Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes
Open Access
- 11 March 2020
- journal article
- research article
- Published by MDPI AG in Journal of Clinical Medicine
- Vol. 9 (3), 753
- https://doi.org/10.3390/jcm9030753
Abstract
Patients on haemodialysis (HD-patients) have an increased risk of premature death. Low levels of IgM antibodies against malondialdehyde (anti-MDA) are associated with increased risk of cardiovascular disease (CVD) with underlying potential mechanisms described. Here, we studied subclasses and isotypes of anti-MDA in 210 HD-patients with mortality as outcome (56% men, median age 66, Interquartile range (IQR) 51–74 years, vintage time 29 (15–58) months, mean follow up period of 41 (20–60)months). Patients were also divided into inflamed c-reactive protein (CRP >5.6 mg/mL) and non-inflamed. Antibody levels were measured by ELISA. In multivariate risk analysis, patients in low tertile of IgM anti-MDA sub-distribution hazard ratio (sHR 0.54); 95% confidence interval (CI: 0.34–0.89) inversely and significantly associated with all-cause mortality after five years, after adjusting for confounders. Low tertile of IgG (sHR 0.48, 95%CI: 0.25–0.90, p = 0.02) and IgG1 (sHR 0.50, CI: 0.24–1.04, p = 0.06) was associated low mortality among non-inflamed patients. In contrast, anti-MDA IgG2 among inflamed patients was significantly associated with increased mortality, IgG2(sHR 2.33, CI: 1.16–4.68, p = 0.01). IgM anti-MDA was a novel biomarker among HD-patients with low levels being associated with mortality, while low levels of IgG and IgG1 but not IgA anti-MDA were associated with mortality only among non-inflamed patients. IgG2 anti-MDA was a significant risk marker among inflamed patients, which could be related to infection.This publication has 29 references indexed in Scilit:
- Immunity, atherosclerosis and cardiovascular diseaseBMC Medicine, 2013
- Estimation of Oxidative Stress Markers in Chronic Kidney DiseaseKidney and Blood Pressure Research, 2010
- Chronic kidney disease: a public health priority and harbinger of premature cardiovascular diseaseJournal of Internal Medicine, 2010
- Autoimmunity and the Clearance of Dead CellsCell, 2010
- Increased prevalence of vulnerable atherosclerotic plaques and low levels of natural IgM antibodies against phosphorylcholine in patients with systemic lupus erythematosusArthritis Research & Therapy, 2010
- Comorbidity and Acute Clinical Events as Determinants of C-Reactive Protein Variation in Hemodialysis Patients: Implications for Patient SurvivalAmerican Journal of Kidney Diseases, 2009
- Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease PatientClinical Journal of the American Society of Nephrology, 2008
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999
- Autoantibodies to OxLDL Are Decreased in Individuals With Borderline HypertensionHypertension, 1999
- Macrophages that have ingested apoptotic cells in vitro inhibit proinflammatory cytokine production through autocrine/paracrine mechanisms involving TGF-beta, PGE2, and PAF.JCI Insight, 1998