Antibodies against phosphorylcholine and protection against atherosclerosis, cardiovascular disease and chronic inflammation

Introduction Chronic inflammatory diseases include cardiovascular disease (CVD), atherosclerosis, rheumatic and autoimmune diseases, and others, constituting a large part of the disease burden. It is therefore of major importance to improve understanding of underlying mechanisms, prediction, and treatment. Areas covered Broad fields including atherosclerosis, immunology, and inflammation are covered, through searches on PubMed and background knowledge. Phosphorylcholine (PC) is both a danger-associated molecular pattern (DAMP), present on oxidized LDL (OxLDL) in atherosclerotic lesions and dead cells, and a pathogen associated molecular pattern (PAMP), present on microorganisms. IgM and IgG1 antibodies against PC (anti-PC) are associated with protection in several chronic inflammatory conditions, especially in CVD and atherosclerosis where most research has been done. PC-immunization ameliorates atherosclerosis in animal models and several potential underlying mechanisms have been proposed, including anti-inflammatory, decreased uptake of OxLDL in the artery wall, promotion of T regulatory cells. Anti-PC develops during the first years of life. Low levels of IgM and IgG1 anti-PC may be caused by lack of exposure to microorganisms, including nematodes and helminths among others. Expert opinion anti-PC could improve prediction of clinical outcome and raising anti-PC could be developed into a novel therapy.