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Rheumatology Advance Access originally published online on June 3, 2008
Rheumatology 2008 47(8):1144-1150; doi:10.1093/rheumatology/ken120
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Natural antibodies against phosphorylcholine as potential protective factors in SLE

J. Su1,2,*, X. Hua1,2,*, H. Concha2, E. Svenungsson3, A. Cederholm1,2 and J. Frostegård1

1Rheumatology Unit, 2Center for Infectious Medicine, Department of Medicine, Karolinska University Hospital, Huddinge and 3Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Stockholm, Sweden.

Correspondence to: J. Su, Department of Medicine, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden. E-mail: jun.su{at}ki.se


  Abstract

Objective. We have recently reported that natural antibodies against phosphorylcholine (anti-PC) have atheroprotective properties. Here we compare anti-PC with other autoantibodies in SLE patients with and without cardiovascular disease (CVD).

Methods. Twenty-six women (52 ± 8.2 yrs) with SLE and a history of CVD (SLE cases) were compared with 26 age-matched women with SLE without CVD (SLE controls) and 26 age-matched population-based control women (controls). PC was conjugated with BSA (PC-BSA) or keyhole-limpet haemocyanin (PC-KLH). Anti-PC and antibodies against phosphatidylserine (anti-PS) and BSA (anti-BSA) were studied by ELISA. Anti-PC-IgG were extracted from intravenous immunoglobulin (IVIG). Activation of endothelial cells by platelet-activating factor (PAF) was studied with FACScan.

Results. IgG anti-PC-BSA and anti-PC-KLH were decreased among SLE-cases and SLE-controls as compared with controls (P < 0.005 and P < 0.05), respectively. SLE cases were more prevalent in the lowest 25th percentile of anti-PC-IgM (and IgG) as compared with controls (P < 0.05) but anti-PC-IgM levels did not differ significantly between groups. Among SLE controls, anti-PC-BSA were associated negatively with organ damage (SLICC) and disease activity (SLEDAI) (P < 0.05). Among SLE cases, anti-PC-BSA and anti-PC-KLH were associated negatively with SLICC (P = 0.021; P = 0.010) and anti-PC-BSA was negatively associated with SLEDAI (P < 0.039).

Anti-PS-IgG and anti-BSA-IgG were raised among SLE cases as compared with other groups (P < 0.05) and did not cross-react with anti-PC. Anti-PC-IgG could be extracted from IVIG and inhibited PAF-induced expression of adhesion molecules.

Conclusion. Low levels of anti-PC could be of importance in SLE. Anti-BSA and anti-PS and low levels of anti-PC could contribute to development of CVD in SLE.

KEY WORDS: Systemic lupus erythematosus, Atherosclerosis, Antibodies, Phosphorylcholine

*J. Su and X. Hua equally contributed to this work.

Submitted 27 October 2007; revised version accepted 21 February 2008.
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