Vascular Abnormalities, Paraoxonase Activity, and Dysfunctional HDL in Primary Antiphospholipid Syndrome

Abstract

Context Accelerated atherosclerosis has been described in antiphospholipid syndrome, but the vascular abnormalities and the underlying mechanisms remain unclear.Objectives To compare vascular structure and function in patients with positive antiphospholipid antibodies (aPL) with controls and to assess their relationship with paraoxonase activity. Design, Setting, and ParticipantsA cross-sectional study of 77 women with positive antiphospholipid antibodies from a lupus outpatient clinic in London, England (90% of the eligible population) and 77 controls matched on frequency basis for age and cardiovascular risk factors between June 2006 and April 2009. Carotid intima media thickness (CIMT), flow-mediated dilatation, pulse wave velocity, and paraoxonase activity were measured in all patients. Anti-inflammatory and antioxidant properties of high-density lipoprotein (HDL) were examined.Main Outcome Measures CIMT, pulse wave velocity, flow-mediated dilatation, and paraoxonase. ResultsWomen with aPL had greater CIMT and pulse wave velocity compared with controls (mean [SD], 0.75 [0.16] vs 0.64 [0.

Dysfunctional HDL: From Structure-Function-Relationships to Biomarkers

“…HDL loses potential antiatherosclerotic properties in patients with chronic inflammatory disorders, such as the antiphospholipid syndrome (Charakida et al 2009), systemic lupus erythematosus and rheumatoid arthritis (McMahon et al 2006), scleroderma (Weihrauch et al 2007), metabolic syndrome (de Souza et al 2008), diabetes (Persegol et al 2006;Sorrentino et al 2010), and CAD (Ansell et al 2003;Besler et al 2011;. In a study of 189 patients with chronic kidney disease on hemodialysis, an impaired anti-inflammatory capacity of HDL was correlated with a poor clinical outcome (Kalantar-Zadeh et al 2007).…”

Antiphospholipid Antibodies and Their Association with Atherosclerotic Changes in Patients with Systemic Lupus Erythematosus – Review of Literature and Own Experiences

“…A number of studies confirmed a clinical utility of other noninvasive imaging methods in atherosclerosis diagnosis in PAPS patients showing increased arterial stiffness (Belizna et al, 2008;Charakida et al, 2009) or abnormal ankle-brachial index (Barón et al, 2005).…”

“…Additionally, it was proved that HDL from women with aPL reduced nitric oxide bioavailability. That group was found to have an impaired anti-inflammatory and antioxidant properties (Charakida et al, 2009). …”

The Carotid-Femoral (Aortic) Pulse Wave Velocity and Paraoxonase 1 Activity: Review

“…40 They found an association between paraoxonase activity of high density lipoprotein cholesterol and carotid intima media thickness and PWV in antiphospholipid syndrome, which suggests a possible interaction between antiphospholipid antibodies and PON, leading to reduced PON activity, a concept that was demonstrated in experimental studies. 41 In conclusion, studies which evaluated the association of PON1 and PWV in the literature are controversial.…”

“…34,35 According to current data, there are a few studies in the literature in which connection of PON1 with PWV were evaluated. 18,39,40 Recently, we investigated the mechanism of the effect of valproic acid, carbamazepine, and valproic acid+carbamazepine by determining serum levels of oxidized low-density lipoprotein, apolipoprotein A1, homocysteine, folic acid, vitamin B12, PON1, total antioxidant capacity, malondialdehyde, nitric oxide and thyroid hormones in pediatric epileptic patients. 18 Besides the level of apolipoprotein A1, the activity of PON1 remained unaffected in pediatric patients who used antiepileptic drugs.…”