Abstract

High-density lipoproteins cholesterol (HDLc) levels are decreased in abdominal aortic aneurysm (AAA), which is hallmarked by autoimmunity and lipid aortic deposits. To investigate whether IgG anti-HDL antibodies were present in AAA and their potential association with clinical features, IgG anti-HDL and total IgG along with HDLc plasma levels were measured in 488 AAA patients and 184 controls from the Viborg Vascular (VIVA) study, and in tissue-conditioned media from AAA intraluminal thrombus and media layer samples compared to control aortas. Higher IgG anti-HDL levels were found in AAA compared to controls, even after correcting for total IgG, and after adjusting for potential confounders. IgG anti-HDL levels were correlated with aortic diameter in univariate and adjusted multivariate analyses. IgG anti-HDL antibodies were negatively associated with HDLc levels before and after correcting for potential confounders. Increased anti-HDL antibodies were identified in tissue-conditioned media from AAA samples compared to healthy aortas, with higher levels being observed in the media layer. In conclusion, increased IgG anti-HDL levels (both in plasma and in tissue) are linked to AAA, associated with aortic diameter and HDLc levels. These data suggest a potential immune response against HDL in AAA and support an emerging role of anti-HDL antibodies in AAA.

Highlights

  • Abdominal Aortic Aneurysm (AAA) is hallmarked by a permanent, focal dilation of the abdominal aorta [1]

  • 197 (40.3%) AAA patients were classified as anti-HDL-positive, compared to 58 controls (31.5%, p = 0.035), confirming a higher anti-HDL burden in AAA patients compared to controls

  • Epidemiological evidence supports a negative association of High-density lipoproteins cholesterol (HDLc) with AAA, and a number of studies point to an altered lipid profile in AAA patients, the connection between CVD and

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Summary

Introduction

Abdominal Aortic Aneurysm (AAA) is hallmarked by a permanent, focal dilation of the abdominal aorta [1]. AAA rupture is fatal in most of the cases [2]. A better understanding of its pathogenic mechanisms could lead to the identification of novel biomarkers to improve patient management and stratification. Several risk factors have been related to AAA, such as hypertension, smoking, or obesity. Recent studies suggest that blood lipids may play a role in AAA aetiology [3,4,5,6,7].

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