Clinical Rheumatology

, Volume 37, Issue 4, pp 971–977 | Cite as

Synergism between apolipoprotein E Ɛ4 allele and paraoxonase (PON1) 55-M allele is associated with risk of systemic lupus erythematosus

  • Maryam Tanhapour
  • Ali Miri
  • Asad Vaisi-Raygani
  • Fariborz Bahrehmand
  • Amir Kiani
  • Zohreh Rahimi
  • Tayebeh Pourmotabbed
  • Ebrahim Shakiba
Original Article


Evidences indicate that abnormal lipid metabolism and lipid peroxidation can affect the progression of complications in systemic lupus erythematosus (SLE) patients. Apolipoprotein E (ApoE) and paraoxonase-1 (PON1) play important role in lipid metabolism and protection of lipid peroxidation. The polymorphisms of ApoE and paraoxonase (PON1) L55M (Met < Leu) allele genes lead to disorders in lipid metabolism and are related to atherosclerosis. This study is the first investigation to examine the possible association between ApoE and PON1-L55M polymorphisms and correlation with serum arylesterase (ARE) activities of PON, levels of malondialdehyde (MDA), neopterin, and lipid lipoprotein in SLE patients from Iranian western population. The present case-control study consisted of 107 SLE patients and 101 gender- and age-matched, unrelated, healthy controls from Iran’s western population. The ApoE and PON1-L55M genotypes were identified using PCR-RFLP method. The serum level of MDA, neopterin, lipid levels, and ARE activity were determined by HPLC, commercial kits, and spectrophotometry, respectively. Our results showed that ApoE ε4 and PON1-55M alleles act synergistically to increase the risk of SLE by 1.47 times (p = 0.038). We found that the frequency of ApoE Ɛ3/Ɛ4 genotype was higher in SLE patients (11.2%) compared with control subjects (5%), although the difference was not significant (p = 0.087). This study for the first time not only demonstrates that ApoE Ɛ4 and PON-55M alleles synergistically increase the risk of SLE but also reveals that serum levels of MDA, neopterin, and LDL-C are high in SLE patients. This information may be in value for evaluating SLE progression and in the elucidation of the mechanisms of the disease pathogenesis.


Apolipoprotein E genotypes Arylesterase activity of paraoxonase Malondialdehyde Neopterin Paraoxonase (PON1)-55 polymorphism Systemic lupus erythematosus 



Systemic lupus erythematosus




Reactive oxygen species


Coronary artery disease


Low-density lipoprotein receptor



This work was performed in partial fulfillment of requirements for a M.Sc by degree in Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran (Ali Miri). All authors contributed equally to this study.

Source of Funding

This study was funded by Kermanshah University of Medical Sciences, Kermanshah, Iran, Grant No. 90324.

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  1. 1.Fertility and Infertility Research Center, School of MedicineKermanshah University of Medical SciencesKermanshahIran
  2. 2.Department of Clinical BiochemistryKermanshah University of Medical SciencesKermanshahIran
  3. 3.Medical Biology Research CenterKermanshah University of Medical SciencesKermanshahIran
  4. 4.Department of Toxicology and PharmacologyKermanshah University of Medical SciencesKermanshahIran
  5. 5.Department of Microbiology, Immunology and BiochemistryUniversity of TennesseeKnoxvilleUSA

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