Study finds, Higher levels of Anti-phosphorylcholine autoant
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Immuno-inflammatory mechanisms and autoantibodies could be involved in the pathogenesis of atherosclerotic disease. It has been suggested that anti-phosphorylcholine antibodies (anti-PC) of the IgM subclass may have atheroprotective effects. It was aimed to investigate the association between levels of IgM anti-PC antibodies with cardiovascular events (CVE) in patients with early RA.

The study population was derived from the BARFOT early RA cohort. The outcome of incident CVE (AMI, angina pectoris, coronary intervention, ischemic stroke, TIA) was tracked. Sera collected at inclusion and the 2-year visit were analyzed with ELISA to determine levels of anti-PC IgM. The Kaplan-Meier estimates and Cox proportional hazards regression models were used to compare CV outcome in the groups categorized by baseline median level of IgM anti-PC.

--In all, 653 patients with early RA, 68% women, mean (SD) age 54.8 years, DAS28 5.2, 68% seropositive, and without prevalent CVD, were included. During the follow-up of mean 11.7 years, 141 incident CVE were recorded.

--Baseline IgM anti-PC above median was associated with a reduction in risk of incident CVE in patients aged below 55 years at inclusion, HR 0.360 in males, HR 0.558 in patients with BMI above 30 kg/m2, HR 0.235 and in those who did not achieve DAS28 remission at 1 year, HR 0.592.

--The pattern of associations was confirmed in the models with AUC IgM anti-PC over 2 years.

Finally, larger levels of innate IgM anti-PC autoantibodies were found to protect against CVE in younger RA patients and those at high risk of CVE were: males, obesity, and non-remission at 1 year.