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Volume 13 No. 03
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Accepted Papers

Scientific Investigations

Circulating Anti-Coatomer Protein Complex Subunit Epsilon (COPE) Autoantibodies as a Potential Biomarker for Cardiovascular and Cerebrovascular Events in Patients with Obstructive Sleep Apnea

Takuma Matsumura, MD1; Jiro Terada, MD, PhD1; Taku Kinoshita, MD1; Yoriko Sakurai, MD, PhD1; Misuzu Yahaba, MD, PhD1; Ryogo Ema, MD1; Atsuko Amata, MD1,2; Seiichiro Sakao, MD, PhD1; Kengo Nagashima, PhD3; Koichiro Tatsumi, MD, PhD1; Takaki Hiwasa, PhD4
1Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan; 2Department of Medicine, Nikko Memorial Hospital, Hitachi, Japan; 3Department of Global Clinical Research, Graduate School of Medicine, Chiba University, Chiba, Japan; 4Department of Biochemistry and Genetics, Graduate School of Medicine, Chiba University, Chiba, Japan

Study Objectives:

Although moderate to severe obstructive sleep apnea (OSA) is an independent risk factor for severe arteriosclerotic diseases such as cardiovascular disease (CVD) and stroke, the development of atherosclerosis-related diseases cannot yet be predicted in patients with OSA. In a pilot study, we identified autoantibodies against the coatomer protein complex, subunit epsilon [circulating anti-coatomer protein complex subunit epsilon autoantibody (COPE-Ab)], a cytosolic complex that mediates protein transport in the Golgi compartment, as a potential novel biomarker of atherosclerosis. This study aimed to evaluate whether COPE-Ab levels had an association with cardiovascular and cerebrovascular events in patients with OSA.


Eighty-two adult patients with a diagnosis of OSA via polysomnography and 64 healthy donors were studied. Serum COPE-Ab levels were measured using an amplified luminescence proximity homogeneous assay. Then, clinical factors related to atherosclerosis were evaluated with respect to COPE-Ab levels.


Significant differences in COPE-Ab levels were observed in terms of OSA severity. COPE-Ab levels were significantly higher in patients with OSA and also CVD and/or stroke, hypertension, and a high body mass index. Univariate and multivariate logistic regression analyses of patients with OSA identified elevated COPE-Ab level as a significant predictor of CVD and/or stroke.


An elevated COPE-Ab level may be a potential predictor of the risks of cardiovascular and cerebrovascular events in patients with OSA. Therefore, patients with higher COPE-Ab levels may require more careful and intensive treatment.


A commentary on this article appears in this issue on page 361.


Matsumura T, Terada J, Kinoshita T, Sakurai Y, Yahaba M, Ema R, Amata A, Sakao S, Nagashima K, Tatsumi K, Hiwasa T. Circulating anti-coatomer protein complex subunit epsilon (COPE) autoantibodies as a potential biomarker for cardiovascular and cerebrovascular events in patients with obstructive sleep apnea. J Clin Sleep Med. 2017;13(3):393–400.

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