Elevated [11C]-D-Deprenyl Uptake in Chronic Whiplash Associated Disorder Suggests Persistent Musculoskeletal Inflammation

There are few diagnostic tools for chronic musculoskeletal pain as structural imaging methods seldom reveal pathological alterations. This is especially true for Whiplash Associated Disorder, for which physical signs of persistent injuries to the neck have yet to be established. Here, we sought to visualize inflammatory processes in the neck region by means Positron Emission Tomography using the tracer 11C-D-deprenyl, a potential marker for inflammation. Twenty-two patients with enduring pain after a rear impact car accident (Whiplash Associated Disorder grade II) and 14 healthy controls were investigated. Patients displayed significantly elevated tracer uptake in the neck, particularly in regions around the spineous process of the second cervical vertebra. This suggests that whiplash patients have signs of local persistent peripheral tissue inflammation, which may potentially serve as a diagnostic biomarker. The present investigation demonstrates that painful processes in the periphery can be objectively visualized and quantified with PET and that 11C-D-deprenyl is a promising tracer for these purposes

Plasma oxidized LDL, a predictor for acute myocardial infarction?

Objectives. Oxidized LDL has been attributed a key role in the development of atherosclerosis. Previous studies have demonstrated increased plasma levels of oxidized LDL in patients with established coronary artery disease. The aim of the present study was to investigate if plasma oxidized LDL also predicts risk for development of coronary heart disease (CHD). Design. We used a nested case-control design to study the association between plasma levels of oxidized LDL and risk for development of acute myocardial infarction (AMI) and/or death by CHD. Subjects. Oxidized LDL was analysed by ELISA in cases (n = 26), controls (n = 26) and controls with LDL cholesterol >5.0 mmol L1 (n = 26). Results. Oxidized LDL correlated with total plasma and LDL cholesterol in both cases (r = 0.72, P < 0.01, r = 0.69, P < 0.01, respectively) and controls (r = 0.71, P < 0.01, r = 0.77, P < 0.01, respectively). The oxidized LDL/plasma cholesterol ratio was higher amongst cases (13.5, range 10.7-19.8) than in controls (12.6, range 9.5-15.8, P < 0.05) and hypercholesterolaemic controls (12.2, range 8.0-16.0, P < 0.01). Conclusions. These findings identify high plasma oxidized LDL/total cholesterol ratio as a possible indicator of increased risk for AMI

Humoral Immune Response Against Defined Oxidized Low-Density Lipoprotein Antigens Reflects Structure and Disease Activity of Carotid Plaques.

Background - Immune responses against oxidized low- density lipoprotein ( LDL) play an important role in atherosclerosis. The aim of this study was to investigate if humoral immune response against specific oxidized LDL antigens, such as aldehyde- modified peptide sequences of apolipoprotein B- 100, reflects disease activity and structure of atherosclerotic plaques. Methods and Results - Plaques were obtained from 114 symptomatic subjects referred to carotid endarterectomy and characterized immunohistochemically and histologically. Plasma levels of IgG and IgM against aldehyde- modified apolipoprotein B- 100 amino acid sequences 661 to 680, 3136 to 3155 ( peptide 210), and 3661 to 3680 ( peptide 240) were determined by enzyme- linked immunosorbent assay. High levels of IgG against peptide 210 were associated with increased plaque content of lipids ( r = 0.24, P < 0.05) and hemorrhage ( r = 0.27, P = 0.005), with decreased content of fibrous tissue ( r = - 0.25, P = 0.01), but also with lower total plaque volume ( r = - 0.21, P < 0.05). In contrast, high levels of IgM against peptide 240 were associated with plaques with more fibrous tissue ( r = 0.35, P < 0.001), less lipids ( r = - 0.34, P < 0.001), and less macrophages ( r = - 0.24, P < 0.05). IgM against peptide 210 were found to be associated with plaque fibrous tissue ( r = 0.20, P < 0.05), less lipids ( r = - 0.21, P < 0.05), and less macrophages ( r = - 0.27, P = 0.01). Conclusion - These findings support the notion that immune responses against oxidized LDL epitopes are involved in atherosclerosis and that the level of circulating antibodies against these structures may reflect disease activity in the arterial wall

Identification of immune responses against aldehyde-modified peptide sequences in apolipoprotein B associated with cardiovascular disease

Objective- Atherosclerosis is associated with an immune response against oxidized LDL, which modulates the progression of the disease process. Methods and Results- Using a library of polypeptides covering the complete sequence of apoB-100, the only major protein of LDL, we have identified over 100 different human antibodies reacting against aldehyde-modified apoB-100 sequences. IgM antibody titer levels decreased with age and were associated with the intima-media thickness of the carotid artery in subjects younger than 60 years. There were also inverse associations between IgM levels and oxidized LDL in plasma. In prospective clinical studies, antibody levels against several aldehyde-modified apoB-100 sites were associated with cardiovascular disease in this age group. Whether this immune response is adaptive (protective) or maladaptive (causal) in atherosclerosis requires further investigation. Conclusions- We have characterized a large number of epitopes within the apoB-100 component of oxidized LDL that provoke an immune response in humans. These findings will make it possible to study the role of immune responses against specific sites in oxidized LDL and to determine whether these immune responses influence the risk for future cardiac events