Plasma osteopontin versus intima media thickness of the common carotid arteries in well-characterised patients with systemic lupus erythematosus.

Lina Wirestam,Helene Zachrisson,Christina Svensson,Michele Compagno,Jonas Wetterö,Muna Saleh,Christopher Sjöwall

doi:10.1177/09612033211013898

Lina Wirestam, Helene Zachrisson + Show 5 more

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https://doi.org/10.1177/09612033211013898

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Journal: Lupus	Publication Date: May 6, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: Linköping University, Lund University

Abstract

ObjectiveThe progress of accelerated atherosclerosis in systemic lupus erythematosus (SLE) is incompletely understood. Circulating osteopontin (OPN) is increased in autoimmune conditions, e.g. SLE, and its serum concentration was recently reported to associate with subclinical atherosclerosis in SLE, as measured by carotid intima-media thickness. The aim of this study was to investigate whether OPN may be used as a surrogate biomarker of subclinical atherosclerosis in SLE patients with different disease phenotypes.MethodsWe recruited 60 well-characterised SLE cases and 60 age- and sex-matched healthy controls. The SLE cases were divided into three different disease phenotypes: SLE with antiphospholipid syndrome (APS), lupus nephritis, and isolated skin and joint involvement. Plasma OPN was detected by ELISA (Quantikine®, R&D Systems). Common carotid arteries intima media thickness was compared between the studied groups in relation to OPN levels and risk factors for vascular changes. Intima media thickness of common carotid arteries was measured by using a sensitive ultrasound technique (LOGIQ™ E9 ultrasound, GE Healthcare).ResultsOPN levels were significantly higher among the entire SLE group (n = 60) compared to the healthy controls (P = 0.03). SLE cases with concomitant APS (n = 20) showed higher OPN levels than the controls (P = 0.004), whereas none of the other two subgroups differed significantly from the healthy controls. OPN and intima media thickness were correlated to several traditional risk factors of atherosclerosis, as well as to SLE-related factors. Yet, no significant correlation was observed between OPN levels and ultrasound findings of the common carotid arteries.ConclusionsIn line with previous studies, we observed increased OPN levels among SLE patients as compared to matched controls. However, the OPN concentrations did not correlate with intima media thickness of the common carotid arteries. Based on our findings, the use of OPN as a surrogate biomarker of subclinical atherosclerosis in SLE subjects, regardless of clinical phenotypes, cannot be recommended.

Highlights

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease that usually affects young females and may impair several organ systems, with an increased risk of cerebro- and cardiovascular disease (CVD).[1,2,3] Atherosclerosis is an inflammatory process with immune cell activation, leading to plaque formation and risk of subsequent rupture.[4]
POPN in different SLE phenotypes versus controls pOPN levels were significantly higher among patients with SLE compared to the healthy controls (median 56.6 ng/ml, P 1⁄4 0.03; Figure 1(a))
By comparison of each subgroup with the controls, significantly higher pOPN levels were detected among individuals with antiphospholipid syndrome (APS) (P 1⁄4 0.004; Figure 1(a))

Summary

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease that usually affects young females and may impair several organ systems, with an increased risk of cerebro- and cardiovascular disease (CVD).[1,2,3] Atherosclerosis is an inflammatory process with immune cell activation, leading to plaque formation and risk of subsequent rupture.[4] The systemic inflammation occurring in patients with SLE is thought to accelerate. Traditional risk factors and laboratory data Body mass index (BMI) (kg/m2) Ever smoker (former or current), n (%) Systolic blood pressure (mm Hg) Diastolic blood pressure (mm Hg) Diabetes mellitus, n (%) Raynaud, n (%) eGFR (mL/min/1,73m2) Total cholesterol (mmol/L) High-density lipoprotein (HDL) (mmol/L) Low-density lipoprotein (LDL) (mmol/L) Triglycerides (TG) (mmol/L) hsCRP (mg/L). Sex, smoking habits, diabetes, presence of Raynaud’s phenomenon and ongoing pharmacotherapy (antimalarial agents, glucocorticoids, warfarin, antiplatelet therapy, statins and disease modifying anti-rheumatic drugs (DMARDs)) were collected. The 4-variable Modification of Diet in Renal Disease Study equation based on plasma creatinine was used to estimate the glomerular filtration rate (eGFR).[32]

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