Respuesta autoinmune sistémica en pacientes con aterosclerosis coronaria
2005
Se ha sugerido la existencia de un papel de la autoinmunidad en la aterosclerosis. Se realizo este trabajo para determinar si una respuesta autoinmune sistemica, caracterizada por la presencia de anticuerpos antinucleares (ANA), factor reumatoideo (FR) y alteraciones de las inmunoglobulinas sericas (Igs) esta asociada con la aterosclerosis coronaria. Se estudio el suero de 2 grupos de pacientes; 41 sujetos con al menos 50 % de estenosis en las 3 arterias coronarias principales (EAC) y 26 sujetos sin evidencia de lesiones coronarias (NEAC) determinada mediante angiografia coronaria. Se determinaron los ANA mediante inmunofluorescencia en secciones criostaticas de higado de rata; el FR por fijacion en latex y la cuantificacion de IgG, IgA e IgM por inmunoturbidimetria. Se hallo que la frecuencia de autoanticuerpos detectados en el grupo EAC resulto muy similar a la del grupo NEAC (ANA: 17 % vs. 15 %, p = 0,856; FR: 7 % vs. 4 %, p = 0,559). Se comprobo que las diferencias de los valores promedio de las inmunoglobulinas sericas entre ambos grupos de pacientes no fueron estadisticamente significativas (IgG: 12,4 g/L vs. 13,0 g/L; IgA: 3,6 g/L vs. 3,6 g/L; IgM: 1,2 g/L vs. 1,4 g/L; p = 0,328, p = 0,946, p = 0.157, respectivamente).Se concluyo que segun los resultados, la presencia de ANA, FR y concentraciones anormales de Igs sericas carecen de utilidad para identificar sujetos con aterosclerosis avanzada. It has been suggested that autoimmunity plays a role in atherosclerosis. The aim of this paper was to determine wether a systemic autoimmune response, characterized by the presence of antinuclear antibodies (ANA), rheumatoid factor (RF) and alterations of serum immunglobulins (Igs), is associated with coronary atherosclerosis. The serum of 2 groups of patients was studied; 41 subjects with at least 50 % of stenosis in the 3 main coronary arteries (SCA) and 26 subjects with no evidence of coronary injuries (NECI) determined by coronary angiography. The antinuclear antibodies were determined by immunofluorescence in cryostatic sections of rat liver; the rheumatic factor by fixation in latex and the quantification of IgG, IgA and IgM by immunoturbidimetry. It was found that the frequency of autoantibodies detected in the SCA group proved to be similar to that of the NECAI group (ANA: 17 % vs. 15 %, p = 0,856; RF: 7 % vs. 4 %, p = 0,559). It was shown that the differences of the mean values of serum immunoglobulins between both groups of patients were not statistically significant (IgG: 12,4 g/L vs. 13,0 g/L; IgA: 3,6 g/L vs. 3,6 g/L; IgM: 1,2 g/L vs. 1,4 g/L; p = 0,328, p=0,946,p= 0.157, respectively). According to the results, it was concluded that the presence of ANA, RF and abnormal concentrations of serum Igs were not useful to identify individuals with advanced atherosclerosis.
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