Platelet-activating factor-acetylhydrolase and other novel risk and protective factors for cardiovascular disease in systemic lupus erythematosus
Platelet-activating factor-acetylhydrolase and other novel risk and protective factors for cardiovascular disease in systemic lupus erythematosus
复制标题
DOI：
10.1002/art.20432
复制
发表时间：
2004-09-01
影响因子：
--
通讯作者：
Frosteg책rd, J
中科院分区：
文献类型：
--
作者：
Cederholm, A;Svenungsson, E;Frosteg책rd, J
Objective.动脉粥样硬化和心血管疾病（CVD）中有一个重要的炎症成分。因此，有趣的是，CVD的风险在炎症性疾病如系统性红斑狼疮（SLE）中很高。在这项研究中，我们调查了SLE患者发生CVD的非传统危险因素。将26例有CVD病史的SLE女性患者（平均年龄52岁）与26例年龄匹配的SLE女性患者（无CVD临床表现）（SLE对照组）和26例年龄匹配的健康女性（人群对照组）进行比较。测定了几种新的非传统风险和保护因子的血清水平：热休克蛋白（HSP）相关因子（Hsp 60、Hsp 70、抗人Hsp 60、抗人Hsp 70和抗分枝杆菌Hsp 65）、血小板活化因子乙酰水解酶（PAF-AH）活性、分泌型磷脂酶A（2）GIIA（sPLA（2））和抗内皮细胞抗体（AECA）。用B超检测颈总动脉内膜中层厚度和斑块的存在，作为动脉粥样硬化的替代指标。SLE患者的PAF-AH水平显著升高，而HSP相关因子、AECA或sPLA（2）则无显著升高。仅PAF-AH区分SLE患者和SLE对照组（P = 0.005）。SLE组PAF-AH与低密度脂蛋白胆固醇（LDL）和总胆固醇（TC）显著相关（r = 0.50，P = 0.0093和r = 0.54，P = 0.0045），而对照组两者均无相关性。SLE病例中PAF-AH水平升高以及PAF-AH与LDL胆固醇之间的相关性进一步支持了PAF-AH可能促进SLE动脉粥样硬化血栓形成的观点。热休克蛋白在心血管疾病中的作用是复杂的，因为抗热休克蛋白65似乎与心血管疾病的存在有关，而热休克蛋白70可能对心血管疾病起保护作用。在这项横断面研究中，热休克蛋白相关因子、AECA和sPLA的水平与SLE的心血管疾病无关。
Objective. There is an important inflammatory component to atherosclerosis and cardiovascular disease (CVD). It is therefore interesting that the risk of CVD is high in inflammatory diseases such as systemic lupus erythematosus (SLE). In this study, we investigated nontraditional risk factors for the development of CVD in patients with SLE.Methods. Twenty-six women (mean age 52 years) with SLE and a history of CVD were compared with 26 age-matched women with SLE and no clinical manifestations of CVD (SLE controls) and 26 age-matched healthy women (population controls). Serum levels of several novel nontraditional risk and protective factors were determined: heat-shock protein (HSP)-related factors (Hsp60, Hsp70, anti-human Hsp60, anti-human Hsp70, and anti-mycobacterial Hsp65), platelet-activating factor-acetylhydrolase (PAF-AH) activity, secretory phospholipase A(2) GIIA (sPLA(2)), and antiendothelial cell antibody (AECA). The intima-media thickness and the presence of plaques in the common carotid arteries were determined by B-mode ultrasound as a surrogate measure of atherosclerosis.Results. Levels of PAF-AH, but not HSP-related factors, AECA, or sPLA(2), were significantly increased in SLE cases. Only PAF-AH discriminated between SLE cases and SLE controls (P = 0.005). PAF-AH was significantly associated with low-density lipoprotein (LDL) cholesterol and total cholesterol in the SLE cases (r = 0.50, P = 0.0093 and r = 0.54, P = 0.0045), but not in either control group.Conclusion. The increased levels of PAF-AH in SLE cases and the association between PAF-AH and LDL cholesterol adds support to the notion that PAF-AH may promote atherothrombosis in SLE. The role of HSPs in CVD is complex, since anti-Hsp65 appears to be associated with the presence of CVD, whereas Hsp70 might protect against it. In this cross-sectional study, levels of HSP-related factors, AECA, and sPLA(2) were not associated with CVD in SLE.