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Article

Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes

1
Unit of Immunology and Chronic Disease, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
2
Divisions of Renal Medicine, Department of Clinical Science, Intervention and Technology, 14152 Huddinge, Sweden
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 753; https://doi.org/10.3390/jcm9030753
Received: 6 February 2020 / Revised: 24 February 2020 / Accepted: 25 February 2020 / Published: 11 March 2020
(This article belongs to the Section Nephrology & Urology)
Patients on haemodialysis (HD-patients) have an increased risk of premature death. Low levels of IgM antibodies against malondialdehyde (anti-MDA) are associated with increased risk of cardiovascular disease (CVD) with underlying potential mechanisms described. Here, we studied subclasses and isotypes of anti-MDA in 210 HD-patients with mortality as outcome (56% men, median age 66, Interquartile range (IQR) 51–74 years, vintage time 29 (15–58) months, mean follow up period of 41 (20–60)months). Patients were also divided into inflamed c-reactive protein (CRP >5.6 mg/mL) and non-inflamed. Antibody levels were measured by ELISA. In multivariate risk analysis, patients in low tertile of IgM anti-MDA sub-distribution hazard ratio (sHR 0.54); 95% confidence interval (CI: 0.34–0.89) inversely and significantly associated with all-cause mortality after five years, after adjusting for confounders. Low tertile of IgG (sHR 0.48, 95%CI: 0.25–0.90, p = 0.02) and IgG1 (sHR 0.50, CI: 0.24–1.04, p = 0.06) was associated low mortality among non-inflamed patients. In contrast, anti-MDA IgG2 among inflamed patients was significantly associated with increased mortality, IgG2(sHR 2.33, CI: 1.16–4.68, p = 0.01). IgM anti-MDA was a novel biomarker among HD-patients with low levels being associated with mortality, while low levels of IgG and IgG1 but not IgA anti-MDA were associated with mortality only among non-inflamed patients. IgG2 anti-MDA was a significant risk marker among inflamed patients, which could be related to infection. View Full-Text
Keywords: uremia; hemodialysis; mortality; natural antibodies; malondialdehyde uremia; hemodialysis; mortality; natural antibodies; malondialdehyde
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MDPI and ACS Style

Samal, S.K.; Qureshi, A.R.; Rahman, M.; Stenvinkel, P.; Frostegård, J. Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes. J. Clin. Med. 2020, 9, 753. https://doi.org/10.3390/jcm9030753

AMA Style

Samal SK, Qureshi AR, Rahman M, Stenvinkel P, Frostegård J. Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes. Journal of Clinical Medicine. 2020; 9(3):753. https://doi.org/10.3390/jcm9030753

Chicago/Turabian Style

Samal, Shailesh Kumar, Abdul Rashid Qureshi, Mizanur Rahman, Peter Stenvinkel, and Johan Frostegård. 2020. "Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes" Journal of Clinical Medicine 9, no. 3: 753. https://doi.org/10.3390/jcm9030753

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