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Summary Oxidized low-density lipoprotein (OxLDL) plays a crucial role in the development of atherosclerosis. Carbamylated LDL has been suggested to promote atherogenesis in patients with chronic kidney disease. Here we observed that plasma IgG and IgM antibodies to carbamylated epitopes were associated with IgG and IgM antibodies to oxidation-specific epitopes (ρ = 0·65–0·86, P

Malondialdehyde acetaldehyde (MAA) adducts are generated under oxidative stress and shown to be highly immunogenic. Our aim was to investigate the recognition of MAA adducts by human natural antibodies in newborns before or at the time of full-term pregnancy. Plasma samples of pre-term (n = 11) and full-term (n = 36) newborns were enriched in specific IgM binding to MAA adducts compared with the maternal plasma IgM levels. Umbilical cord blood lymphocyte phage display library was generated to clone Fabs that specifically recognized MAA adducts without cross-reactivity to malondialdehyde. Fab clones from the antibody libraries of the pre-term and full-term newborns showed high sequence homology to the germline genes encoding the variable regions of antibodies, confirming that these Fabs represented the natural antibody repertoire of human fetuses. The MAA-specific umbilical cord blood Fabs bound to apoptotic human endothelial cells and the binding was efficiently competed with MAA adducts. The MAA-specific Fabs also recognized epitopes on advanced atherosclerotic lesions, and the uptake of infrared (IR)-labeled MAA-low-density lipoprotein by mouse J774A.1 macrophages was significantly reduced in the presence of these Fabs. In conclusion, MAA adducts were identified as one of the major antigenic targets for human natural antibodies already before the time of birth. MAA-specific natural antibodies are suggested to regulate apoptotic cell clearance starting from fetal development and to participate in the immunomodulation of atherosclerosis development during adulthood.

Objective Increased risk for atherosclerosis is associated with infectious diseases including periodontitis. Natural IgM antibodies recognize pathogen-associated molecular patterns on bacteria, and oxidized lipid and protein epitopes on low-density lipoprotein (LDL) and apoptotic cells. We aimed to identify epitopes on periodontal pathogen Porphyromonas gingivalis recognized by natural IgM binding to malondialdehyde (MDA) modified LDL. Methods and Results Mouse monoclonal IgM (MDmAb) specific for MDA-LDL recognized epitopes on P. gingivalis on flow cytometry and chemiluminescence immunoassays. Immunization of C57BL/6 mice with P. gingivalis induced IgM, but not IgG, immune response to MDA-LDL and apoptotic cells. Immunization of LDLR−/− mice with P. gingivalis induced IgM, but not IgG, immune response to MDA-LDL and diminished aortic lipid deposition. On Western blot MDmAb bound to P. gingivalis fragments identified as arginine-specific gingipain (Rgp) by mass spectrometry. Recombinant domains of Rgp produced in E. coli were devoid of phosphocholine epitopes but contained epitopes recognized by MDmAb and human serum IgM. Serum IgM levels to P. gingivalis were associated with anti-MDA-LDL levels in humans. Conclusion Gingipain of P. gingivalis is recognized by natural IgM and shares molecular identity with epitopes on MDA-LDL. These findings suggest a role for natural antibodies in the pathogenesis of two related inflammatory diseases, atherosclerosis and periodontitis.

Plasma oxidized low-density lipoprotein (OxLDL) is known to be associated with obesity, metabolic syndrome, and diabetes.The objective of the study was to investigate the association between plasma IgA, IgM, and IgG titers to OxLDL, phosphocholine (PC), and streptococcal cell wall polysaccharide (CWPS) and markers of glucose metabolism, type 2 diabetes, and liver adiposity.A population-based cohort of middle-aged Finns (n = 1039) participated in the study.Plasma IgM, IgG, and IgA to copper oxidized LDL (CuOx-LDL) and malondialdehyde-modified low-density lipoprotein (MDA-LDL), PC, and CWPS were determined with chemiluminescent ELISA and liver adiposity with ultrasonography.IgA autoantibody titers to OxLDL and PC, but not CWPS, were positively associated with fasting blood glucose and plasma insulin levels and inversely with insulin sensitivity index. IgA to OxLDL was significantly higher (P = 0.013 for CuOx-LDL and P = 0.016 for MDA-LDL) and IgG to OxLDL significantly lower (P = 0.036 for CuOx-LDL and P = 0.001 for MDA-LDL) among the subjects with type 2 diabetes compared with subjects with normal or impaired glucose metabolism when adjusted for age, sex, body mass index, smoking, and alcohol consumption. Logistic regression analysis showed that high plasma IgA to OxLDL and low IgG to MDA-LDL were independent risk factors for type 2 diabetes. Plasma IgA titers to OxLDL demonstrated a significant association with liver adiposity (P = 0.012) and gamma-glutamyltransferase levels (P = 0.002).Plasma IgA titers to OxLDL were positively and IgG titers negatively associated with markers of glucose metabolism. High plasma IgA and low IgG to OxLDL were independent risk factors for type 2 diabetes.