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Influence of autoimmunity and inflammation on endothelial function and thrombosis in systemic lupus erythematosus patients

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Abstract

The aim of this study is to assess the relationship between autoimmunity and endothelial activation/damage (ICAM-1 and vWF serum levels) and the degree of prothrombotic activity (thrombin–antithrombin complexes—TAT serum levels) in SLE. In 60 clinically stable SLE patients, levels of the following parameters were estimated in their serum: lupus anticoagulant (LA), anticardiolipin antibodies in both IgG and IgM classes (aCL-IgG and aCL-IgM, respectively), antiβ2GPI antibodies in both IgG and IgM classes (antiβ2GPI-IgG and antiβ2GPI-IgM, respectively), ICAM, von Willebrand factor (vWF), TAT, CRP, C3c, C4, and IL-6. ICAM-1 values exceeded the upper reference limit in 9 (15%) patients. vWF levels were increased in 21 (35%) patients. In all patients with elevated ICAM-1 values, vWF were also increased. TAT concentrations were elevated in 12 (20%) people. ICAM-1 were significantly higher in patients with elevated aCL-IgM (> 30 MPL vs ≤ 30 MPL; p < 0.05). Similarly, ICAM-1 were significantly higher in patients with elevated antiβ2-GPI-IgM (> 20 SMU vs ≤ 20 SMU; p < 0.05). There was no significant difference in ICAM-1 levels in relation to LA-positivity. vWF were not significantly different in relation to antiphospholipid antibodies nor the inflammation marker levels. TAT were significantly higher in patients with elevated aCL-IgM (> 30 MPL vs ≤ 30 MPL; p < 0.05). In one third of young patients with stable SLE, signs of endothelial activation/damage were found, as shown by elevated plasma ICAM-1 or vWF. Increased prothrombotic tendency manifested by elevated TAT was found in one fifth of the patients. Elevated anticardiolipin (IgM) and anti-β2-glycoprotein I (IgM) antibodies influence endothelial dysfunction and enhance prothrombotic state.

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Authors and Affiliations

  1. Department for Diagnosis, John Paul II Hospital, Prądnicka str. 80, 31-202, Krakow, Poland

    Kamil Bugała

  2. Jagiellonian University Medical College, Krakow, Poland

    Monika Komar, Grzegorz Kopeć, Jacek Musiał, Piotr Podolec & Wojciech Płazak

  3. Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland

    Adam Mazurek, Monika Komar, Grzegorz Kopeć, Piotr Podolec & Wojciech Płazak

  4. Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland

    Krzysztof Gryga & Jacek Musiał

  5. Rheumatology Unit, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy

    Carlo Perricone

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  1. Kamil Bugała
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  2. Adam Mazurek
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Correspondence to Kamil Bugała.

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Before entering the study, each patient was informed about its aims and gave informed consent to participate. The study protocol was in line with the guidelines of the 1975 Declaration of Helsinki. The study obtained a positive opinion and approval from the Ethical Committee of the Jagiellonian University in Krakow.

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Bugała, K., Mazurek, A., Gryga, K. et al. Influence of autoimmunity and inflammation on endothelial function and thrombosis in systemic lupus erythematosus patients. Clin Rheumatol 37, 2087–2093 (2018). https://doi.org/10.1007/s10067-018-4104-4

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  • DOI: https://doi.org/10.1007/s10067-018-4104-4

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