Antibodies to platelet‐activating factor are associated with borderline hypertension, early atherosclerosis and the metabolic syndrome

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Abstract
Wu R, Lemne C, de Faire U, Frostegård J (Karolinska Hospital and Karolinska Institute, Stockholm, Sweden). Antibodies to platelet‐activating factor (PAF) are associated with borderline hypertension, early atherosclerosis and the metabolic syndrome. J Intern Med 1999; 246: 389–397. Objective. Platelet‐activating factor (PAF) is a phospholipid inflammatory mediator which is synthesized by a variety of cells, including monocytes and endothelial cells, and PAF can be retained in activated endothelial cell membranes. Furthermore, PAF‐like lipids are produced in other phospholipid membranes as in oxidized LDL. Atherosclerosis is a chronic inflammation in the artery wall, but little is known about the role of immune reactions in the early stages of development of cardiovascular disease. In the present study we investigated if there are antibodies to PAF (aPAF) that may play a role in borderline hypertension and early atherosclerosis. Design. Seventy‐three men with borderline hypertension (BHT) and 73 age‐matched normotensive (NT) men (diastolic blood pressure 85–94 and P = 0.0007). Antibodies to the biologically inactive lysoPAF did not differ between BHT and NT group. aPAF levels were associated with IM‐thickness in the left (P = 0.02) and right (P = 0.009) carotid artery. Furthermore, aPAF levels were enhanced in individuals with the metabolic syndrome (n = 44) as compared to those without (n = 102; P = 0.009), and also significantly associated with insulin levels (P = 0.02) and insulin resistance (P = 0.02). Conclusions. aPAF antibodies may reflect early vascular changes and thus serve as novel markers for disease, and they may also be pathogenic, by eliciting an inflammatory reaction in the vascular wall.