4 years ago

Natural antibodies to oxidation-specific epitopes: Innate immune response and venous thromboembolic disease

M. Kammer, C.J. Binder, L. Eischer, S. Eichinger, M. Ozsvar Kozma, P.A. Kyrle
Background and objectives Natural antibodies to oxidation-specific epitopes protect from atherothrombotic events. Whether mechanisms of innate immunity are relevant in the pathogenesis of venous thromboembolism (VTE) is unknown. Patients/Methods We measured plasma levels of IgM antibodies to oxidized low-density lipoproteins (OxLDL) and phosphocholine (PC) by enzyme linked immune assay in 663 patients with unprovoked VTE, who were prospectively followed after discontinuation of anticoagulation for a median of 8.8 years. Study endpoint was recurrent VTE. Results IgM antibody levels to OxLDL and PC were higher in patients without compared to those with recurrent VTE (n=174, 26.2%). For each doubling of OxLDL-IgM or PC-IgM the hazard ratio (HR) of recurrence was 0.88 (95% CI 0.77-1.01) and 0.82 (95% CI 0.71–0.94), respectively. After five years the probability of recurrence in patients with PC-IgM levels in the highest tertile (> 19.6 RLU/100ms) was 13.0% (95% CI 8.1%-17.6%) compared to 21.1% (95% CI 14.9%-26.9%) in the middle and 20.6% (95% CI 14.7%-26.0%) in the lowest tertile, respectively. The corresponding HR was 0.56 (0.39–0.82) for PC-IgM levels in the highest compared to the lowest tertile. Neither IgG antibody levels to OxLDL nor PC were associated with risk of VTE. Conclusion Levels of OSE-specific natural IgM antibodies are inversely related to the risk of VTE. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/jth.13874

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