Vasoregulatory Autoantibodies and Clinical Outcome After Ischemic Stroke— PROSCIS-B

Thomas G. Liman*, Bob Siegerink, Sophie Piper, Rusan Catar, Guido Moll, Gabriela Riemekasten, Harald Heidecke, Peter U. Heuschmann, Mitchell S.V. Elkind, Duska Dragun, Matthias Endres

*Corresponding author for this work

Abstract

BACKGROUND: Vasoregulatory autoantibodies including autoantibodies targeting G-protein–coupled receptors might play a functional role in vascular diseases. We investigated the impact of vasoregulatory autoantibodies on clinical outcome after ischemic stroke. 

METHODS AND RESULTS: Data were used from the PROSCIS-B (Prospective Cohort With Incident Stroke–Berlin). Autoantibody-targeting receptors such as angiotensin II type 1 receptor (AT1R), endothelin-1 type A receptor, complement factor-3 and-5 receptors, vascular endothelial growth factor receptor-1 and-2, vascular endothelial growth factor A and factor B were measured. We explored associations of high antibody levels with (1) poor functional outcome defined as modified Rankin Scale >2 or Barthel Index <60 at 1 year after stroke, (2) Barthel Index scores over time using general estimating equations, and (3) secondary vascular events (recurrent stroke, myocardial infarction) or death up to 3 years using Cox proportional hazard models. We included 491 patients with ischemic stroke with data on autoantibody levels and outcome. In models adjusted for demographics and vascular risk factors, high autoantibody concentrations (quartile 4) targeting complement factor C3a receptor, vascular endothelial growth factor receptor-2, and vascular endothelial growth factor B were associated with poor functional outcome at 1 year: (odds ratio, 2.0 [95% CI, 1.1–3.6]; odds ratio, 1.8 [95% CI, 1.1–3.2]; and odds ratio, 2.1 [95% CI, 1.2–3.6], respectively) and with lower Barthel Index scores over 3 years (complement factor C3a receptor: adjusted β=−3.3 [95% CI, −5.7 to −0.5]; VEGF-B: adjusted β=−2.4 [95% CI, −4.8 to −0.06]). Patients with high autoantibody levels were not at higher risk for secondary vascular events or death. 

CONCLUSIONS: High levels of autoantibodies against vascular endothelial growth factor receptor-2, vascular endothelial growth factor B, and complement factor C3a receptor measured are associated with poor functional outcome after stroke but not with recurrent vascular events or death. 

REGISTRATION: URL: https://www.clinicaltrials.gov

Unique identifier: NCT01363856.

Original languageEnglish
Article numbere032441
JournalJournal of the American Heart Association
Volume12
Issue number23
DOIs
Publication statusPublished - 05.12.2023

Research Areas and Centers

  • Academic Focus: Center for Infection and Inflammation Research (ZIEL)

DFG Research Classification Scheme

  • 205-18 Rheumatology
  • 204-05 Immunology

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