Should antibodies to high-density lipoprotein cholesterol and its components be measured in all systemic lupus erythematosus patients to predict risk of atherosclerosis?

摘要

The risk of fatal or debilitating atherosclerotic events is increased 7-10-fold in systemic lupus erythem-atosus (SLE) and 3-fold in rheumatoid arthritis (RA) (1). In this issue of Arthritis & Rheumatism, O'Neill and colleagues (2) add- to evidence that IgG antibodies to high-density lipoproteins (HDLs), to their major apoli-poprotein constituent apolipoprotein A-I (Apo A-I), and to C-reactive protein (CRP) are present in the sera of 12-45% of patients with SLE depending on disease activity. The antibodies are more prevalent in patients with active disease, and they are significantly correlated with each other but not with standard risk factors for atherosclerosis such as hypertension, diabetes, and smoking. Levels of anti-Apo A-I rise significantly during disease flares. Identification of these antibodies in SLE and their association with disease activity reported by several other groups are referenced by O'Neill et al.