Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, USA.
Department of Medicine, Division of Cardiology, New York University School of Medicine, New York, NY, USA.
Clin Immunol. 2014 Jul;153(1):1-7. doi: 10.1016/j.clim.2014.03.017. Epub 2014 Apr 3.
Noninvasive carotid measurements have proven value in the estimation of future cardiovascular (CV) outcomes in systemic lupus erythematosus (SLE). Natural IgM-antibodies to phosphorylcholine (PC) epitopes can enhance apoptotic-cell clearance and induce anti-inflammatory pathways. Herein, we show that subclinical CV disease, as detected by carotid ultrasound, in a cross-sectional SLE cohort was associated with lower levels of IgM anti-PC, as well as lower levels of the ratio of IgM anti-PC/total IgM, compared to patients without plaque (p=0.004 and p=0.02, respectively). The IgM anti-PC/total IgM association remained significant after adjusting for age, cholesterol and hypertension. Adiponectin and sE-selectin were significantly elevated in patients with plaque, and statistical models showed that combining adiponectin, sE-selectin and IgM anti-PC/total IgM was better for predicting plaque than either test alone. These results support the hypothesis that IgM-natural autoantibodies may inhibit atherogenesis, and confirm the utility of IgM anti-PC levels as a biomarker for subclinical CV disease.
无创性颈动脉测量在评估系统性红斑狼疮（SLE）患者未来心血管（CV）结局方面具有重要价值。天然 IgM 抗体针对磷酸胆碱（PC）表位可以增强凋亡细胞的清除，并诱导抗炎途径。在此，我们显示，通过颈动脉超声检测到的横断面 SLE 队列中的亚临床 CV 疾病与 IgM 抗 PC 水平降低以及 IgM 抗 PC/总 IgM 比值降低相关，与无斑块患者相比（p=0.004 和 p=0.02，分别）。调整年龄、胆固醇和高血压后，IgM 抗 PC/总 IgM 相关性仍然显著。斑块患者的脂联素和 sE-选择素显著升高，统计模型显示，联合脂联素、sE-选择素和 IgM 抗 PC/总 IgM 预测斑块的效果优于单独任何一种检测。这些结果支持 IgM 天然自身抗体可能抑制动脉粥样硬化形成的假说，并证实 IgM 抗 PC 水平作为亚临床 CV 疾病的生物标志物的效用。
