From the Institute of Environmental Medicine, Unit of Immunology and Chronic Disease, Karolinska Institutet, Stockholm; Department of Laboratory Medicine, Division of Clinical Physiology, and Department of Rheumatology, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden.
J Rheumatol. 2013 Nov;40(11):1856-64. doi: 10.3899/jrheum.121173. Epub 2013 Sep 15.
We have reported that the prevalence of atherosclerotic plaques and their echolucency was increased in systemic lupus erythematosus (SLE). We here study antibodies against oxidized cardiolipin (anti-OxCL) and phosphatidylserine (anti-OxPS) in SLE and in relation to atherosclerosis measures.
Patients with SLE (n = 114) were compared with age- and sex-matched population-based controls (n = 122). Common carotid intima-media thickness and plaque occurrence were determined by B-mode ultrasonography. Plaques were graded according to echogenicity as 1-4, with 1 being echolucent. Antibodies were determined by ELISA.
In the SLE group, the prevalence of low IgM anti-OxPS and low total IgM levels (below 33rd percentile) was increased compared to controls (p = 0.045 and p = 0.0079, respectively). Among SLE patients with atherosclerotic plaques, the prevalence of low IgM anti-OxPS (p = 0.0019) and anti-OxCL (p = 0.031) was increased. Only IgM anti-OxPS remained significant (p = 0.019) after adjusting for other significant factors. Echolucent plaques (total, or left side) were more prevalent among SLE patients with low IgM anti-OxCL and anti-OxPS when controlled for other significant factors (p < 0.05). Low total IgM was independently associated with echolucent plaque on left side (p < 0.05), but not other atherosclerosis measures. IgM anticardiolipin antibodies (aCL) and antiphosphatidylserine antibodies (anti-PS) were higher among SLE patients with cardiopulmonary disease, including arterial, valvular, and venous disease (p < 0.05). There were no associations between antibodies and other disease manifestations or activity. Both anti-OxCL and anti-OxPS, in contrast to aCL, and anti-PS, were cofactor-β2-glycoprotein I (β2-GPI)-independent.
The prevalence of low levels of IgM anti-OxCL and anti-OxPS (both cofactor-β2-GPI-independent) is associated with the presence of plaques and echolucent plaques in SLE.
我们曾报道过系统性红斑狼疮（SLE）患者的动脉粥样硬化斑块及其回声强度增加。本研究旨在探讨 SLE 患者抗氧化心磷脂（anti-OxCL）和抗磷脂酰丝氨酸（anti-OxPS）抗体与动脉粥样硬化指标的关系。
我们比较了 114 例 SLE 患者与年龄和性别匹配的基于人群的对照组（n = 122）。采用 B 型超声检测颈总动脉内膜中层厚度和斑块形成。根据回声强度将斑块分为 1-4 级，1 级为低回声。采用 ELISA 法检测抗体。
与对照组相比，SLE 患者的低 IgM 抗 OxPS 和低总 IgM 水平（低于第 33 百分位）的患病率增加（p = 0.045 和 p = 0.0079）。在有动脉粥样硬化斑块的 SLE 患者中，低 IgM 抗 OxPS（p = 0.0019）和抗 OxCL（p = 0.031）的患病率增加。在校正其他显著因素后，只有 IgM 抗 OxPS 仍具有显著意义（p = 0.019）。在控制其他显著因素后，低 IgM 抗 OxCL 和抗 OxPS 的 SLE 患者总回声和（或）左侧回声不匀的斑块更常见（p < 0.05）。低总 IgM 与左侧回声不匀的斑块独立相关（p < 0.05），但与其他动脉粥样硬化指标无关。SLE 合并心肺疾病（包括动脉、瓣膜和静脉疾病）患者的 IgM 抗心磷脂抗体（aCL）和抗磷脂酰丝氨酸抗体（anti-PS）水平升高（p < 0.05）。抗体与其他疾病表现或活动无相关性。与 aCL 和 anti-PS 不同，抗 OxCL 和抗 OxPS 均与补体因子β2-糖蛋白 I（β2-GPI）无关。
低水平的 IgM 抗 OxCL 和抗 OxPS（两者均与补体因子β2-GPI 无关）与 SLE 患者斑块和回声不匀斑块的存在相关。
