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Antiendothelial antibodies in sera of patients with infective endocarditis
I Portig1, V Beck, S Pankuweit
1Klinikum der Philipps--Universität SP Kardiologie, Marburg, Germany. wolf@mailer.uni-marburg.de
Abstract:
Infective endocarditis is characterized by the colonization of endocardium by microorganisms. Except for Staphylococcus aureus, microorganisms are not able to adhere to and grow on endocardial cells; prior damage, e.g., by shear stress or other mechanical factors, is necessary. But other causes may well have a share. This study was, therefore, designed to identify immunological factors, especially antibodies against endothelial cells, which could contribute to the initiation of endocardial injury. Sera of patients with infective endocarditis and healthy controls were investigated for the presence of antibodies against endothelial antigen. As the antigen source human umbilical vein endothelial cells were used. Antibodies against endothelial cells were detected by indirect immunofluorescence, ELISA, immunoblotting, antibody dependent cellular cytotoxicity, and antibody mediated cytotoxicity. Antibodies against endothelial cells were found in seven out of fifteen patients. These antibodies were directed against cytoplasmic structures and only appeared in the course of the disease. A correlation between the presence of these antibodies and disease activity or the outcome of disease was not observed. These antibodies may develop as a consequence of damage to endocardial cells (thereby exposing intracellular antigen to the immune system) and do not seem to play a role in the pathogenesis of infective endocarditis.
Insights
This study investigated antibodies against endothelial cells in infective endocarditis patients. Researchers found these antibodies develop after endocardial damage and do not initiate the disease.
Area of Science:
- Immunology
- Cardiology
- Pathogenesis
Background:
- Infective endocarditis involves microorganism colonization of the endocardium.
- Microbial adherence to endocardial cells typically requires prior damage, except for Staphylococcus aureus.
- The role of immunological factors, particularly antibodies against endothelial cells, in initiating endocardial injury is unclear.
Purpose of the Study:
- To identify immunological factors, specifically antibodies against endothelial cells, contributing to endocardial injury in infective endocarditis.
- To investigate the presence and characteristics of anti-endothelial cell antibodies in patients with infective endocarditis.
Main Methods:
- Sera from infective endocarditis patients and healthy controls were analyzed.
- Human umbilical vein endothelial cells served as the antigen source.
- Detection methods included indirect immunofluorescence, ELISA, immunoblotting, antibody-dependent cellular cytotoxicity, and antibody-mediated cytotoxicity.
Main Results:
- Antibodies against endothelial cells were detected in 7 out of 15 infective endocarditis patients.
- These antibodies targeted cytoplasmic structures and appeared during the disease course.
- No correlation was found between antibody presence and disease activity or outcome.
Conclusions:
- Anti-endothelial cell antibodies in infective endocarditis may arise secondary to endocardial cell damage.
- These antibodies likely do not play a primary role in the pathogenesis of infective endocarditis.
- Further research may clarify the precise role of immune responses in endocardial injury.