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Decreased endothelin receptor A autoantibody levels are associated with early ischaemic events in patients with giant-cell arteritis
  1. Sebastian Klapa1,2,
  2. Antje Müller1,
  3. Andreas Koch2,
  4. Harald Heidecke3,
  5. Wataru Kähler2,
  6. Juliane Junker3,
  7. Susanne Schinke1,
  8. Gabriela Riemekasten1,
  9. Peter Lamprecht1
  1. 1 Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
  2. 2 Institute of Experimental Medicine c/o German Naval Medical Institute, Christian-Albrechts-University Kiel, Kronshagen, Germany
  3. 3 CellTrend GmbH, Luckenwalde, Brandenburg, Germany
  1. Correspondence to Dr Sebastian Klapa, Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany; sebastian.klapa{at}

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Endothelin 1 (ET-1) is a potent vasoactive peptide hormone produced by endothelial cells, macrophages and vascular smooth muscle cells (VSMCs). Elevated ET-1 plasma levels have been reported in patients with ischaemic complications in giant-cell arteritis (GCA), a systemic vasculitis predominantly affecting large vessels and their branches.1 In temporal artery biopsy specimens, increased expression of ET-1 and the G protein-coupled vasoconstrictive endothelin receptor A (ETAR) has been found.2 ETAR activation induces focal adhesion kinase-mediated morphological changes and increased motility of VSMC potentially contributing to intimal hyperplasia and vascular occlusion in GCA.3 VSMC migration can be blocked by specific ETAR antagonists.3 Notably, disease-specific anti-G protein-coupled receptor autoantibody (aab) signatures have been found in different autoimmune diseases.4 5 Anti-ETAR aabs are increased and associated with pulmonary arteriolar occlusion and hypertension in systemic sclerosis.5 6 Anti-ETAR aabss induce vascular adhesion molecules, interleukin (IL)-8 and chemokine ligand CCL-18 productions and exhibit chemotactic activity by mediating neutrophil and T cell migration.5 6

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  • Handling editor Josef S Smolen

  • Contributors SK, HH, JJ and AM coordinated the laboratory examinations and data analysis. SK, PL, AK, WK, SS and GR coordinated the clinical examinations and reviewed data analysis as well as revised the manuscript. SK, AM, PL and GR designed, coordinated the study and reviewed the data. SK, GR, PL and AM wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Institutional review board at the University of Luebeck (Az 16-199).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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