Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens; and Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, Greece.
Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens; and Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Greece.
Clin Exp Rheumatol. 2018 May-Jun;36 Suppl 112(3):61-67. Epub 2018 Aug 13.
The higher incidence of atherosclerosis and cardiovascular disease (CVD) in patients with systemic autoimmune diseases cannot be attributed exclusively to traditional risk factors for CVD. Antibodies to oxidised Low Density Lipoprotein (ox-LDL) seem to have a crucial role in atherogenesis.
Sera from 63 consecutive patients with primary Sjögren's syndrome (pSS), 121 with systemic lupus erythematosus (SLE), 79 with rheumatoid arthritis (RA) and 26 apparently healthy individuals were evaluated for the presence of antibodies to ox-LDL by ELISA. The femoral and/or carotid intima media thickness (IMT) and plaque formation as well as traditional CVD risk factors and disease-related features were recorded for all study participants.
Anti-ox-LDL antibody levels were significantly reduced in SS and RA patients, but not in SLE patients, compared to their healthy counterparts. Subsequently, SS patients were divided into two groups according to antibody levels to ox-LDL, using as cut off the median of each group studied. SS patients with high titres of antibodies to ox-LDL displayed higher rates of autoantibodies to Ro/SSA and La/SSB antigens, purpura, low complement levels and increased SS activity index. On the other hand, the high anti-ox-LDL group was characterised by reduced rates of carotid and/or femoral plaque after adjusting for potential confounders (OR [95%CI]: 0.14 [0.03-0.72]). Such associations were not shown in all other groups included in the study.
These findings suggest that antibodies to ox-LDL, possibly resulting from B cell hyperactivity, might exert a protective role in the development of atherosclerosis among primary SS patients.
系统性自身免疫性疾病患者动脉粥样硬化和心血管疾病（CVD）的发病率较高，不能仅归因于 CVD 的传统危险因素。氧化型低密度脂蛋白（ox-LDL）抗体似乎在动脉粥样硬化形成中起关键作用。
通过 ELISA 法检测 63 例原发性干燥综合征（pSS）、121 例系统性红斑狼疮（SLE）、79 例类风湿关节炎（RA）患者及 26 名健康对照者血清中 ox-LDL 抗体。记录所有研究参与者的股动脉和/或颈动脉内膜中层厚度（IMT）和斑块形成情况以及传统 CVD 危险因素和与疾病相关的特征。
与健康对照组相比，SS 和 RA 患者的抗 ox-LDL 抗体水平显著降低，但 SLE 患者的抗 ox-LDL 抗体水平没有降低。随后，根据 ox-LDL 抗体水平将 SS 患者分为两组，以每组研究的中位数为界值。ox-LDL 抗体高滴度的 SS 患者表现出更高的 Ro/SSA 和 La/SSB 自身抗体、紫癜、低补体水平和增加的 SS 活动指数。另一方面，在调整潜在混杂因素后（OR [95%CI]：0.14 [0.03-0.72]），高抗 ox-LDL 组颈动脉和/或股动脉斑块的发生率较低。在研究中包括的所有其他组中，均未显示出这些关联。
这些发现表明，ox-LDL 抗体可能是由于 B 细胞过度活跃而产生的，可能在原发性 SS 患者的动脉粥样硬化发展中发挥保护作用。
