Impact of SARS-CoV2 infection on anti-apolipoprotein A-1 IgG response in inflammatory rheumatic diseases

Celine Lamacchia; Denis Mongin; Catherine Juillard; Paola Antinori-Malaspina; Cem Gabay; Axel Finckh; Sabrina Pagano; Nicolas Vuilleumier

doi:10.3389/fimmu.2023.1154058

Impact of SARS-CoV2 infection on anti-apolipoprotein A-1 IgG response in inflammatory rheumatic diseases

Front Immunol. 2023 May 10:14:1154058. doi: 10.3389/fimmu.2023.1154058. eCollection 2023.

Authors

Celine Lamacchia¹, Denis Mongin¹, Catherine Juillard², Paola Antinori-Malaspina², Cem Gabay^{1

3}, Axel Finckh^{1

3}, Sabrina Pagano², Nicolas Vuilleumier²

Affiliations

¹ Division of Rheumatology, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
² Division of Laboratory Medicine, Department of Diagnostics and of Medical Specialties, Geneva University Hospitals and Geneva University, Geneva, Switzerland.
³ Geneva Center for Inflammation Research (GCIR), University of Geneva, Geneva, Switzerland.

Abstract

Objectives: To investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection on anti-apolipoprotein A-1 IgG (AAA1) humoral response in immunosuppressed inflammatory rheumatic diseases (IRD) patients.

Methods: This is a nested cohort study from the prospective Swiss Clinical Quality Management registry. A total of 368 IRD patients for which serum samples were available before and after the SARS-CoV2 pandemic were included. Autoantibodies against ApoA-1 (AAA1) and its c-terminal region (AF3L1) were measured in both samples. The exposure of interest was anti-SARS-CoV2 spike subunit 1 (S1) seropositivity measured in the second sample. The effect of SARS-CoV2 infection (anti-S1 seropositivity) on becoming AAA1 or AF3L1 positive and on the change of AAA1 or AF3L1 optical density (OD) between the two samples was tested with multivariable regressions.

Results: There were 12 out of 368 IRD patients who were seroconverted against S1. The proportion of patients becoming AF3L1 seropositive was significantly higher in anti-S1-positive patients, compared with anti-S1-negative patients (66.7% versus 21.6%, p = 0.001). Adjusted logistic regression analyses indicated that anti-S1 seroconversion was associated with a sevenfold increased risk of AFL1 seropositivity (odds ratio: 7.4, 95% confidence interval (95% CI): 2.1-25.9) and predicted median increase in AF3L1 OD values (+0.17, 95% CI: 0.08-0.26).

Conclusions: SARS-CoV2 infection is associated with a marked humoral response against the immunodominant c-terminal region of ApoA-1 in IRD patients. The possible clinical impact of AAA1 and AF3L1 antibodies on disease progression, cardiovascular complications, or long COVID syndrome deserves future investigations.

Keywords: anti-apolipoprotein A-1 IgG; autoantibodies; autoimmunity; inflammatory rheumatic diseases; severe acute respiratory syndrome coronavirus 2.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Apolipoprotein A-I
COVID-19*
Cohort Studies
Humans
Immunoglobulin G
Post-Acute COVID-19 Syndrome
Prospective Studies
Rheumatic Fever*
SARS-CoV-2

Substances

Apolipoprotein A-I
Immunoglobulin G

Grants and funding

This work was funded by Geneva University Hospitals Project and Development Grant, the Schmidheiny Foundation and the De Reuter Foundation (Grant N°657). Open access funding by University of Geneva.