Several lines of evidence suggest that chronic inflammation and immune dysregulation
are related to altered lipid profiles in rheumatoid arthritis (RA), but the actual
mechanisms are still unclear. We wondered whether the development of antibodies against
high-density lipoprotein (HDL) can be found in RA patients linked to clinical and
cardiovascular (CV) risk factors. To this end, immunoglobulin G (IgG) anti-HDL antibodies
and total IgG serum levels were quantified in 212 RA patients, 131 sex- and age-matched
healthy controls (HC), and 52 subjects with traditional CV risk factors (tCVRs). A
subgroup of 13 RA patients was prospectively followed on TNFα-blockade. TNFα, interferon
(IFN)α, MIP1α, IFNγ, IL-8, VEGF, GM-CSF, IL-17, MCP-1, SDF-1α, resistin, and leptin
serum levels were quantified by immunoassays. IgG anti-HDL levels were higher in RA
patients compared with HC (P < 0.0001) and tCVR subjects (P = 0.015). Differences with HC remained after correction for total IgG levels (P < 0.003). Anti-HDL/IgG were negatively associated with HDL levels in RA (−1.182 [−1.823
to −0.541], P = 0.0003) after adjusting for demographical, clinical, inflammatory parameters, and
treatments. RA patients with high levels of anti-HDL/IgG (n = 40, 18.8%) were more
likely to have experienced a CV event (P < 0.0001) and exhibited increased levels of several proinflammatory mediators (C-reactive
protein, IFNα, MIP1α, IFNγ, IL-8, GM-CSF, IL-17 and MCP-1). Finally, change in anti-HDL
antibodies on TNFα-blockade was independently associated with increasing HDL levels.
Overall, IgG anti-HDL antibodies are increased in RA independently of tCVRs and associated
with a proinflammatory milieu and impaired lipid blood profile, which may contribute
to the increased rate of CV events in these patients.
Abbreviations:
Apo A1 (Apolipoprotein A1), CVD (cardiovascular disease), DAS28 (disease activity score 28-joints), ELISA (enzyme-linked immunosorbent assay), HDL (high-density lipoprotein), IgG (immunoglobulin G), RA (rheumatoid arthritis), tCVR (traditional cardiovascular risk factors)To read this article in full you will need to make a payment
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Biography
Javier Rodríguez-Carrio, PhD, is a postdoctoral fellow is the Department of Functional Biology at the University of Oviedo in Spain. Dr. Rodríguez-Carrio's research interests are the identification of new biomarkers of cardiovascular risk that can be easily integrated into the clinical setting for the personalized care of patients.
Article info
Publication history
Published online: July 29, 2015
Accepted:
July 23,
2015
Received in revised form:
July 1,
2015
Received:
May 21,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
