Coronary Artery Disease but Not Coronary Calcification Is Associated with Elevated Levels of Cardiolipin, Beta-2-Glycoprotein-I, and Oxidized LDL Antibodies

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Abstract

Background: Autoimmune factors have been shown to play a role in atherosclerosis. The aim of this study is to correlate 5 autoantibodies (anticardiolipin, anti-CL, β2-glycoprotein-I, β2GPI, phosphatidylcholine, oxidized low-density lipoprotein, oxLDL, endothelial cell) with the presence of coronary heart disease, angiographic findings, and with coronary artery calcification. Methods: The levels of the 5 autoantibodies and a control antifibroblast line of 126 coronary heart disease patients and 20 healthy controls were measured. Fifty-one patients underwent coronary angiography, and 98 patients had coronary artery calcium determination using spiral computerized tomography (dual mode). Results: Levels of 3 autoantibodies (anti-CL, β2GPI, oxLDL) were significantly elevated in coronary heart disease patients compared with controls (p < 0.001,p = 0.001, p < 0.001, respectively). Within the subgroup of patients with significant coronary artery stenosis, anti-CL antibodies were also elevated (p = 0.008). No correlation was found between anti-CL, and anti-β2GPI autoantibody levels and coronary calcium scores as measured by spiral computerized tomography. However, anti-oxLDL antibodies were raised in patients with no calcification detected by spiral computerized tomography, compared with the patients with any coronary calcification (p = 0.046). Conclusion: Anti-CL, β2GPI and oxLDL antibodies are elevated in coronary heart disease patients regardless of coronary calcification.

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Enhancement of Atherosclerosis in Beta-2-Glycoprotein I-Immunized Apolipoprotein E-Deficient Mice

Arnon Afek, Jacob George, Yehuda Shoenfeld … (1999)

We have previously shown that low density lipoprotein receptor-deficient (LDL-RD) mice immunized with β 2 -glycoprotein I (β2GPI; a target of autoimmune anticardiolipin antibodies) developed enhanced early atherosclerosis, when fed a normal chow diet. The current study was undertaken to evaluate the effect of immunization with β2GPI and the addition of a high fat diet on the progression of atherosclerosis in the apolipoprotein E (ApoE)-deficient mouse. Six-week-old female ApoE-deficient mice (n = 10) were immunized subcutaneously with either human β2GPI or with ovalbumin, both emulsified in complete Freund’s adjuvant and fed a high fat diet for 6 weeks. The β2GPI-immunized mice were found to develop accelerated atherosclerosis when compared with their ovalbumin-immunized littermates (aortic lesion area of 137,500 ± 13,801 vs. 72,444 ± 14,465 µm 2 , respectively; p = 0.0067). The β2GPI-immunized mice developed high titers of anti-β2GPI antibodies, 10 days after the procedure, which were sustained until the sacrifice. LDL extracted from both study groups displayed similar susceptibility to ex vivo oxidation. These results confirm our previous study in which we found increased atherosclerosis in β2GPI-immunized LDL-RD mice fed a chow diet. In the current study we show that the proatherogenic effect of β2GPI immunization is maintained despite high cholesterol levels and is not associated with increased susceptibility of LDL to ex vivo oxidation.