doi: 10.1161/01.CIR.0000143225.07377.EA
(Circulation. 2004;110:2552-2558.)
© 2004 American Heart Association, Inc.
Editorial |
Are Anti–Oxidized Low-Density Lipoprotein Antibodies Pathogenic or Protective?
From the Department of Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Israel (Y.S.); RDL Reference Laboratory, Los Angeles, Calif (R.W.); Specialty Laboratories, Santa Monica, Calif (L.D.D.); and Department of Cell Chemistry, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan (E.M.).
Correspondence to Y. Shoenfeld, MD, FRCP, Head, Department of Medicine B, Sheba Medical Center, Tel-Hashomer 52621, Israel. E-mail shoenfel@post.tau.ac.il
Key Words: Editorials • lipoproteins • atherosclerosis • cardiovascular diseases • antibodies
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Despite a recent decline, atherosclerosis remains the most common cause of death in the Western world. The disease course of atherosclerosis is characterized by its chronicity, with progression in its initial stages being particularly insidious. Chronic inflammation is the pathological hallmark of atherosclerosis,1–4 and inflammatory processes are instrumental at all stages of this disease. Even before the development of detectable intimal lesions, the expression pattern of the endothelium has been shown to be inflammatory in nature, conforming to the response-to-injury hypothesis first postulated by the late Russell Ross.5 Thus, in lesion-prone sites of the arterial tree, the endothelial expression of adhesion molecules is upregulated, reflecting endothelial dysfunction secondary to unfavorable blood rheology6 and/or hypercholesterolemia.7–9
Atherosclerosis is known today to be associated with the burden of infection as well.10 The presence of infectious/inflammatory pathogeneses raises the autoimmune aspect of the condition.11–14
Anti–oxidized LDL (oxLDL) antibodies are exceptional among the autoantibodies prevalent in atherosclerosis: on the one hand, a correlation was found between the existence and titers of anti-oxLDL antibodies and the extent of atherosclerosis and cardiovascular disease (CVD) (Table 1). On the other hand, experimental data indicate that anti-oxLDL antibodies may be protective.
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OxLDL: A Notorious Molecule That May Play a Role as an Autoantigen
oxLDL frequently presents in the sera of patients with autoimmune conditions, acute coronary syndrome, or stable coronary artery disease (CAD).15–18 OxLDL has been associated with both subclinical atherosclerosis and inflammatory variables.19 A large amount of oxLDL accumulates in atherosclerotic plaques,20–22 and the serum concentrations
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