Antibodies against apolipoprotein A1 in HDL cholesterol also were elevated and were associated with the presence of tumor necrosis factor. Whether these anti-apo A1 antibodies play a pathogenic role—for example, by inhibiting the anti-inflammatory properties of HDL—is under investigation, Dr. Su said.
▸ Homocysteine. Hyperhomocysteinemia in patients with lupus correlates with markers of inflammatory activity and is a risk factor for cardiovascular disease, said Elisabet Svenungsson, M.D. In fasting blood samples obtained from a cohort of 208 patients, homocysteine levels were associated with acute phase reactants including C-reactive protein, serum amyloid A protein, fibrinogen, and complement.
Hyperhomocysteinemia also correlated with the presence of arterial disease and nephritis. “It may cause endothelial activation and damage and thus adds to the inflammatory burden that we believe renders SLE patients highly susceptible to cardiovascular disease,” she said.
—Nancy Walsh