Anti-endothelial cell antibodies are associated with peripheral arterial disease and markers of endothelial dysfunction and inflammation

Our aim is to describe the effect of circulating anti-endothelial cell antibodies on the endothelial dysfunction, inflammation and early structural changes of the vascular wall that surround peripheral arterial disease. For this purpose, an observational translational controlled study was carried out. We included 32 patients with symptomatic peripheral arterial disease and 16 healthy control individuals with no previous autoimmune disease. We assessed the flow-mediated arterial dilatation as a marker of endothelial function, the carotid intima-media thickness and the plasma levels of C-reactive protein in all the subjects. Circulating anti-endothelial cell antibodies were detected with indirect immunofluorescence. We found a higher prevalence of these autoantibodies in patients than in controls (40% vs. 6%; P=0.01). Flow-mediated arterial dilatation was lower in subjects with anti-endothelial cell antibodies [3.10% (0-5.05%) vs. 12.54% (6.74-18.40%); P<0.01]. Carotid intima-media thickness [1.04 (0.78-1.17) vs. 0.72 (0.54-1.02) mm; P=0.01] and C-reactive protein level [10.00 (3.50-14.80) vs. 3.00 (3.00-6.95) mg/l; P=0.01] were higher in subjects seropositive for these autoantibodies. We concluded that circulating anti-endothelial cell antibodies could be associated with peripheral arterial disease in individuals with no previous autoimmune disease; however, further prospective studies are required to establish a causal relationship.