Higher Cardiovascular Risk in Common Variable Immunodeficiency and X-Linked Agammaglobulinaemia Patients

Vieira, Daniele Gonçalves; Costa‐Carvalho, Beatriz Tavares; Hix, Sonia; Silva, Rosangela da; Correia, Milena; Sarni, Roseli Oselka Saccardo

doi:10.1159/000435818

Cited by 16 publications

(19 citation statements)

References 33 publications

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“…Other inflammation markers, SAA and ferritin concentrations, were also increased in the patients, but this increase was not statistically significant (P ¼ 0.110, P ¼ 0.716). Vieira et al 29 showed that CVID patients had presented themselves with increased inflammatory markers -CRP (P ¼ 0.008) and TNF-alpha (P < 0.001) concentrations were significantly higher.…”

Section: Discussionmentioning

confidence: 98%

“…Lipid profile changes are well-known risk factors for adult coronary artery diseases, but we can find only a few research works for CVID. Vieira et al 29 investigated the lipid profile and other cardiovascular risk biomarkers in CVID. HDL-cholesterol (P ¼ 0.025) and apolipoprotein A-I (P ¼ 0.013) concentrations were significantly lower in patients which can predispose to a high cardiovascular risk and there was a negative correlation between HDL-cholesterol and triglyceride (r ¼ À0.641; P ¼ 0.001) concentrations.…”

Section: Discussionmentioning

confidence: 99%

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Chitotriosidase enzyme activity: is this a possible chronic inflammation marker in children with common variable immunodeficiency and early atherosclerosis?

et al. 2017

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Background Common variable immunodeficiency is a rare clinically symptomatic primary immunodeficiency disorder which manifests a wide variability of symptoms, complications. Atherosclerosis in common variable immunodeficiency patients has not been investigated yet contrary to other severe clinical complications. We aimed to investigate the chitotriosidase enzyme's role as an inflammation and atherosclerosis marker in paediatric common variable immunodeficiency patients. Methods Common variable immunodeficiency patients (n = 24) and healthy controls (n = 23) evaluated for chitotriosidase activity with other inflammation markers (hsCRP, myeloperoxidase, serum amyloid A, ferritin), lipid profile and echocardiographic findings (carotid artery intima media thickness - cIMT, brachial artery flow-mediated vazodilatation - FMD%). Results In patients, the mean chitotriosidase activity (8.98 ± 6.28) was significantly higher than the controls (5.17 ± 3.42) ( P = 0.014). Chitotriosidase showed positive relation with hs-CRP ( P = 0.011) and SAA ( P = 0.011) but had no relation with ferritin ( P = 0.155), HDL ( P = 0.152) or LDL-cholesterol ( P = 0.380). Mean cIMT increased in patients compared with the controls ( P < 0.001) but did not show any relation with chitotriosidase ( P = 0.546). FMD% decreased in patients ( P < 0.001) also showing no relation with chitotriosidase ( P = 0.298). Ventricular myocardial performance indexes had no significant difference, but RVEF% decreased in patients ( P = 0.043). Conclusions High chitotriosidase activity in common variable immunodeficiency patients demonstrated in vivo the presence of activated macrophages indicating ongoing inflammation. Echocardiographic diastolic functional deficiency, increased cIMT and decreased FMD% may be accepted as early atherosclerotic findings, but none of them showed relationship with chitotriosidase activities.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Chitotriosidase enzyme activity: is this a possible chronic inflammation marker in children with common variable immunodeficiency and early atherosclerosis?

et al. 2017

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“…Inflammation parameters, such as TNF-alpha, CRP and IL-6 are also known to play an effective role in the pathogenesis of atherosclerosis which is a chronic disease. In addition, apo-A and high-density lipoprotein cholesterol levels and chronic inflammation were lower in this patient group (21). When evaluated with this evidence, atherosclerotic heart disease was considered to have started at an early stage in CVID patients and was thought to display a rapid course.…”

Section: Discussionmentioning

confidence: 86%

“…In CVID patients, the disease is usually diagnosed within about 8 years after first symptoms, and this diagnostic delay results in delayed initiation of standard treatments (immunoglobulin), thereby increasing (19). Although the life expectancy of CVID patients increases with improved treatment methods, the presence of chronic inflammation leads to the development of different diseases in this patient group (20,21). In CVID patients, TNFalpha and CRP levels were found to be higher as indicators of chronic inflammation compared to healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

“…In CVID patients, TNFalpha and CRP levels were found to be higher as indicators of chronic inflammation compared to healthy subjects. The clinical presentation of this disease is known to be more severe in patients with high inflammation parameters (21,22). Inflammation parameters, such as TNF-alpha, CRP and IL-6 are also known to play an effective role in the pathogenesis of atherosclerosis which is a chronic disease.…”

