Thrombosis research · 2025
Antibodies to oxidation-specific epitopes characterize hemodialysis patients protected from cardiovascular events.
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Vostatek Rafaela, Afonyushkin Taras, Kozma Maria Ozsvar, Schmaldienst Sabine, Lorenz Matthias, Klauser-Braun Renate, Pabinger Ingrid, Säemann Marcus, Ay Cihan, Binder Christoph J, Königsbrügge Oliver
Аннотация
BACKGROUND: Despite the high risk of cardiovascular disease (CVD) in patients on hemodialysis (HD), some appear protected from CVD-associated mortality and survive long-term on HD. The immune system can recognize oxidation-specific epitopes (OSEs) and create antibodies with pro- or antithrombotic properties. This study aimed to elucidate the role of natural antibodies against OSEs in patients on hemodialysis (HD) and their association with cardiovascular outcomes.
METHODS: Serum levels of IgM and IgG autoantibodies to OSEs (including CuOx-LDL, MDA-LDL, and MAA-BSA) were measured using an ELISA assay in a prospective population-based cohort study of prevalent HD patients. The risk for the occurrence of the 3P-MACE outcome (myocardial infarction, ischemic stroke, and cardiovascular death) with the association of antibodies against OSEs was statistically analyzed in a competing risk framework.
RESULTS: In our study of 595 patients with ESKD (236 (37 %) women, median age: 67 (25th to 75th percentile 55-75) years); 54 patients were long-term survivors (>10 years on HD). There was no association between IgM and IgG antibodies to OSEs with the risk of 3P-MACE occurrence after adjusting for age, atrial fibrillation, stroke, and coronary heart disease. However, long-term survivors on HD, exhibited higher levels of antibodies to OSEs compared to other patients and lower risk of 3P-MACE (IgG MAA-BSA median 97,663.83 in long-term survivors versus 70,833.50 RLU rest of the cohort, p = 0.001).
CONCLUSION: Natural autoantibodies against OSEs were not associated with the overall risk of 3P-MACE in this cohort of HD patients. However, we found that long-term survivors had higher levels of natural autoantibodies against OSEs.
METHODS: Serum levels of IgM and IgG autoantibodies to OSEs (including CuOx-LDL, MDA-LDL, and MAA-BSA) were measured using an ELISA assay in a prospective population-based cohort study of prevalent HD patients. The risk for the occurrence of the 3P-MACE outcome (myocardial infarction, ischemic stroke, and cardiovascular death) with the association of antibodies against OSEs was statistically analyzed in a competing risk framework.
RESULTS: In our study of 595 patients with ESKD (236 (37 %) women, median age: 67 (25th to 75th percentile 55-75) years); 54 patients were long-term survivors (>10 years on HD). There was no association between IgM and IgG antibodies to OSEs with the risk of 3P-MACE occurrence after adjusting for age, atrial fibrillation, stroke, and coronary heart disease. However, long-term survivors on HD, exhibited higher levels of antibodies to OSEs compared to other patients and lower risk of 3P-MACE (IgG MAA-BSA median 97,663.83 in long-term survivors versus 70,833.50 RLU rest of the cohort, p = 0.001).
CONCLUSION: Natural autoantibodies against OSEs were not associated with the overall risk of 3P-MACE in this cohort of HD patients. However, we found that long-term survivors had higher levels of natural autoantibodies against OSEs.