HDL levels correlated with serum levels of high avidity IgG anti-double-stranded DNA.
CONCLUSION
Persistent disease activity is associated with a significant increase in IgG anti-Apo A-I and anti-HDL in patients with SLE.
目的
系统性红斑狼疮（SLE）患者的炎症性疾病活动可能影响动脉粥样硬化的发展，导致其心血管疾病（CVD）风险增加。这一过程可能由抗载脂蛋白A-I（抗Apo A-I）、抗高密度脂蛋白（抗HDL）和抗C反应蛋白（抗CRP）自身抗体介导。我们开展这项研究以检验这些抗体水平是否会随着SLE疾病活动增加而升高。
方法
检测以下几组人群血清中IgG抗Apo A-I、抗HDL和抗CRP水平：39例在过去2年中疾病活动持续较高（英国狼疮评估组 [BILAG] A或B评分）的患者、42例在过去2年中疾病活动持续较低（无BILAG A或B评分）的患者、34名健康对照者、25例获取了配对样本（疾病发作期和静止期）并进行比较的个体患者、16例新诊断为狼疮性肾炎且获取了多个样本并进行了长达2年的前瞻性随访的患者，以及24例发生了CVD事件的SLE患者。
结果
SLE患者血清中IgG抗Apo A-I、抗HDL和抗CRP水平高于对照组。疾病活动持续较高的患者抗Apo A-I和抗HDL水平高于疾病活动较低的患者，但抗CRP水平并非如此。发生CVD事件的患者中这3种自身抗体的平均水平介于疾病活动高和低的两组患者的平均水平之间。仅疾病发作期个体患者样本中的抗Apo A-I水平显著高于疾病静止期样本中的水平。在狼疮性肾炎患者中，抗Apo A-I和抗HDL水平与高亲和力IgG抗双链DNA血清水平相关。
结论
SLE患者疾病持续活动与IgG抗Apo A-I和抗HDL显著升高有关。
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