Page 12 - N&V Winter 2019

End of Grant Report to LUPUS UK

Prof. I.Giles and Prof. A.rahman

How are adverse pregnancy outcomes and Factor (F)Xa reactive
IgG associated with cardiovascular disease (CVD) and endothelial
dysfunction in patients with systemic lupus erythematosus (SLE)?

Patients with systemic lupus erythematosus produced to fight infection. In SLE however, between these sub-groups. Of the MPs
(SLE) have an increased risk of developing an over-activation of the immune system studied only platelet MPs were found to be
heart attacks and strokes, known as cardio- leads to production of autoantibodies that higher in patients with SLE compared to
vascular disease (CVD), and pregnancy target healthy tissue, such as skin or kidneys healthy controls (p=0.025) but these raised
complications, such as miscarriage, and thus cause disease. In SLE, autoanti- levels did not distinguish the presence of
compared to the general population. In the bodies have been identified against plaque. We did not find an association
general population pregnancy compli- various parts of the body including blood between pregnancy complications and
cations and CVD may share common causes clotting factors Factor Xa (FXa) and subclinical CVD but almost half the women
because women with a past-history of thrombin (Thr). In the general population (45%) with SLE had no children, more than
pregnancy complications have an increased FXa and Thr are thought to contribute to double the rate expected in UK women of
risk of developing CVD later on in life. In the thickening of blood vessels, in a process the same mean age. A total of 61% had
SLE however, typical risk factors for CVD, known as atherosclerotic plaque formation, APO (adverse pregnancy outcomes) and
such as smoking and high cholesterol, do which leads to CVD. So we examined rates of miscarriage were higher (31%)
not fully explain its increased risk so we whether autoantibodies against FXa or Thr than in the general population (15-20%). A
examined whether other factors may be are also associated with CVD in SLE. We systematic review of relevant published
important in this project. also tested whether MPs shed by cells that work showed an overall reduction in
We examined whether certain atypical line blood vessels (endothelial cells), or fertility and parity in women with SLE but
factors were associated with the presence circulating blood cells (platelets, involved in could not identify the cause. In our study of
of early CVD that had been detected in clotting) were associated with CVD in SLE. low bone mineral density we found 81% of
blood vessels by ultrasound scans in In 100 patients with SLE who had patients had available bone density scans
patients with SLE who did not have any undergone ultrasound imaging of blood and 65% had thin bones but that was not
symptoms of CVD, known as subclinical vessels we found 36 had increased associated with presence of subclinical CVD.
CVD. These factors included a past history thickening of blood vessels walls, known as The main findings of this work are that
of pregnancy problems, certain immune atherosclerotic plaque and 64 had no anti-FXa autoantibodies are found less
and cellular factors and the presence of plaque. Overall, 95% were female with a commonly in patients with subclinical CVD
osteoporosis (or thin bones) that has also mean age of 45.2 years. Anti-FXa and that these patients have an increased
been linked with the development of CVD autoantibodies were found in 44% and risk of adverse pregnancy outcomes and
in the general population.
anti-Thr autoantibodies in 31% of all 100 reduced family size. Further LUPUS UK
The immune and cellular factors we studied SLE patients. Anti-FXa autoantibodies were funded research is now underway to
were linked to activation of the immune found more frequently in 33/64 (52%) of understand how anti-FXa autoantibodies
system causing autoantibody formation and patients without plaque compared with influence disease features in SLE and
cellular products known as microparticles 11/36 (31%) of patients with plaque exactly how pregnancy impacts upon
(MP). Antibodies are products of the (p=0.04), whilst there was no difference in patients with SLE.
normal immune system that are normally the presence of anti-Thr autoantibodies

LUPUS UK Legacy Guide

The Guide describes what is vital in the writing of a will and what can happen if people fail to
record their wishes correctly. Almost 50% of adults have not made a will and their estates could
thus be disposed of in a way that would not have met with their wishes.
The luPus uK legacy Guide does not attempt to offer a comprehensive summary of legacy options
nor does it try to make a thorough and exhaustive resume of present law regarding the drawing-up of
a will. The Guide is a first step; there is no substitute for taking properly qualified advice on such an
important issue.
If you would like a copy please contact National Office on
01708 731251

Use the Awareness Leaflet enclosed to order your

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luPus uK NEWS & VIEWS SUMMER 2019