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Journal of Lipid Research, Vol. 47, 2208-2214, October 2006
Copyright © 2006 by American Society for Biochemistry and Molecular Biology

Autoantibody titers against OxLDL are correlated with Achilles tendon thickness in patients with familial hypercholesterolemia

Sofia G. Tsouli^*, Dimitrios N. Kiortsis, Evangelia S. Lourida, Vasilios Xydis^**, Loukas D. Tsironis, Maria I. Argyropoulou^**, Moses Elisaf^* and Alexandros D. Tselepis^1,

^* Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
Laboratory of Physiology, Medical School, University of Ioannina, 45110 Ioannina, Greece
Laboratory of Biochemistry, Department of Chemistry, Medical School, University of Ioannina, 45110 Ioannina, Greece
^** Department of Radiology, Medical School, University of Ioannina, 45110 Ioannina, Greece

Published, JLR Papers in Press, August 3, 2006.

¹ To whom correspondence should be addressed. e-mail: atselep{at}uoi.gr

Achilles tendon xanthomas are associated with increased cardiovascular risk in patients with familial hypercholesterolemia (FH). Oxidized low density lipoprotein (OxLDL), the antibodies against OxLDL, and the LDL-associated phospholipase A₂ (Lp-PLA₂) may play important roles in atherogenesis. We investigated the possible association between plasma levels of OxLDL, Lp-PLA₂ activity, and autoantibody titers against various types of mildly OxLDL with Achilles tendon thickness (ATT). ATT was determined by sonography in 80 unrelated heterozygous FH patients. Three different types of mildly OxLDL were prepared: OxLDL_L, OxLDL_P, and OxLDL_D, at the end of the lag, propagation, and decomposition phases of oxidation, respectively. Similar types of OxLDL were also prepared after inactivation of the LDL-associated Lp-PLA₂. These types were denoted OxLDL(–)_L, OxLDL(–)_P, and OxLDL(–)_D. FH patients exhibited significantly higher plasma OxLDL levels and serum IgG titers against OxLDL_P and OxLDL_D compared with 40 normolipidemic apparently healthy controls. ATT values were positively correlated with autoantibody titers against OxLDL_P and OxLDL_D; however, in multiple regression analysis, ATT was independently associated only with the autoantibody titers against OxLDL_D. We conclude that the IgG autoantibody titers against OxLDL_D but not OxLDL or Lp-PLA₂ may play an important role in the pathogenesis of Achilles tendon xanthomas in FH patients.

Supplementary key words antibody • oxidized low density lipoprotein • platelet-activating factor acetylhydrolase • phospholipase A₂

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