Hydroxychloroquine increased cholesterol transfer to high-density lipoprotein in systemic lupus erythematosus : A possible mechanism for the reversal of atherosclerosis in the disease

INTRODUCTION: The beneficial effect of hydroxychloroquine (HCQ) in decreasing LDL levels on Systemic Lupus Erythematosus (SLE) is well defined. The influence of this drug on HDL levels is still under debate and information about its effect on cholesterol reverse transport is lacking.

OBJECTIVE: To evaluate the effects of HCQ on HDL levels and the transfer of lipids to this lipoprotein in SLE.

METHODS: Nineteen SLE patients using only HCQ (SLE WITH HCQ), 19 SLE patients without any therapy (SLE WITHOUT THERAPY), and 19 healthy controls (CONTROL) were included. All three groups were premenopausal women age- and gender-matched. Serum lipids and apolipoproteins were determined by commercial kits. An in vitro transfer of four lipids (14C-Phospolipid, 3H-Cholesteryl ester, 3H-Triglyceride, and 14C-Unesterified cholesterol) from a radioactively labeled nanoemulsion donor to HDL was performed in all participants.

RESULTS: Groups had comparable mean age, weight, height, BMI(body mass index), and waist circumference (p > .05). Mean HDL levels were higher in SLE WITH HCQ group compared to SLE WITHOUT THERAPY(58.37 ± 14.04 vs 49.79 ± 8.0 mg/dL; p < .05) but lower than CONTROL (58.37 ± 14.04 vs 68.58 ± 9.99 mg/dL; p < .05). Total cholesterol (TC) and LDL levels were also significantly lower in SLE WITH HCQ compared SLE WITHOUT THERAPY(148.16 ± 16.43 vs 167.11 ± 30.18 mg/dL; p < .05, 75.05 ± 22.52 vs 96.05 ± 25.63 mg/dL; p < .05) and CONTROL (148.16 ± 16.43 vs 174.11 ± 23.70 mg/dL; p < .05, 75.05 ± 22.52 vs 88.53 ± 20.24 mg/dL; p < .05). The in vitro lipid transfer to HDL study revealed a significant difference among the three groups (p = .002) with a higher transfer of unesterified cholesterol(UC) in SLE WITH HCQ compared to SLE WITHOUT THERAPY(5.40 ± 1.05% vs. 4.44 ± 1.05%; p < .05). The latter was significantly decreased compared to CONTROL (5.40 ± 1.05% vs. 5.99 ± 1.71%; p < .05).The percentages of transfer of triacylglycerol (4.93 ± 0.69% vs. 4.50 ± 0.69% vs. 5.14 ± 1.01%; p = .054), esterified cholesterol (5.24 ± 0.70% vs. 4.96 ± 0.89% vs. 5.69 ± 1.27%; p = .079), and phospholipid (15.67 ± 1.03% vs. 15.34 ± 1.44% vs. 16.47 ± 1.89%; p = .066) were similar among groups.

CONCLUSION: The present study is the first to demonstrate that HCQ promoted a higher transfer of unesterified cholesterol which may account for the increased HDL levels in lupus patients under HCQ. This desirable effect may underlie the reported reduced atherosclerosis in SLE.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Lupus - 31(2022), 6 vom: 25. Mai, Seite 659-665

Sprache:

Englisch

Beteiligte Personen:

Lang, Maria G [VerfasserIn]
Vinagre, Carmen Gc [VerfasserIn]
Bonfa, Eloisa [VerfasserIn]
Freitas, Fatima R [VerfasserIn]
Pasoto, Sandra G [VerfasserIn]
Brito, Tatiane S [VerfasserIn]
Seguro, Luciana Pc [VerfasserIn]
Maranhão, Raul C [VerfasserIn]
Borba, Eduardo F [VerfasserIn]

Links:

Volltext

Themen:

4QWG6N8QKH
97C5T2UQ7J
Antirheumatic Agents
Cardiovascular disease
Cholesterol
HDL cholesterol
Hydroxychloroquine
Journal Article
Lipid metabolism
Lipoproteins
Lipoproteins, HDL
Systemic lupus erythematosus
Triglycerides

Anmerkungen:

Date Completed 26.04.2022

Date Revised 26.04.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1177/09612033221090127

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM338631003