The authors declare that they have no conflicts of interest.
Ethical approval
This study complies with the Declaration of Helsinki (2013), and it was approved by the Local Ethical Committee of the L.G. Sokolov North-Western District Scientific and Clinical Centre, approval number 7 dated Dec 08, 2022.
Consent to participate
Informed consent to participate in the study was obtained from all participants.
This work was supported by the grant of the Government of the Russian Federation for the state support of scientific research carried out under the supervision of leading scientists, agreement NO. 075-15-2022-1110 dated June 30, 2022. Scientific research was performed at the Laboratory of Microangiopathic Mechanisms of Atherogenesis of St. Petersburg State University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Das D, Podder S. Unraveling the molecular crosstalk between Atherosclerosis and COVID-19 comorbidity.Comput Biol Med. 2021;134:104459. [DOI] [PubMed] [PMC]
Makarova YA, Ryabkova VA, Salukhov VV, Sagun BV, Korovin AE, Churilov LP. Atherosclerosis, Cardiovascular Disorders and COVID-19: Comorbid Pathogenesis.Diagnostics (Basel). 2023;13:478. [DOI] [PubMed] [PMC]
Zumla A, Chan JF, Azhar EI, Hui DS, Yuen KY. Coronaviruses - drug discovery and therapeutic options.Nat Rev Drug Discov. 2016;15:327–47. [DOI] [PubMed] [PMC]
Chan JF, Lau SK, Woo PC. The emerging novel Middle East respiratory syndrome coronavirus: the "knowns" and "unknowns".J Formos Med Assoc. 2013;112:372–81. [DOI] [PubMed] [PMC]
Li X, Luk HKH, Lau SKP, Woo PCY. Human Coronaviruses: General Features. Reference Module in Biomedical Sciences. 2019. [DOI]
Hasöksüz M, Kiliç S, Saraç F. Coronaviruses and SARS-COV-2.Turk J Med Sci. 2020;50:549–56. [DOI] [PubMed] [PMC]
Shang J, Wan Y, Luo C, Ye G, Geng Q, Auerbach A, et al. Cell entry mechanisms of SARS-CoV-2.Proc Natl Acad Sci. 2020;117:11727–34. [DOI]
Voss C, Esmail S, Liu X, Knauer MJ, Ackloo S, Kaneko T, et al. Epitope-specific antibody responses differentiate COVID-19 outcomes and variants of concern.JCI Insight. 2021;6:e148855. [DOI]
Vinciguerra M, Romiti S, Fattouch K, De Bellis A, Greco E. Atherosclerosis as Pathogenetic Substrate for Sars-Cov2 Cytokine Storm.J Clin Med. 2020;9:2095.
Liu Y, Zhang HG. Vigilance on New-Onset Atherosclerosis Following SARS-CoV-2 Infection.Front Med. 2021;7:629413. [DOI] [PubMed] [PMC]
Vinciguerra M, Romiti S, Sangiorgi GM, Rose D, Miraldi F, Greco E. SARS-CoV-2 and Atherosclerosis: Should COVID-19 Be Recognized as a New Predisposing Cardiovascular Risk Factor?J Cardiovasc Dev Dis. 2021;8:130. [DOI]
Grzegorowska O, Lorkowski J. Possible Correlations between Atherosclerosis, Acute Coronary Syndromes and COVID-19.J Clin Med. 2020;9:3746. [DOI] [PubMed] [PMC]
Ross R. Atherosclerosis – an inflammatory disease.N Engl J Med. 1999;340:115–26. [DOI]
Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis.Nature. 2011;473:317–25. [DOI]
Emeson EE, Shen ML, Bell CG, Qureshi A. Inhibition of atherosclerosis in CD4 T-cell-ablated and nude (nu/nu) C57BL/6 hyperlipidemic mice.Am J Pathol. 1996;149:675–85. [PubMed] [PMC]
Clerc G. Atherosclerosis as an immune disease?Med Hypotheses. 1991;36:24–6. [DOI]
Shoenfeld Y, Agmon-Levin N, Rose NR, editors. Infection and Autoimmunity. 2nd ed. New York: Elsevier; 2015.
