Researchers identified ApoB:A1 ratio and metabolomic lipoprotein signatures as possible novel biomarkers to predict cardiovascular risk in juvenile systemic lupus erythematosus, according to data presented at the EULAR Annual Congress.
“Patient stratification using these biomarkers could provide an opportunity for tailored disease treatments using lipid modification therapy and lifestyle interventions,” George Robinson, MD, of the department of rheumatology and the Centre for Adolescent Rheumatology at University College London, said in a press release.
Robinson and colleagues investigated dyslipidemia and other cardiovascular outcomes in a cohort of 35 patients who had been matched with 39 age- and gender-matched healthy controls. They performed metabolic biomarker analysis and in-depth immune cell phenotyping on both serum and peripheral blood mononuclear cells. A third validation cohort comprised 31 juvenile SLE patients.
Unbiased hierarchical clustering showed the presence of three stratified groups based on metabolomic profiles. Each of these groups demonstrated unique lipoprotein profiles, along with immune cell phenotypes and clinical presentation.
The first group was marked by decreased atheroprotective HDL, along with and increased atherogenic very LDL and LDL, according to the findings. Features of the second group included high HDL but lower very LDL and LDL. The researchers suggested that the first group could be at a high risk for cardiovascular outcomes, and the second group at lower risk. Regarding the third group, an intermediate cardiovascular risk profile with a pro-inflammatory immune cell profile were the primary characteristics.
A key distinction between the first and second groups was ApoB:A1 ratio, which the researchers suggested may serve as a predictive biomarker of high and low cardiovascular risk (ROC area under the curve > 0.99). Longitudinal analysis results indicated that this ratio had stability over time.
Robinson and colleagues noted that the atherogenic index of plasma, ApoB:A1 ratios, and lipid biomarkers had previously been associated with atherosclerotic plaque in adult individuals with SLE.
Findings from the current study showed that patients in the first group had significantly higher plasmablasts and activated T-cells compared with controls. Moreover, clinical features in this group were associated with an increase in disease activity. The researchers failed to observe these immunopathogenic properties in the second group. —by Rob Volansky
Robinson G, et al. OP0148. Presented at: EULAR Annual Congress; June 12-15, 2019; Madrid.
Disclosure: Robinson reports no relevant financial disclosures.