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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Natural antibodies against phosphorylcholine as potential protective factors in SLE
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
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Abstract |
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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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