Powell AM, Black MM. Epitope spreading: protection from pathogens, but propagation of autoimmunity?Clin Exp Dermatol. 2001;26:427–33. [DOI]
Sercarz EE, Lehmann PV, Ametani A, Benichou G, Miller A, Moudgil K. Dominance and crypticity of T cell antigenic determinants.Annu Rev Immunol. 1993;11:729–66. [DOI] [PubMed]
Ehl S, Hombach J, Aichele P, Hengartner H, Zinkernagel RM. Bystander activation of cytotoxic T cells: studies on the mechanism and evaluation of in vivo significance in a transgenic mouse model.J Exp Med. 1997;185:1241–51. [DOI] [PubMed] [PMC]
Fujinami RS, Oldstone MB. Amino acid homology between the encephalitogenic site of myelin basic protein and virus: mechanism for autoimmunity.Science. 1985;230:1043–5. [DOI] [PubMed]
Kanduc D. Homology, similarity, and identity in peptide epitope immunodefinition.J Pept Sci. 2012;18:487–94. [DOI] [PubMed]
Getts DR, Chastain EM, Terry RL, Miller SD. Virus infection, antiviral immunity, and autoimmunity.Immunol Rev. 2013;255:197–209. [DOI] [PubMed] [PMC]
Rojas M, Herrán M, Ramírez-Santana C, Leung PSC, Anaya JM, Ridgway WM, et al. Molecular mimicry and autoimmunity in the time of COVID-19.J Autoimmun. 2023;139:103070. [DOI] [PubMed] [PMC]
Churilov LP, Kanduc D, Ryabkova VA. COVID-19: adrenal response and molecular mimicry.Isr Med Assoc J. 2021;23:618–9. [PubMed]
Normatov MG, Karev VE, Kolobov AV, Mayevskaya VA, Ryabkova VA, Utekhin VJ, et al. Post-COVID Endocrine Disorders: Putative Role of Molecular Mimicry and Some Pathomorphological Correlates.Diagnostics (Basel). 2023;13:522. [DOI] [PubMed] [PMC]
Kanduc D. Pentapeptides as minimal functional units in cell biology and immunology.Curr Protein Pept Sci. 2013;14:111–20. [DOI] [PubMed]
Kanduc D. Immunogenicity, Immunopathogenicity, and Immunotolerance in One Graph.Anticancer Agents Med Chem. 2015;15:1264–8. [DOI] [PubMed]
Mutoh T, Shirai T, Ishii T, Shirota Y, Fujishima F, Takahashi F, et al. Identification of two major autoantigens negatively regulating endothelial activation in Takayasu arteritis.Nat Commun. 2020;11:1253. [DOI] [PubMed] [PMC]
Xia S, Ozsvath K, Hirose H, Tilson MD. Partial amino acid sequence of a novel 40-kDa human aortic protein, with vitronectin-like, fibrinogen-like, and calcium binding domains: aortic aneurysm-associated protein-40 (AAAP-40) [human MAGP-3, proposed].Biochem Biophys Res Commun. 1996;219:36–9. [DOI]
Matsunaga A, Harita Y, Shibagaki Y, Shimizu N, Shibuya K, Ono H, et al. Identification of 4-Trimethylaminobutyraldehyde Dehydrogenase (TMABA-DH) as a Candidate Serum Autoantibody Target for Kawasaki Disease.PLoS One. 2015;10:e0128189. [DOI]
Hu CJ, Pan JB, Song G, Wen XT, Wu ZY, Chen S, et al. Identification of Novel Biomarkers for Behcet Disease Diagnosis Using Human Proteome Microarray Approach.Mol Cell Proteomics. 2017;16:147–56. [DOI]
Sanjadi M, Rezvanie Sichanie Z, Totonchi H, Karami J, Rezaei R, Aslani S. Atherosclerosis and autoimmunity: a growing relationship.Int J Rheum Dis. 2018;21:908–21. [DOI]
