Associação de anticorpos naturais à autoantígenos derivados da apolipoproteína B na evolução do infarto agudo do miocárdio
Data
2022-07
Autores
Fakhouri, Tereza Luiza Bellincanta [UNIFESP]
Orientadores
Fonseca, Henrique Andrade Rodrigues
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Avaliar a modulação de autoanticorpos IgM e IgG anti-ApoB-A, anticorpos totais IgM e IgG e interleucina 10 em pacientes com infarto agudo do miocárdio com e sem supra desnivelamento do segmento ST.
Materiais e Métodos: Estudo de coorte prospectivo, unicêntrico com inclusão consecutiva de pacientes apresentando infarto agudo do miocárdio apresentando (IAMCSST) ou, não apresentando o supradesnivelamento do segmento ST (IAMSSST) de ambos os sexos. O segmento do estudo foi de 42 dias após admissão hospitalar. Amostras de sangue de 12 horas de jejum desses foram coletadas para análise laboratorial de colesterol total, HDL-c, LDL-c, triglicérides e glicose através de método enzimático. Também avaliamos os títulos de autoanticorpos anti-ApoB-A peptide, anticorpos totais e interleucina 10 através do método de Enzyme-linked Immunosorbent Assay. Antes da alta hospitalar todos os pacientes foram submetidos a angiografia coronariana para avaliação da extensão e gravidade da aterosclerose coronariana. Utilizamos o teste de Kolgomorov-Smirnov para verificação da homogeneidade da amostra, qui-quadrado para comparação de variáveis categóricas. Test T de Student ou Mann-Whitney foram utilizados para comparação de variáveis entre dois grupos, com p<0,05.
Resultados: 112 pacientes, sendo 65% do sexo masculino e 33,9% apresentavam IAMCSST. Os dados foram comparáveis no momento de admissão, apenas os títulos de anticorpos IgM total foi menor no grupo com supra e maior no grupo sem supra (p<0,05). Os títulos de autoanticorpos IgM anti-ApoB-A ao longo do seguimento apresentou elevação (P<0,05), enquanto foi observado uma redução nos títulos de IgM total no plasma (P<0,05), em ambos os grupos ao longo do seguimento de 42 dias. Interessantemente, não foram observados modulações ao longo do seguimento nos títulos de anticorpos totais e autoanticorpos IgG anti-ApoB-A.. As alterações nos títulos de autoanticorpos IgM anti-ApoB-A não apresentaram correlações com a gravidade da aterosclerose avaliada pelo Gensine Score.
Conclusão: O presente estudo revela que uma nova região conservada da sequência da apolipoproteína B, denominada como ApoB-A, pode ser reconhecida pela resposta imune humoral natural ao longo do curso natural do infarto agudo do miocárdio.
Abstract Objectives: To evaluate the modulation of anti-ApoB-A IgM and IgG autoantibodies, total IgM and IgG antibodies and interleukin 10 in patients with acute myocardial infarction with and without ST segment elevation. Materials and Methods: Prospective, single-center cohort study with consecutive inclusion of patients with acute myocardial infarction presenting (STEMI) or not presenting ST-segment elevation (NSTEMI) of both sexes. The study segment was 42 days after hospital admission. Blood samples after 12 hours of fasting were collected for laboratory analysis of total cholesterol, HDL-c, LDL-c, triglycerides and glucose using an enzymatic method. We also evaluated the titers of anti-ApoB-A peptide autoantibodies, total antibodies and interleukin 10 using the Enzyme-linked Immunosorbent Assay method. Before hospital discharge, all patients underwent coronary angiography to assess the extent and severity of coronary atherosclerosis. We used the Kolgomorov-Smirnov test to verify the homogeneity of the sample, chi-square to compare categorical variables. Student's T test or Mann-Whitney test were used to compare variables between two groups, with p<0.05. Results: 112 patients, 65% male and 33.9% had STEMI. Data were comparable at the time of admission, only total IgM antibody titers were lower in the group with supra and higher in the group without supra (p<0.05). Anti-ApoB-A IgM autoantibody titers during follow-up showed an increase (P<0.05), while a reduction in plasma total IgM titers (P<0.05) was observed in both groups throughout the follow-up period of the 42-day follow-up. Interestingly, no modulations were observed over follow-up in total antibody titers and IgG anti-ApoB-A autoantibodies. Changes in IgM anti-ApoB-A autoantibody titers did not correlate with the severity of atherosclerosis assessed by the Gensine Score. Conclusion: The present study reveals that a new conserved region of the apolipoprotein B sequence, called ApoB-A, can be recognized by the natural humoral immune response throughout the natural course of acute myocardial infarction.
Abstract Objectives: To evaluate the modulation of anti-ApoB-A IgM and IgG autoantibodies, total IgM and IgG antibodies and interleukin 10 in patients with acute myocardial infarction with and without ST segment elevation. Materials and Methods: Prospective, single-center cohort study with consecutive inclusion of patients with acute myocardial infarction presenting (STEMI) or not presenting ST-segment elevation (NSTEMI) of both sexes. The study segment was 42 days after hospital admission. Blood samples after 12 hours of fasting were collected for laboratory analysis of total cholesterol, HDL-c, LDL-c, triglycerides and glucose using an enzymatic method. We also evaluated the titers of anti-ApoB-A peptide autoantibodies, total antibodies and interleukin 10 using the Enzyme-linked Immunosorbent Assay method. Before hospital discharge, all patients underwent coronary angiography to assess the extent and severity of coronary atherosclerosis. We used the Kolgomorov-Smirnov test to verify the homogeneity of the sample, chi-square to compare categorical variables. Student's T test or Mann-Whitney test were used to compare variables between two groups, with p<0.05. Results: 112 patients, 65% male and 33.9% had STEMI. Data were comparable at the time of admission, only total IgM antibody titers were lower in the group with supra and higher in the group without supra (p<0.05). Anti-ApoB-A IgM autoantibody titers during follow-up showed an increase (P<0.05), while a reduction in plasma total IgM titers (P<0.05) was observed in both groups throughout the follow-up period of the 42-day follow-up. Interestingly, no modulations were observed over follow-up in total antibody titers and IgG anti-ApoB-A autoantibodies. Changes in IgM anti-ApoB-A autoantibody titers did not correlate with the severity of atherosclerosis assessed by the Gensine Score. Conclusion: The present study reveals that a new conserved region of the apolipoprotein B sequence, called ApoB-A, can be recognized by the natural humoral immune response throughout the natural course of acute myocardial infarction.