AUTHOR=Zimmermann Silke , Weißenfels Markus , Krümmer Norma , Härtig Wolfgang , Weise Gesa , Branzan Daniela , Michalski Dominik , Pelz Johann Otto 

TITLE=Elevated serum levels of anti-collagen type I antibodies in patients with spontaneous cervical artery dissection and ischemic stroke: a prospective multicenter study

JOURNAL=Frontiers in Immunology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1348430

DOI=10.3389/fimmu.2024.1348430

ISSN=1664-3224

ABSTRACT=Introduction: Spontaneous cervical artery dissection (sCAD) is a rare vasculopathy whose trigger is still unknown. We hypothesized that autoimmunity against components of the vascular wall might play a critical role in sCAD, and examined anti-collagen type I antibodies in patients with sCAD, acute ischemic stroke, patients with thromboendarterectomy, and controls.
Methods: Fifty-seven patients with sCAD (age 45.7±10.2 years, female 18 (31.6%)) were prospectively enrolled in four German stroke centers. Blood samples were collected at baseline, at day 10±3, and after 6±1 months. Patients with ischemic stroke not related to CAD (n=54, age 56.7±13.7 years, female 15 (27.8%)), healthy probands (n=80, age 57.4±12.9 years, female 56 (70%)), and patients undergoing thromboendarterectomy of the carotid artery (n=9, age 70.7±9.3 years, female 2 (22.2%)) served as controls. Anti-collagen type I antibodies were determined by enzyme-linked immunosorbent assays (ELISAs). 
Results: Patients with acute sCAD had higher serum levels of anti-collagen type I antibodies (33.9±24.6 µg/ml) than probands (18.5±11.0 µg/ml; p <0.001) but lower levels than patients with ischemic stroke not related to sCAD (47.8±28.4 µg/ml; p=0.003). In patients with sCAD, serum levels of anti-collagen type I antibodies were similar in the acute, subacute, and chronic phase. Levels of anti-collagen type I antibodies significantly correlated with circulating collagen type I (rho=0.207, p=0.003).
Conclusion: Anti-collagen type I antibodies seem not to represent a trigger for acute sCAD or ischemic stroke but may rather be linked to the metabolism and turnover of collagen type I.