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Antiphospholipid antibodies in patients with calcific aortic valve stenosis

Oscar Plunde1,2, Elisabet Svenungsson1,3, Giulia Ferrannini1,2

  • 1Department of Medicine Solna, Karolinska Institutet.

Rheumatology (Oxford, England)
|August 12, 2022
PubMed

Insights

Antiphospholipid antibodies (aPL) IgG are more common in patients with calcific aortic valve stenosis (CAVS). aPL positivity impacts aortic valve gene expression, suggesting a potential role in CAVS development and offering new therapeutic targets.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Genomics

Background:

  • Antiphospholipid syndrome (APS) is characterized by antiphospholipid antibodies (aPL) and associated thrombotic or obstetric complications.
  • aPL are frequently observed in systemic lupus erythematosus (SLE) and myocardial infarction.
  • The association between aPL and calcific aortic valve stenosis (CAVS) in the general population remains unclear.

Purpose of the Study:

  • To determine the prevalence of aPL in patients with CAVS.
  • To investigate the association of aPL with CAVS.
  • To analyze the impact of aPL on aortic valve (AV) transcriptomics in CAVS patients.

Main Methods:

  • A cohort of 233 CAVS patients and matched controls were analyzed for aPL (anti-cardiolipin and anti-β2Glycoprotein-I of IgG/M/A isotypes).
  • Microarray analysis was performed on AV tissue from aPL-positive and aPL-negative CAVS patients.
  • Supervised machine learning was used to identify genes predicting CAVS progression.

Main Results:

  • The prevalence of any aPL was 6.4% in CAVS patients.
  • aPL IgG was significantly more prevalent in CAVS cases (4.6%) compared to controls (0.6%) (P=0.04).
  • AV tissue from aPL-positive patients showed enrichment in interferon signaling pathways and identified 100 differentially expressed genes predictive of CAVS progression.

Conclusions:

  • aPL IgG is more prevalent in CAVS patients than in controls.
  • aPL positivity is linked to altered AV transcriptomics, involving interferon pathways and local disease progression.
  • Further research is warranted to establish aPL as a risk marker or causal factor for CAVS, potentially leading to precision therapies.
Abstract

Keywords:
SLEaPLantiphospholipid syndromecalcific aortic valve stenosisheart valve diseasetranscriptomics

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