Autoantibodies to apolipoprotein A-1 as a biomarker of cardiovascular autoimmunity

Table 1 Koch posultates applied to the role of autoimmunity in atherosclerosis

Basic Koch postulates	Koch postulates transposed to the role of autoimmunity in atherosclerosis	Koch postulates met ?
Pathogens must be detected in the diseased host at every stage of the disease	Autoantibodies and auto-reactive T cells can be detected in atherosclerotic plaques and serum of patients in primary or secondary prevention of CVD	Yes
Pathogens must be isolated from the diseased host and grown in culture	Autoreactive T-cells can be isolated and cultivated from diseased host presenting experimental atherosclerosis	Yes
When inocculated in healthy animals, the pathogens from pure culture must induce the disease	Passive or active immunization drastically affect the course of atherogenesis in animal models	Yes
The pathogen must be re-isolated from the diseased animal and must correspond to the primary pathogen in pure culture	Protective autoantibodies of expected specificity can be isolated from animals exposed to active immunization	Partly

To establish a causality link between a mircoorganism and an infection, the four Koch postulates must be fulfilled. When applied to the role of autoimmunity in atherosclerosis, the Koch postulates support a causal role between autoimmunity, atherosclerosis and cardiovascular disease (CVD). Adapted from references[20-28].