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Negi P, Heikkilä T, Vuorenpää K, Tuunainen E, Nammas W, Maaniitty T, Knuuti J, Metso J, Lövgren J, Jauhiainen M, Lamminmäki U, Pettersson K, Saraste A. Time-resolved fluorescence based direct two-site apoA-I immunoassays and their clinical application in patients with suspected obstructive coronary artery disease. Front Cardiovasc Med 2022; 9:912578. [PMID: 36312264 PMCID: PMC9614376 DOI: 10.3389/fcvm.2022.912578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Objective High-density lipoprotein (HDL) is a heterogeneous group of subpopulations differing in protein/lipid composition and in their anti-atherogenic function. There is a lack of assays that can target the functionality of HDL particles related to atherosclerosis. The objective of this study was to construct two-site apolipoprotein A-I (apoA-I) assays and to evaluate their clinical performance in patients with suspected obstructive coronary artery disease (CAD). Approach and results Direct two-site apoA-I assays (named 109-121 and 110-525) were developed to identify the presence of apoA-I in the HDL of patients with CAD using apoA-I antibodies as a single-chain variable fragment fused with alkaline phosphatase. ApoA-I109-121 and apoA-I110-525 were measured in 197 patients undergoing coronary computed tomography angiography (CTA) and myocardial positron emission tomography perfusion imaging due to suspected obstructive CAD. Among patients not using lipid-lowering medication (LLM, n = 125), the level of apoA-I110-525 was higher in the presence than in the absence of coronary atherosclerosis [21.88 (15.89-27.44) mg/dl vs. 17.66 (13.38-24.48) mg/dl, P = 0.01)], whereas there was no difference in apoA-I109-121, HDL cholesterol, and apoA-I determined using a polyclonal apoA-I antibody. The levels of apoA-I109-121 and apoA-I110-525 were similar in the presence or absence of obstructive CAD. Among patients not using LLM, apoA-I110-525 adjusted for age and sex identified individuals with coronary atherosclerosis with a similar accuracy to traditional risk factors [area under the curve [AUC] (95% CI): 0.75(0.66-0.84) 0.71 (0.62-0.81)]. However, a combination of apoA-I110-525 with risk factors did not improve the accuracy [AUC (95% CI): 0.73 (0.64-0.82)]. Conclusion Direct two-site apoA-I assays recognizing heterogeneity in reactivity with apoA-I could provide a potential approach to identify individuals at a risk of coronary atherosclerosis. However, their clinical value remains to be studied in larger cohorts.
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Affiliation(s)
- Priyanka Negi
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland,*Correspondence: Priyanka Negi
| | - Taina Heikkilä
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland
| | - Karoliina Vuorenpää
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland
| | - Emilia Tuunainen
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland
| | - Wail Nammas
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland,Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Teemu Maaniitty
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Jari Metso
- Minerva Foundation Institute for Medical Research, Biomedicum, Helsinki, Finland,National Institute for Health and Welfare, Genomics and Biobank Unit, Biomedicum 2U, Helsinki, Finland
| | - Janita Lövgren
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland
| | - Matti Jauhiainen
- Minerva Foundation Institute for Medical Research, Biomedicum, Helsinki, Finland,National Institute for Health and Welfare, Genomics and Biobank Unit, Biomedicum 2U, Helsinki, Finland
| | - Urpo Lamminmäki
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland
| | - Kim Pettersson
- Department of Life Technologies/Biotechnology, University of Turku, Turku, Finland
| | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland,Antti Saraste
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