Chakravarti R, Gupta K, Swain M, Willard B, Scholtz J, Svensson LG, et al. 14-3-3 in Thoracic Aortic Aneurysms: Identification of a Novel Autoantigen in Large Vessel Vasculitis.Arthritis Rheumatol. 2015;67:1913–21. [DOI]
Getz GS, Reardon CA. Atherosclerosis: cell biology and lipoproteins.Curr Opin Lipidol. 2020;31:35–7. [DOI]
Lu S, White JV, Nwaneshiudu I, Nwaneshiudu A, Monos DS, Solomides CC, et al. Human abdominal aortic aneurysm (AAA): Evidence for an autoimmune antigen-driven disease.Autoimmun Rev. 2022;21:103164. [DOI]
Hartley A, Haskard D, Khamis R. Oxidized LDL and anti-oxidized LDL antibodies in atherosclerosis - Novel insights and future directions in diagnosis and therapy.Trends Cardiovasc Med. 2019;29:22–6. [DOI]
Tilson MD. Similarities of an autoantigen in aneurysmal disease of the human abdominal aorta to a 36-kDa microfibril-associated bovine aortic glycoprotein.Biochem Biophys Res Commun. 1995;213:40–3. [DOI] [PubMed]
Shoenfeld Y, Meroni PL, Churilov LP. Guide in Autoimmune Diseases for General Medical Practice. Saint Petersburg: ELBI; 2017. Russian.
Nicholls SJ, Hazen SL. Myeloperoxidase, modified lipoproteins, and atherogenesis.J Lipid Res. 2009;50 Suppl:S346–51. [DOI] [PubMed] [PMC]
Kattoor AJ, Kanuri SH, Mehta JL. Role of Ox-LDL and LOX-1 in Atherogenesis.Curr Med Chem. 2019;26:1693–700. [DOI] [PubMed]
Liu P, Sun Z, Zhang Y, Guo W. Myeloid related protein 8/14 is a new candidate biomarker and therapeutic target for abdominal aortic aneurysm.Biomed Pharmacother. 2019;118:109229. [DOI] [PubMed]
UniProt Consortium. UniProt: a worldwide hub of protein knowledge.Nucleic Acids Res. 2019;47:D506–15. [DOI] [PubMed] [PMC]
Gavrilova NY, Normatov MG, Soprun LA, Utekhin VJ, Fedotkina TV, Churilov LP. Autoantigens of Small Nerve Fibers and Human Coronavirus Antigens: Is There a Possibility for Molecular Mimicry?Curr Microbiol. 2024;81:366. [DOI] [PubMed]
Vita R, Mahajan S, Overton JA, Dhanda SK, Martini S, Cantrell JR, et al. The Immune Epitope Database (IEDB): 2018 update.Nucleic Acids Res. 2019;47:D339–43. [DOI] [PubMed] [PMC]
Valcovici M, Iacob MS, Sharma A, Pah AM, Marin-Bancila L, Berceanu MMV, et al. The Junction of Allergic Inflammation and Atherosclerosis: Pathways and Clinical Implications-A Review.Life (Basel). 2025;15:964. [DOI] [PubMed] [PMC]
Liang K, Dong SR, Peng H. Serum levels and clinical significance of IFN-γ and IL-10 in patients with coronary heart disease.Eur Rev Med Pharmacol Sci. 2016;20:1339–43. [PubMed]
Dimitrov I, Bangov I, Flower DR, Doytchinova I. AllerTOP v.2--a server for in silico prediction of allergens.J Mol Model. 2014;20:2278. [DOI] [PubMed]
Gupta S, Kapoor P, Chaudhary K, Gautam A, Kumar R; Open Source Drug Discovery Consortium; Raghava GP. In silico approach for predicting toxicity of peptides and proteins.PLoS One. 2013;8:e73957. [DOI] [PubMed] [PMC]
