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Oxidized LDL-anti-oxidized LDL immune complexes and diabetic nephropathy
D H Atchley1, M F Lopes-Virella, D Zheng
1Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Diabetologia
|November 19, 2002
Summary
High concentrations of oxidized LDL-anti-oxidized LDL immune complexes correlate with abnormal proteinuria in diabetic patients. These findings suggest a link between these complexes and the progression of kidney damage in diabetes.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Immunology
Background:
- Oxidized low-density lipoprotein (oxLDL) is immunogenic, forming immune complexes with antibodies.
- These oxLDL-anti-oxLDL immune complexes are implicated in atherosclerosis and inflammation.
- Macroalbuminuria is a known risk factor for coronary heart disease, suggesting shared pathogenic pathways with atherosclerosis.
Purpose of the Study:
- To investigate the correlation between the quantity and characteristics of oxLDL-anti-oxLDL immune complexes and the degree of albuminuria.
- To explore the relationship in patients with Type 1 diabetes mellitus.
Main Methods:
- Study included 33 macroalbuminuric, 29 microalbuminuric, and 43 normoalbuminuric patients with Type 1 diabetes, matched for age, sex, and HbA1c.
- Isolated and characterized oxLDL-anti-oxLDL immune complexes in all patients.
- A subgroup underwent further characterization of the antibody moiety of the immune complexes.
Main Results:
- Concentrations of oxLDL immune complexes were significantly higher in macroalbuminuric patients compared to normoalbuminuric patients (272±20 vs 204±18 μg/ml, p<0.03).
- The antibody avidity (lower Kd) of oxLDL antibodies was greater in patients with abnormal albuminuria than in those with normoalbuminuria (0.86±0.1x10⁻⁸ vs 1.13±0.1x10⁻⁸ mol/l, p<0.05).
Conclusions:
- Elevated concentrations of oxLDL-anti-oxLDL immune complexes are associated with abnormal proteinuria in Type 1 diabetes.
- Immune complexes formed with higher-avidity antibodies appear particularly linked to the development or progression of proteinuria.
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