Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Low Levels of Atheroprotective Natural IgM Antibodies Against Phosphorylcholine and Increased Prevalence of Vulnerable Atherosclerotic Plaques in Patients with SLE.
Anania2, Cristina, Gustafsson2, Thomas, Hua2, Xiang, Su2, Jun, Heimburger1, Mikael, Jogestrand2, Tomas, Frostegard2, Johan
We recently reported that natural antibodies against phosphorylcholine (anti-PC) are negatively associated with atherosclerosis and cardiovascular disease (CVD) in the general population: low IgM anti-PC levels predict increased risk of CVD and high levels protect against increase in atherosclerosis over time. We have determined two potential mechanisms: anti-inflammatory effects of anti-PC (inhibiting inflammatory phospholipids which are implicated in both atherosclerosis and RA) and decreased uptake of oxidized lipids in macrophages. According to our hypothesis, an immune deficient state low levels of anti-PC predispose to chronic inflammatory diseases. We here study atheroslerosis as determined by carotid ultrasound in systemic lupus erythematosus (SLE) and the role of traditional and non-traditional risk factors for atherosclerosis and CVD.
One hundred fourteen patient with SLE were compared with one hundred twenty two age- and sex matched population-based controls. Common carotid intima-media thickness (IMT), calculated intima-media area (cIMa) and plaque occurrence were determined by B-mode ultrasound as a surrogate measure of atherosclerosis. Plaques were graded according to echogenicity and grouped as 14, with 1 being echoluscent, and considered most vulnerable. Osteoporosis was studied by DXA and anti-PC by ELISA.
IMT and cIMa did not differ significantly between groups. However, plaques were more often found in SLE patients (p=0.029). Age, LDL and IgM anti-PC (lowest tertile) were independently associated with plaque occurrence in SLE. Further, in the left carotid arteries echoluscent plaques (grade 1) were more prevalent in SLE as compared to controls p<0.016).
Triglycerides, insulin resistance (determined by homeostasis model assessment of insulin resistance) hypertension, and C-reactive protein (CRP) were increased in SLE (p<0.01) while smoking, LDL and HDL did not differ between groups. Low levels of anti-PC IgM (lowest tertile) were more common in SLE patients than in controls (p=0.0022). Osteoporosis was more prevalent in the hip in SLE-patients as compared to controls (p<0.05) but not otherwise. 18.4% of SLE patients and 1.6% of controls (p<0.01) exhibited a history of CVD (myocardial infarction, angina, heart valve disease, stroke or claudication).
Plaque occurrence and the frequency of vulnerable plaques in the carotid arteries are increased in SLE. Anti-PC could be a novel risk marker also with a therapeutic potential in SLE.
To cite this abstract, please use the following information:
Anania, Cristina, Gustafsson, Thomas, Hua, Xiang, Su, Jun, Heimburger, Mikael, Jogestrand, Tomas, et al; Low Levels of Atheroprotective Natural IgM Antibodies Against Phosphorylcholine and Increased Prevalence of Vulnerable Atherosclerotic Plaques in Patients with SLE. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1194