Nagpal G, Usmani SS, Dhanda SK, Kaur H, Singh S, Sharma M, et al. Computer-aided designing of immunosuppressive peptides based on IL-10 inducing potential.Sci Rep. 2017;7:42851. [DOI] [PubMed] [PMC]
Dhanda SK, Vir P, Raghava GP. Designing of interferon-gamma inducing MHC class-II binders.Biol Direct. 2013;8:30. [DOI] [PubMed] [PMC]
Imai M, Kawamura M, Kochi I, Matsuoka T, Kihara S, Yamamoto H. Anti-Apo B-100 Autoantibody is a Marker of Unstable Coronary Plaque.J Atheroscler Thromb. 2021;28:1025–34. [DOI] [PubMed] [PMC]
Egusa G. Autoantibodies Against ApoB-100 as a New Marker of Coronary Vulnerable Plaque.J Atheroscler Thromb. 2021;28:1020–2. [DOI] [PubMed] [PMC]
Csernok E. Anti-neutrophil cytoplasmic antibodies and pathogenesis of small vessel vasculitides.Autoimmun Rev. 2003;2:158–64. [DOI] [PubMed]
Kallenberg CG. Autoantibodies to myeloperoxidase: clinical and pathophysiological significance.J Mol Med (Berl). 1998;76:682–7. [DOI] [PubMed]
Slot MC, Theunissen R, van Paassen P, Damoiseaux JG, Tervaert JW; Limburg Nephrology Working Group. Anti-oxidized low-density lipoprotein antibodies in myeloperoxidase-positive vasculitis patients preferentially recognize hypochlorite-modified low density lipoproteins.Clin Exp Immunol. 2007;149:257–64. [DOI] [PubMed] [PMC]
L'Huillier AG, Pagano S, Baggio S, Meyer B, Andrey DO, Nehme M, et al. Autoantibodies against apolipoprotein A-1 after COVID-19 predict symptoms persistence.Eur J Clin Invest. 2022;52:e13818. [DOI] [PubMed] [PMC]
Lamacchia C, Mongin D, Juillard C, Antinori-Malaspina P, Gabay C, Finckh A, et al. Impact of SARS-CoV2 infection on anti-apolipoprotein A-1 IgG response in inflammatory rheumatic diseases.Front Immunol. 2023;14:1154058. [DOI] [PubMed] [PMC]
Máčalík R, Petráš M, Čelko AM, Chmátal P, Tlapák J, Dlouhý P, et al. BMI-Associated Anti-Apolipoprotein A-1 Positivity in Healthy Adults after mRNA-Vaccination against COVID-19.Vaccines (Basel). 2023;11:670. [DOI] [PubMed] [PMC]
Crossey E, Amar MJA, Sampson M, Peabody J, Schiller JT, Chackerian B, et al. A cholesterol-lowering VLP vaccine that targets PCSK9.Vaccine. 2015;33:5747–55. [DOI] [PubMed] [PMC]
Yamagata H, Hayashi A, Yoshida Y, Koshizaka M, Onishi S, Yoshida T, et al. Association of high proprotein convertase subtilisin/kexin type 9 antibody level with poor prognosis in patients with diabetes: a prospective study.Sci Rep. 2023;13:5391. [DOI] [PubMed] [PMC]
Pearce WH, Shively VP. Abdominal aortic aneurysm as a complex multifactorial disease: interactions of polymorphisms of inflammatory genes, features of autoimmunity, and current status of MMPs.Ann N Y Acad Sci. 2006;1085:117–32. [DOI] [PubMed]
Augé N, Maupas-Schwalm F, Elbaz M, Thiers JC, Waysbort A, Itohara S, et al. Role for matrix metalloproteinase-2 in oxidized low-density lipoprotein-induced activation of the sphingomyelin/ceramide pathway and smooth muscle cell proliferation.Circulation. 2004;110:571–8. [DOI] [PubMed]
