Circulating antibodies against MAA adducts as biomarker for coronary artery disease
In various embodiments methods are provided for identifying a mammal having an elevated risk for an adverse cardiac event (e.g. an MI) and/or determining the prognosis for the mammal. In certain embodiments the methods comprise determining, or causing to be determined, the presence and/or level of antibodies that bind a malondialdehyde-acetaldheyde adduct (MAA adduct) in a biological sample from the mammal, where an elevated level of anti-MAA adduct antibodies, as compared to the level found in a normal healthy mammal is an indicator that that said mammal has one or more atherosclerotic lesions and/or is at elevated risk for a myocardial infarction.
1. A method of treating a mammal, said method comprising:
i) identifying a mammal having an elevated level of IgG antibodies and/or IgM antibodies that bind a malondialdehyde-acetaldehyde adduct (MAA adduct) as compared to the level found in a normal healthy mammal, and a level of IgA antibodies that bind an MAA adduct comparable to or lower than the levels found in a normal healthy mammal; and
treating said mammal for unstable angina; or
ii) identifying a mammal having an elevated level of IgG antibodies and/or IgM antibodies that bind a malondialdehyde-acetaldehyde adduct (MAA adduct) as compared to the level found in a normal healthy mammal, and a level of IgA antibodies that bind an MAA adduct elevated as compared to that found in a normal healthy mammal and/or an acute myocardial infarction (AMI) patient; and
treating said mammal for a stable angina.
2. The method of claim 1 , wherein said method comprises:
identifying a mammal having an elevated level of IgG antibodies and/or IgM antibodies that bind a malondialdehyde-acetaldehyde adduct (MAA adduct) as compared to the level found in a normal healthy mammal, and a level of IgA antibodies that bind an MAA adduct comparable to or lower than the levels found in a normal healthy mammal; and
treating said mammal for unstable angina.
3. The method of claim 2 , wherein said treating said mammal for unstable angina comprises a treatment selected from the group consisting of angioplasty, percutaneous intervention (PCI), and coronary bypass surgery.
4. The method of claim 1 , wherein said method comprises:
identifying a mammal having an elevated level of IgG antibodies and/or IgM antibodies that bind a malondialdehyde-acetaldehyde adduct (MAA adduct) as compared to the level found in a normal healthy mammal, and a level of IgA antibodies that bind an MAA adduct elevated as compared to that found in a normal healthy mammal and/or an acute myocardial infarction (AMI) patient; and
treating said mammal for a stable angina.
5. The method of claim 4 , wherein said treating said mammal for a stable angina comprises administration of one or more pharmaceuticals selected from the group consisting of a statin, a beta blocker, nitroglycerin or other nitrate, heparin, an angiotensin converting enzyme (ACE) inhibitor, an angiotensin receptor blocker (ARB), aspirin and other anti-platelets, a calcium channel blocker, and Ranolazine.
6. The method of claim 1 , wherein the level of IgG, IgA, and IgM antibodies are determined in a biological sample from said mammal where said biological sample comprises a sample selected from the group consisting of whole blood, a blood fraction, plasma, serum, interstitial fluid, oral fluid, pericardial fluid, cerebral spinal fluid, and peritoneal fluid.
7. The method of claim 6 , wherein the levels of IgG, IgA, and IgM antibodies are detected in an assay wherein the biological sample is fractionated to separate a fraction comprising said antibodies from at least one other sample component.
8. The method of claim 6 , wherein:
measurements of IgG antibodies, and IgA antibodies that bind a MAA adduct are determined in an assay wherein the antibodies and/or a complex formed between the antibodies and a MAA adduct becomes labeled with a detectable label; and/or
measurements of IgG antibodies, and IgA antibodies that bind a MAA adduct are determined in an assay wherein the antibodies go from an unbound state to a bound state by forming a complex with another assay component; and/or
measurements of IgG antibodies, and IgA antibodies that bind a MAA adduct are determined in an assay wherein the antibodies initially present in a soluble phase becomes immobilized on a solid phase.
9. The method of claim 6 , wherein the level of one or more of the IgG antibodies, and/or the IgA antibodies is measured using an assay selected from the group consisting of SDS/PAGE, isoelectric focusing, 2-dimensional gel electrophoresis, a hemagluttination assay, and an immunoassay.
10. The method of claim 9 , wherein the level of one or more of the IgG antibodies, and/or the IgA antibodies are measured using an ELISA assay.
11. The method of claim 9 , wherein said immunoassay comprises:
providing a MAA adduct immobilized on a solid support;
contacting said MAA adduct with said biological sample under conditions in which anti-MAA adduct antibodies in said sample bind to said MAA adduct forming an adduct/antibody complex; and
contacting said complex with detection antibodies that specifically bind IgG antibodies or IgA antibodies, or contacting said complex with a detection reagent that binds any antibody; and
detecting and/or quantifying the bound detection antibodies or the bound detection reagent.
12. The method of claim 11 , wherein
said detection antibodies are attached to a detectable label or bound by another antibody attached to a detectable label; and/or said detection reagent is attached to a detectable label and/or said detection reagent is bound by an antibody attached to a detectable label; and
said detecting and/or quantifying comprises detecting and/or quantifying said detectable label.