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on March 15, 2007

Stroke. 2007
Published online before print March 15, 2007, doi: 10.1161/STROKEAHA.106.474577
A more recent version of this article appeared on May 1, 2007
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Submitted on October 9, 2006
Revised on December 5, 2006
Accepted on December 11, 2006

Association Between IgM Against an Aldehyde-Modified Peptide in Apolipoprotein B-100 and Progression of Carotid Disease

Gunilla Nordin Fredrikson PhD*; Bo Hedblad MD, PhD; Göran Berglund MD, PhD; Ragnar Alm BSI; Jan-Åke Nilsson BSI; Alexandru Schiopu MD, PhD; Prediman K. Shah MD; and Jan Nilsson MD, PhD

From the Department of Clinical Sciences (G.N.F., B.H., G.B., R.A., J.-A.N., A.S., J.N.), Malmö University Hospital, Lund University, Malmö, Sweden; the Department of Biomedical Laboratory Science (G.N.F.), Malmö University, Sweden; and the Atherosclerosis Research Center and Division of Cardiology (P.K.S.), Cedars-Sinai Medical Center and David Geffen School of Medicine at UCLA School of Medicine, Los Angeles, Calif.

* To whom correspondence should be addressed. E-mail: Gunilla.Nordin_Fredrikson{at}med.lu.se.

Background and Purpose--Autoantibodies against antigens in oxidized low-density lipoprotein are common in people; experimental studies suggest that these immune responses have a functional role in the disease process. The aim of this study was to evaluate the relationship between the immune response against one defined oxidized low-density lipoprotein antigen, the aldehyde-modified peptide corresponding amino acids 3136 and 3155 (MDA-p210) in apolipoprotein (apo) B-100, and progression of carotid intima media thickness (IMT).

Methods--IgM and IgG against MDA-p210 were determined by enzyme-linked immunosorbent assay at baseline and after 12 months of treatment with placebo, metoprolol, fluvastatin, or metoprolol/fluvastatin in 751 individuals participating in the BCAPS. Carotid IMT was assessed by ultrasonography at baseline and after 18 and 36 months of treatment.

Results--Antibody levels did not change in response to treatment, but high baseline MDA-p210 IgM levels were associated with a more rapid progression of carotid disease both at 18 (r=0.09, P<0.05) and 36 months (r=0.12, P<0.005). At 36 months, the difference in IMT progression rate per year between those with high MDA-p210 IgM levels and those with low was 0.011 mm (95% CI=0.005 to 0.018 mm, P<0.0001). Treatment with fluvastatin markedly decreased the progression of IMT among subjects with high but not with low MDA-p210 IgM levels. There was no association between MDA-p210 IgG and carotid IMT progression.

Conclusions--IgM against the aldehyde-modified peptide corresponding amino acids 3136 and 3155 in apo B-100 is common in subjects with asymptomatic carotid disease, and high levels are associated with a more rapid progression of carotid IMT. The observation that the effect of fluvastatin was restricted to subjects with high MDA-p210 IgM levels may reflect the increased rate of disease progression in this group.


Key words: atherosclerosis • carotid arteries • echocardiography • immune system • lipoproteins




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