Autoantibodies against heartmuscle sarcolemma in sera of patients with an idiopathic cardiomyopathy

Abstract

68 patients with clinical and hemodynamical diagnosis of idiopathic cardiomyopathy (CM) were analysed for antibody in their sera using an immunofluorescence sandwich technique after titration of the sera in tissue sections. 60 of these patients had antibodies against heart muscle sarcolemma with titers up to 1:64. Out of these, the antibodies in 9 sera could be absorbed with group A streptococci. The antibodies reacted in no case with striated or smooth muscle sarcolemma. The 25 patients with an obstructive type of CM showed the highest titers and 12 of them, in addition, had antinuclear factors in their sera. These findings suggested an auto-allergic etiology for most cases of idiopathic CM.

Immunological results in myocardial diseases

“…In only one of thirty control patients (clinically healthy persons) was the immunofluorescence test positive. The results obtained for patients with congestive cardiomyopathy are similar to those found by Das et al (1973); Robinson, Anderson and Grieble (1966) and Sack, Sebening and Wachsmut (1975).…”

Heart antibodies in cardiomyopathies.

“…14 Eight of Bolte's 10 positive congestive cardiomyopathy sera exhibited 'sarcolemmal' fluorescence, but photographic representation of such fluorescence (personal observation, meeting of International Society and Federation of Cardiology, London, January 1978) showed only an endomyseal staining pattern which is of no significance. 22 The report of Sack et al 12 using a double sandwich technique shows a surprising lack of positive results in controls though this method is more sensitive and less specific than the single sandwich technique. Again no mention of how control and test sera were assessed is made.…”

Controversial issues in cardiac pathophysiology

“…Although data on circulating (3,11,30,31,37,38,39,40,41,42,44,46,48,56,61) and bound (3,11,30,37,39,40,43) antiheart antibodies (Table 3) were published, some of the studies have not been performed in a blind manner (3,11) or lacked adequate control groups (11). In both biopsies and the analysis of circulating antisarcolemmal antibodies only cryostat sections of heterologous of homologous cardiac tissue have been available to date in which non organ-specific antibodies against capillaries or external (collagenous) perimysium could not be early distinguished from antisarcolemmal antibodies.…”