Purpose: It was confirmed experimentally that antiendothelial cell antibodies (AECA) react directly with the vascular endothelium and are involved in the pathogenesis of vasculitis. There is evidence for a role of AECA in atherosclerosis. To search for correlations between intima-media thickness (IMT) and high titer of AECA in patients with systemic lupus erythematosus (SLE).
Material and methods: IMT of carotid arteries was measured with B-mode ultrasound in 103 SLE patients and 30 healthy subjects (control group). The presence of AECA was determined with indirect immunofluorescence using human umbilical vein endothelial cells as target. Statistical analysis was performed with chi2 Yates, chi2 Pearson, R Spearman rank test, and logistic multivariate regression analysis.
Results: Normal IMT (< or = 0.65 mm) was found in 34 patients. In 52 patients, IMT was 0.66-0.86 mm and in 17 it exceeded 0.86 mm. The difference in comparison with the control group was significant (p = 0.0002). High titers of AECA were significantly more frequent in patients with SLE than in controls (p = 0.0001). In SLE patients, high titers of AECA correlated with IMT greater than 0.86 mm (OR = 6.61; 95% CI: 1.6-28.3).
Conclusions: The presence of antiendothelial cell antibodies is a risk factor for premature, subclinical atherosclerosis in patients with SLE.