Study of anti-apolipoprotein A-I antibodies and paraoxonase 1 activity in systemic lupus erythematosus patients; correlation with disease activity and damage indices

IntroductionSystemic lupus erythematosus (SLE) patients have an increased risk of atherosclerosis. Identification of at-risk patients and the pathogenesis of atherosclerosis in SLE remain elusive. Paraoxonase 1 (PON1) and anti-apolipoprotein A-I antibody (anti-Apo A-I) appear to have a potential role in premature atherosclerosis in SLE.Aim of the workTo assess two novel risk factors of atherosclerosis in SLE patients; PON1 activity, and anti-Apo A-I antibody levels, in order to elucidate any possible correlation between both of them, and to demonstrate their relations to disease activity disease activity as well as disease related damage.Patients and methodsForty SLE female patients and 40 apparently healthy volunteers were included in this study. Anti-Apo A-I antibody levels and PON1 activity levels were assessed. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaboration Clinics (SLICC)/American College of Rheumatology (ACR) damage index were preformed to all patients.ResultsCompared with controls, SLE patients showed significantly lower PON1 activity and significantly higher titers of anti Apo A-I. Anti-Apo A-I antibody titers correlated inversely with PON1 activity. Elevated titers of anti-Apo A-I antibody and reduced PON1 activity were related to increased SLEDAI and (SLICC/ACR) damage index scores.ConclusionThere is a decreased PON1 activity and formation of anti-Apo A-I antibodies in SLE patients and both of them correlated with disease activity as well as disease-related damage. PON1 activity and anti-Apo A-I antibodies might be involved in the pathogenesis of premature atherosclerosis in SLE patients.