Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Atherosclerosis. 2014 Jan;232(1):242-8. doi: 10.1016/j.atherosclerosis.2013.11.041. Epub 2013 Nov 23.
Experimental studies have suggested that autoimmunity is involved in atherosclerosis and provided evidence that both protective and pro-atherogenic immune responses exist. This concept has received support from small clinical studies implicating autoantibodies directed against apolipoprotein B-100 (apoB-100) in human atherosclerosis. We examined circulating autoantibodies directed against native and malondialdehyde (MDA)-modified epitope p210 of apoB-100 (IgG-p210nat and IgM-p210MDA) in relation to early atherosclerosis in a large, European longitudinal cohort study of healthy high-risk individuals.
IgG-p210nat and IgM-p210MDA were quantified in baseline plasma samples of 3430 participants in the IMPROVE study and related to composite and segment-specific measures of severity and rate of progression of carotid intima-media thickness (cIMT) determined at baseline and after 30 months. IgM-p210MDA autoantibody levels were independently related to several cIMT measures both in the common carotid artery and in the carotid bulb, including measures of cIMT progression, higher levels being associated with lower cIMT or slower cIMT progression. Consistent inverse relationships were also found between plasma levels of IgG-p210nat and baseline composite measures of cIMT. These associations disappeared when adjusting for established and emerging risk factors, and there were no associations with rate of cIMT progression besides in certain secondary stratified analyses.
The present study provides further evidence of involvement of autoantibodies against native and MDA-modified apoB-100 peptide 210 in cardiovascular disease in humans and demonstrates that these associations are present already at a subclinical stage of the disease.
实验研究表明,自身免疫与动脉粥样硬化有关,并提供了证据表明存在保护性和促动脉粥样硬化免疫反应。这一概念得到了一些小型临床研究的支持,这些研究表明,针对载脂蛋白 B-100(apoB-100)的自身抗体与人类动脉粥样硬化有关。我们研究了针对天然和丙二醛(MDA)修饰的 apoB-100 表位 p210 的循环自身抗体(IgG-p210nat 和 IgM-p210MDA)与健康高危人群的大型欧洲纵向队列研究中的早期动脉粥样硬化的关系。
在 IMPROVE 研究的 3430 名参与者的基线血浆样本中定量测定 IgG-p210nat 和 IgM-p210MDA,并将其与基线和 30 个月后确定的颈动脉内膜-中层厚度(cIMT)的复合和节段特异性严重程度和进展率相关。IgM-p210MDA 自身抗体水平与颈总动脉和颈动脉窦中的几个 cIMT 指标独立相关,包括 cIMT 进展指标,较高的水平与较低的 cIMT 或较慢的 cIMT 进展相关。在基线 cIMT 的复合指标中,也发现 IgG-p210nat 血浆水平与多个 cIMT 指标呈负相关。当调整既定和新兴的危险因素时,这些关联就消失了,除了在某些次要分层分析中,与 cIMT 进展率没有关联。
本研究进一步证明了针对天然和 MDA 修饰的 apoB-100 肽 210 的自身抗体在人类心血管疾病中的作用,并表明这些关联在疾病的亚临床阶段就已经存在。