Section: Discussionmentioning

confidence: 99%

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Electrocardiographic Alterations in Patients with Common Variable Immune Deficiency

Alsancak¹,

Çölkesen²

2020

Istanbul Med J

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Amaç: Ortak değişken immün yetmezlik (CVID), antikor eksikliği sendromları arasında en heterojen gruptur, ancak kardiyovasküler sistem üzerindeki etkileri henüz net bir şekilde tanımlanamamıştır. Burada, bu hastalığın olası aritmojenik etkilerini, elektrokardiyografi ile değerlendirmeyi amaçladık. Yöntemler: Çalışmaya 30 CVID hastası ile yaş ve komorbiditeleri eşleşen 30 gönüllü kontrol grubu dahil edildi. Tüm katılımcıların elektrokardiyografik ve ekokardiyografik değerleri kaydedildi. QRS, QT, Tp-e manuel olarak ölçüldü. QTc, Bazett formülü kullanılarak hesaplandı. Daha sonra, Tp-e/QT, Tp-e/QTc, QT/QRS ve QTc/QRS oranları hesaplandı ve gruplar arasında karşılaştırılma yapıldı. Bulgular: CVID grubunda PR aralığı ve P dalga dispersiyonu daha yüksek bulundu. Ayrıca, QT aralığı ve düzeltilmiş QT aralığı, T peak-to-end interval, CVID kolunda daha yüksekti ve QT/QRS oranı ile elde edilen kardiyak elektrofizyolojik denge indeksi değeri CVID grubunda da daha yüksekti. CVID grubunda P terminal kuvveti olan hasta sayısı da daha fazla idi. Sonuç: Bu çalışma sonucunda, CVID hastalarının normal sağlıklı bireylere göre aritmi gelişme sıklığının daha yüksek olabileceği bulunmuştur.

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Increased Plasma Levels of Triglyceride-Enriched Lipoproteins Associate with Systemic Inflammation, Lipopolysaccharides, and Gut Dysbiosis in Common Variable Immunodeficiency

et al. 2023

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Purpose Triglycerides (TG) and their major transport lipoprotein in the circulation (VLDL) appear to be related to inflammation. Patients with common variable immunodeficiency (CVID) have inflammatory complications associated with gut microbial dysbiosis. We hypothesized that CVID patients have disturbed TG/VLDL profiles associated with these clinical characteristics. Methods We measured plasma concentrations of TGs, inflammatory markers, and lipopolysaccharide (LPS) in 95 CVID patients and 28 healthy controls. Additionally, in 40 CVID patients, we explored plasma lipoprotein profiling, fatty acid, gut microbial dysbiosis, and diet. Results TG levels were increased in CVID patients as compared to healthy controls (1.36 ± 0.53 mmol/l versus 1.08 ± 0.56 [mean, SD], respectively, P = 0.008), particularly in the clinical subgroup “Complications,” characterized by autoimmunity and organ-specific inflammation, compared to “Infection only” (1.41 mmol/l, 0.71[median, IQR] versus [1.02 mmol/l, 0.50], P = 0.021). Lipoprotein profile analyses showed increased levels of all sizes of VLDL particles in CVID patients compared to controls. TG levels correlated positively with CRP (rho = 0.256, P = 0.015), IL-6 (rho = 0.237, P = 0.021), IL-12 (rho = 0.265, P = 0.009), LPS (r = 0.654, P = 6.59 × 10−13), CVID-specific gut dysbiosis index (r = 0.315, P = 0.048), and inversely with a favorable fatty acid profile (docosahexaenoic acid [rho = − 0.369, P = 0.021] and linoleic acid [rho = − 0.375, P = 0.019]). TGs and VLDL lipids did not appear to be associated with diet and there were no differences in body mass index (BMI) between CVID patients and controls. Conclusion We found increased plasma levels of TGs and all sizes of VLDL particles, which were associated with systemic inflammation, LPS, and gut dysbiosis in CVID, but not diet or BMI.

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Higher Cardiovascular Risk in Common Variable Immunodeficiency and X-Linked Agammaglobulinaemia Patients

Cited by 16 publications

References 33 publications

Chitotriosidase enzyme activity: is this a possible chronic inflammation marker in children with common variable immunodeficiency and early atherosclerosis?

Chitotriosidase enzyme activity: is this a possible chronic inflammation marker in children with common variable immunodeficiency and early atherosclerosis?

Electrocardiographic Alterations in Patients with Common Variable Immune Deficiency

Increased Plasma Levels of Triglyceride-Enriched Lipoproteins Associate with Systemic Inflammation, Lipopolysaccharides, and Gut Dysbiosis in Common Variable Immunodeficiency

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