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Novel organ-specific circulating cardiac autoantibodies in dilated cardiomyopathy
A L Caforio1, E Bonifacio, J T Stewart
1Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.
Insights
Organ-specific cardiac autoantibodies are more prevalent in dilated cardiomyopathy patients. These antibodies were linked to milder symptoms and earlier disease onset in dilated cardiomyopathy cases.
Area of Science:
- Immunology
- Cardiology
- Autoimmunity
Background:
- Dilated cardiomyopathy is a complex heart condition.
- The role of organ-specific autoantibodies in its pathogenesis is unclear.
Purpose of the Study:
- To investigate the presence and significance of organ-specific cardiac autoantibodies in dilated cardiomyopathy.
Main Methods:
- Indirect immunofluorescence was used to analyze sera from patients with dilated cardiomyopathy, heart failure, other cardiac diseases, and healthy controls.
- Absorption studies confirmed the cardiac specificity of observed antibody patterns.
Main Results:
- Organ-specific cardiac antibodies were significantly more frequent in dilated cardiomyopathy patients (26%) compared to other groups.
- These antibodies were associated with fewer symptoms (New York Heart Association class I) and more recent disease onset (<2 years).
Conclusions:
- Organ-specific cardiac autoantibodies are a potential biomarker for dilated cardiomyopathy.
- Their presence may indicate a specific autoimmune component in the disease, particularly in earlier stages.
Abstract:
To determine whether organ-specific cardiac autoantibodies are present in dilated cardiomyopathy, indirect immunofluorescence on human heart and skeletal muscle was used to test sera from 200 normal subjects and from 65 patients with dilated cardiomyopathy, 41 with chronic heart failure due to myocardial infarction and 208 with other cardiac disease. Three immunofluorescence patterns were observed: diffuse cytoplasmic on cardiac tissue only (organ-specific), fine striational on cardiac and, to a lesser extent, skeletal muscle (cross-reactive 1) and broad striational on both cardiac and skeletal muscle (cross-reactive 2). Cardiac specificity of the cytoplasmic pattern was confirmed by absorption studies with homogenates of human atrium, skeletal muscle and rat liver. Organ-specific cardiac antibodies (IgG; titer range 1/10 to 1/80) were more frequent in patients with dilated cardiomyopathy (17 [26%] of 65) than in those with other cardiac disease (2 [1%] of 208, p less than 0.0001) or heart failure (0 [0%] of 41, p less than 0.001) or in normal subjects (7 [3.5%] of 200, p less than 0.0001). Organ-specific cardiac antibodies were more common in patients with dilated cardiomyopathy and in those with fewer symptoms (8 of 15 in New York Heart Association functional class I versus 9 of 50 in classes II to IV, p less than 0.01) and more recent (less than 2 years) onset of disease (9 of 19 versus 8 of 46, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)