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IgG anti-apoA-1 levels associated with SLE disease activity, treatment
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Serum levels of immunoglobulin G anti-apoA-1 antibodies in patients with systemic lupus erythematosus were associated with disease activity, higher corticosteroid dose and not taking hydroxychloroquine, according to researchers from the University College London.
Serum samples were collected from 499 patients with systemic lupus erythematosus (SLE) taken within 1 year of diagnosis between 1978 and 2011. Samples from 100 healthy control participants were anonymized and matched by age, gender and ethnicity.
A longitudinal arm of the study was developed by selecting 397 samples from a subgroup of 49 patients who had a mean of eight samples each and varying levels of disease activity over time. Forty-seven of the patients were also coincidentally part of an early disease group.
Immunoglobulin G (IgG) anti-apoA-1 antibody, anti-Sm, anti-RNP, anti-Ro anti-La, C3 and anti-ds-DNA levels were measured using enzyme-linked immunosorbent assay.
Data on damage in patients measured in patients with SLE using the Systemic Lupus International Collaborative Clinics Damage Index (SLICC-DI) was available for 236 patients studied between 2006 and 2008. Disease activity was measured using the British Isles Lupus Assessment Group (BILAG) index.
Detailed statistical analysis revealed that IgG anti-apoA-1 antibody levels were significantly lower in patients with positive ant-La and anti-Sm; however, no relationship was shown with C3 or anti-dsDNA, according to the researchers.
Patients with persistent moderate-to-high disease activity had 30% higher IgG anti-apoA-1 levels than patients with persistently low disease activity. Additionally, higher levels of IgG anti-apoA-1 were seen in patients with high BILAG scores.
Patients who received treatment with hydroxychloroquine were observed to have 30% lower levels of IgG anti-apoA-1 than patients who did not take hydroxychloroquine, and patients administered high-dose prednisolone had 39% higher levels than patients prescribed low doses. Multivariate analysis revealed no other colinearities, and IgG anti-apoA-1 positivity did not correspond with later cardiovascular disease or mortality risk, according to the researchers. – by Shirley Pulawski
Disclosures: The authors report no relevant financial disclosures.
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