Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.

PURPOSE:Inflammatory rheumatic diseases (IRD) are associated with accelerated coronary artery disease (CAD), which may result from both systemic and vascular wall inflammation. There are indications that complement may be involved in the pathogenesis of CAD in Systemic Lupus Erythematosus (SLE) and...

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Main Authors: Kelly J Shields, Tom Eirik Mollnes, Jon Roger Eidet, Knut Mikkelsen, Sven M Almdahl, Barbara Bottazzi, Torstein Lyberg, Susan Manzi, Joseph M Ahearn, Ivana Hollan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5375133?pdf=render
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author Kelly J Shields
Tom Eirik Mollnes
Jon Roger Eidet
Knut Mikkelsen
Sven M Almdahl
Barbara Bottazzi
Torstein Lyberg
Susan Manzi
Joseph M Ahearn
Ivana Hollan
author_facet Kelly J Shields
Tom Eirik Mollnes
Jon Roger Eidet
Knut Mikkelsen
Sven M Almdahl
Barbara Bottazzi
Torstein Lyberg
Susan Manzi
Joseph M Ahearn
Ivana Hollan
author_sort Kelly J Shields
collection DOAJ
description PURPOSE:Inflammatory rheumatic diseases (IRD) are associated with accelerated coronary artery disease (CAD), which may result from both systemic and vascular wall inflammation. There are indications that complement may be involved in the pathogenesis of CAD in Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). This study aimed to evaluate the associations between circulating complement and complement activation products with mononuclear cell infiltrates (MCI, surrogate marker of vascular inflammation) in the aortic media and adventitia in IRDCAD and non-IRDCAD patients undergoing coronary artery bypass grafting (CABG). Furthermore, we compared complement activation product deposition patterns in rare aorta adventitial and medial biopsies from SLE, RA and non-IRD patients. METHODS:We examined plasma C3 (p-C3) and terminal complement complexes (p-TCC) in 28 IRDCAD (SLE = 3; RA = 25), 52 non-IRDCAD patients, and 32 IRDNo CAD (RA = 32) from the Feiring Heart Biopsy Study. Aortic biopsies taken from the CAD only patients during CABG were previously evaluated for adventitial MCIs. The rare aortic biopsies from 3 SLE, 3 RA and 3 non-IRDCAD were assessed for the presence of C3 and C3d using immunohistochemistry. RESULTS:IRDCAD patients had higher p-TCC than non-IRDCAD or IRDNo CAD patients (p<0.0001), but a similar p-C3 level (p = 0.42). Circulating C3 was associated with IRD duration (ρ, p-value: 0.46, 0.03). In multiple logistic regression analysis, IRD remained significantly related to the presence and size of MCI (p<0.05). C3 was present in all tissue samples. C3d was detected in the media of all patients and only in the adventitia of IRD patients (diffuse in all SLE and focal in one RA). CONCLUSION:The independent association of IRD status with MCI and the observed C3d deposition supports the unique relationship between rheumatic disease, and, in particular, SLE with the complement system. Exaggerated systemic and vascular complement activation may accelerate CVD, serve as a CVD biomarker, and represent a target for new therapies.
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spelling doaj.art-8a45801315ac494f8d734b26a28381a82022-12-22T03:49:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017457710.1371/journal.pone.0174577Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.Kelly J ShieldsTom Eirik MollnesJon Roger EidetKnut MikkelsenSven M AlmdahlBarbara BottazziTorstein LybergSusan ManziJoseph M AhearnIvana HollanPURPOSE:Inflammatory rheumatic diseases (IRD) are associated with accelerated coronary artery disease (CAD), which may result from both systemic and vascular wall inflammation. There are indications that complement may be involved in the pathogenesis of CAD in Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). This study aimed to evaluate the associations between circulating complement and complement activation products with mononuclear cell infiltrates (MCI, surrogate marker of vascular inflammation) in the aortic media and adventitia in IRDCAD and non-IRDCAD patients undergoing coronary artery bypass grafting (CABG). Furthermore, we compared complement activation product deposition patterns in rare aorta adventitial and medial biopsies from SLE, RA and non-IRD patients. METHODS:We examined plasma C3 (p-C3) and terminal complement complexes (p-TCC) in 28 IRDCAD (SLE = 3; RA = 25), 52 non-IRDCAD patients, and 32 IRDNo CAD (RA = 32) from the Feiring Heart Biopsy Study. Aortic biopsies taken from the CAD only patients during CABG were previously evaluated for adventitial MCIs. The rare aortic biopsies from 3 SLE, 3 RA and 3 non-IRDCAD were assessed for the presence of C3 and C3d using immunohistochemistry. RESULTS:IRDCAD patients had higher p-TCC than non-IRDCAD or IRDNo CAD patients (p<0.0001), but a similar p-C3 level (p = 0.42). Circulating C3 was associated with IRD duration (ρ, p-value: 0.46, 0.03). In multiple logistic regression analysis, IRD remained significantly related to the presence and size of MCI (p<0.05). C3 was present in all tissue samples. C3d was detected in the media of all patients and only in the adventitia of IRD patients (diffuse in all SLE and focal in one RA). CONCLUSION:The independent association of IRD status with MCI and the observed C3d deposition supports the unique relationship between rheumatic disease, and, in particular, SLE with the complement system. Exaggerated systemic and vascular complement activation may accelerate CVD, serve as a CVD biomarker, and represent a target for new therapies.http://europepmc.org/articles/PMC5375133?pdf=render
spellingShingle Kelly J Shields
Tom Eirik Mollnes
Jon Roger Eidet
Knut Mikkelsen
Sven M Almdahl
Barbara Bottazzi
Torstein Lyberg
Susan Manzi
Joseph M Ahearn
Ivana Hollan
Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.
PLoS ONE
title Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.
title_full Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.
title_fullStr Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.
title_full_unstemmed Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.
title_short Plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases.
title_sort plasma complement and vascular complement deposition in patients with coronary artery disease with and without inflammatory rheumatic diseases
url http://europepmc.org/articles/PMC5375133?pdf=render
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