학술논문

Anti-ApoA-1 IgG serum levels predict worse poststroke outcomes.
Document Type
Article
Source
European Journal of Clinical Investigation. Sep2016, Vol. 46 Issue 9, p805-817. 13p.
Subject
*AUTOANTIBODIES
*APOLIPOPROTEIN A
*STROKE patients
*HEALTH outcome assessment
*IMMUNOGLOBULIN G
*CORONARY disease
*ASTROCYTOMAS
Language
ISSN
0014-2972
Abstract
Background Autoantibodies to apolipoprotein A-1 (anti-ApoA-1 IgG) were shown to predict major adverse cardiovascular events and promote atherogenesis. However, their potential relationship with clinical disability and ischaemic lesion volume after acute ischaemic stroke ( AIS) remains unexplored. Materials and methods We included n = 76 patients admitted for AIS and we investigated whether baseline serum anti-ApoA-1 IgG levels could predict (i) AIS-induced clinical disability [assessed by the modified Rankin Scale ( mRS)], and (ii) AIS-related ischaemic lesion volume [assessed by Computed Tomography ( CT)]. We also evaluated the possible pro-apoptotic and pro-necrotic effects of anti-ApoA-1 IgG on human astrocytoma cell line (U251) using flow cytometry. Results High levels of anti-ApoA-1 IgG were retrieved in 15·8% (12/76) of patients. Increased baseline levels of anti-ApoA-1 IgG were independently correlated with worse mRS [β = 0·364; P = 0·002; adjusted odds ratio ( OR): 1·05 (95% CI 1·01-1·09); P = 0·017] and CT-assessed ischaemic lesion volume [β = 0·333; P < 0·001; adjusted OR: 1·06 (95% CI 1·01-1·12); P = 0·048] at 3 months. No difference in baseline clinical, biochemical and radiological characteristics was observed between patients with high vs. low levels of anti-ApoA-1 IgG. Incubating human astrocytoma cells with anti-ApoA-1 IgG dose dependently induced necrosis and apoptosis of U251 cells in vitro. Conclusion Anti-ApoA-1 IgG serum levels at AIS onset are associated with poorer clinical recovery and worse brain lesion volume 3 months after AIS. These observations could be partly explained by the deleterious effect of anti-ApoA-1 IgG on human brain cell survival in vitro and may have clinical implication in the prediction of poor outcome in AIS. [ABSTRACT FROM AUTHOR]