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New biomarkers for cardiovascular risk in juvenile-onset SLE

The results of a study presented at EULAR 2019 identify ApoB:A1 ratio and metabolomic lipoprotein signatures as potential  biomarkers for cardiovascular risk in patients with  juvenile-onset systemic lupus erythematosus (JSLE).1
In depth metabolomics was used to investigate dyslipidaemia and cardiovascular risk in a cohort of patients with  JSLE. Unbiased hierarchical clustering stratified patients by metabolomic profile and revealed three distinct groups.
Groups One and Two were identified as high and low cardiovascular risk respectively  based on their  unique lipoprotein profile, immune cell phenotype and clinical presentation. Further analysis identified ApoB:A1 ratio as a highly predictive biomarker distinguishing between these high and low cardiovascular risk groups. Longitudinal analysis revealed that the ApoB:A1 ratio biomarker remained stable overtime.1
Our study identifies ApoB:A1 ratio and metabolomic lipoprotein signatures as potential new biomarkers to predict cardiovascular risk in patients with juvenile-onset SLE,” said Dr George Robinson, Senior Research Associate, Centre for Adolescent Rheumatology Versus Arthritis, University  College London, UK.
Patient stratification using these biomarkers could provide an opportunity for tailored disease treatments using lipid modification therapy and lifestyle interventions.”
The patients in Group One were identified as high cardiovascular risk due to their lipoprotein profile (decreased  high  density  lipoproteins  (HDL)  and  increased  very low and low density lipoproteins (VLDL/LDL)). 
Group One had a significant increase in plasmablasts and activated T-cells  compared  to  matched  healthy controls and had clinical  features  associated  with increased  disease  activity. These immunopathogenic properties were not seen in the low cardiovascular risk Group Two which also had the opposite lipoprotein profile (increased HDL and  decreased  VLDL/LDL). Group  Three had  an  intermediate  CVR  but a pro-inflammatory immune cell profile.1
Regular assessment for traditional and disease-related risk factors for cardiovascular disease is very important in patients with SLE,” said Tanita Wilhelmer, Chair, Young PARE. “We welcome these data to support the identification of those at greatest risk.”  
  1. Robinson G et al. Metabolomics in juvenile-onset SLE: identifying new biomarkers to predict cardiovascular risk. EULAR 2019; Madrid: Abstract OP0148.