A role for autoantibodies in atherogenesis

Area of Science:

• Immunology
• Cardiovascular Medicine
• Rheumatology

Background:

• Individuals with autoimmune diseases have an elevated risk of cardiovascular disease (CVD).
• The contribution of autoimmune processes and inflammation versus treatments (e.g., steroids) to this CVD risk is unclear.
• Chronic inflammation and autoantibodies are implicated in atherogenesis.

Purpose of the Study:

• To systematically review the literature and establish the association between autoantibodies and atherosclerosis.
• To investigate this association in individuals without a clinical autoimmune disease diagnosis.

Main Methods:

• Systematic review of five databases (search until June 2016).
• Inclusion of analytical studies on adults with at least two studies per autoantibody.
• Quality assessment using Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool; random effects models for pooling.

Main Results:

• Elevated anti-cardiolipin (OR=1.30), anti-oxidized LDL IgG (OR=1.25), anti-CCP (OR=3.09), and anti-HSP60 IgA (OR=1.57) were associated with increased cardiovascular risk.
• Anti-phosphorylcholine IgM (OR=1.31) was associated with protection against CVD.
• These associations were observed independently of therapeutic treatments.

Conclusions:

• Autoantibodies play a significant role in mediating cardiovascular events, independent of treatments.
• Autoantibodies may serve as markers for immune dysregulation and CVD risk.
• Further research into autoantibodies as CVD risk markers is warranted.