Eliason JL, Hannawa KK, Ailawadi G, Sinha I, Ford JW, Deogracias MP, et al. Neutrophil depletion inhibits experimental abdominal aortic aneurysm formation.Circulation. 2005;112:232–40. [DOI] [PubMed]
Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism.Int J Obes Relat Metab Disord. 2000;24 Suppl 2:S109–12. [DOI] [PubMed]
Stabouli S, Papakatsika S, Kotsis V. Hypothyroidism and hypertension.Expert Rev Cardiovasc Ther. 2010;8:1559–65. [DOI] [PubMed]
Talwar S, Harker JA, Openshaw PJM, Thwaites RS. Autoimmunity in long COVID.J Allergy Clin Immunol. 2025;155:1082–94. [DOI] [PubMed]
Joubert B, Dalmau J. The role of infections in autoimmune encephalitides.Rev Neurol (Paris). 2019;175:420–6. [DOI] [PubMed]
Sato Y, Jain A, Ohtsuki S, Okuyama H, Sturmlechner I, Takashima Y, et al. Stem-like CD4+ T cells in perivascular tertiary lymphoid structures sustain autoimmune vasculitis.Sci Transl Med. 2023;15:eadh0380. [DOI] [PubMed] [PMC]
Ocana E, Bohórquez JC, Pérez-Requena J, Brieva JA, Rodríguez C. Characterisation of T and B lymphocytes infiltrating abdominal aortic aneurysms.Atherosclerosis. 2003;170:39–48. [DOI] [PubMed]
Hervier B, Masseau A, Bossard C, Agard C, Hamidou M. Vasa-vasoritis of the aorta and fatal myocarditis in fulminant Churg-Strauss syndrome.Rheumatology (Oxford). 2008;47:1728–9. [DOI] [PubMed]
Numano F. Vasa vasoritis, vasculitis and atherosclerosis.Int J Cardiol. 2000;75 Suppl 1:S1–8; discussion S17. [DOI] [PubMed]
Frasier KM, Gallagher-Poehls C, Cochrane M, Roy D. Secondary Vasculitis Attributable to Post-COVID Syndrome.Cureus. 2023;15:e44119. [DOI] [PubMed] [PMC]
Chan CJ, Smyth MJ, Martinet L. Molecular mechanisms of natural killer cell activation in response to cellular stress.Cell Death Differ. 2014;21:5–14. [DOI] [PubMed] [PMC]
Stetson DB, Mohrs M, Reinhardt RL, Baron JL, Wang ZE, Gapin L, et al. Constitutive cytokine mRNAs mark natural killer (NK) and NK T cells poised for rapid effector function.J Exp Med. 2003;198:1069–76. [DOI] [PubMed] [PMC]
Billiau A, Matthys P. Interferon-gamma: a historical perspective.Cytokine Growth Factor Rev. 2009;20:97–113. [DOI] [PubMed]
Groettrup M, Khan S, Schwarz K, Schmidtke G. Interferon-gamma inducible exchanges of 20S proteasome active site subunits: why?Biochimie. 2001;83:367–72. [DOI] [PubMed]
Wilson JM, McNamara CA, Platts-Mills TAE. IgE, α-Gal and atherosclerosis.Aging (Albany NY). 2019;11:1900–2. [DOI] [PubMed] [PMC]
Farmani AR, Mahdavinezhad F, Moslemi R, Mehrabi Z, Noori A, Kouhestani M, et al. Anti-IgE monoclonal antibodies as potential treatment in COVID-19.Immunopharmacol Immunotoxicol. 2021;43:259–64. [DOI] [PubMed] [PMC]
Khan A, Roy P, Ley K. Breaking tolerance: the autoimmune aspect of atherosclerosis.Nat Rev Immunol. 2024;24:670–9. [DOI] [PubMed] [PMC]
Talamini L, Fonseca DLM, Kanduc D, Chaloin O, Verdot C, Galmiche C, et al. Long COVID-19 autoantibodies and their potential effect on fertility.Front Immunol. 2025;16:1540341. [DOI] [PubMed] [PMC]
