Cardiac Rhythm and Conduction Disturbances: What is the Role of Autoimmune Mechanisms?

Ristić, Arsen; Maisch, Bernhard

doi:10.1007/s000590050005

Cited by 15 publications

(7 citation statements)

References 42 publications

(60 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The neonatal disease is presumed to be due to transplacental passage of these immunoglobulin G (IgG) autoantibodies from the mother with SLE. 28 Anti-Ro/SS-A and anti-La/SS-B antibodies are also the main autoantibodies detected in infants with congenital heart block and their mothers, 18 where it is found that anti-Ro/SS-A antibodies bind to the fetal cardiac epitopes. 29 Epitopes recognized by anti-Ro/SS-A are located on two proteins (60 and 52 kDa) that are bound intracellularly as a complex to small ribonucleic acids called hY1, hY3, hY4, and hY5.…”

Section: Discussionmentioning

confidence: 99%

“…The cross-reactivity of laminin with anti-La antibodies could be an important factor in the initiation of the autoimmune process. 18 The Ro proteins and the La protein are probably intracellular components of identical or partially identical ribonucleoprotien particles. 30 Isolated endocardial fibroelastosis (EFE) associated with maternal anti-Ro and anti-La antibodies in the absence of complete atrioventricular block has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…17 Anti-Ro/SS-A and anti-La/SS-B antibodies have been implicated in the initiation of the autoimmune inflammatory process of congenital heart block; in fact, they were the main autoantibodies detected in infants with congenital heart block and their mothers. 18 The specific aim of our study was to evaluate the incidence of morphologic and functional cardiac abnormalities in our SLE patient population and to correlate these data with their autoantibody profiles.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiac involvement in patients with systemic lupus erythematosus and correlation of valvular lesions with anti-Ro/SS-A and anti-La/SS-B antibody levels

Shahin

Hamid

et al. 2004

Mod Rheumatol

View full text Add to dashboard Cite

The aim of this study was to evaluate the incidence of morphologic and functional cardiac abnormalities in patients with systemic lupus erythematosus (SLE) and to correlate the findings with levels of anti-Ro/SS-A, anti-La/SS-B, and anti-cardiolipin antibody (aCL). Sixty-two patients with SLE were enrolled in this study. All patients underwent complete history taking, clinical assessment, and standard two-dimensional and Doppler echocardiography. Anti-Ro/SS-A, anti-La/SS-B, and aCL levels were measured using a standardized ELISA test. The patients were subdivided into two subgroups based on the presence or absence of valvular involvement. The two subgroups were then compared. Valvular involvement was present in 19 patients (30.6%), pericardial effusion in 12 patients (19.4%), impaired left ventricular relaxation abnormalities in 2 patients (3.2%), and pulmonary hypertension in 3 patients (4.8%). More patients in the valvular involvement group had positive anti-Ro/SS-A antibodies than in the valvular noninvolvement group (7/19 vs. 4/43). The difference was significant, with P < 0.01. Serum levels of anti-Ro/SS-A levels were significantly higher in the valvular involvement group (33.7 +/- 36.0 vs. 13.7 +/- 25.1; P < 0.01), as were the serum anti-La/SS-B levels (21.9 +/- 23.5 vs. 10.7 +/- 17.8; P < 0.05). The results suggest a causative correlation between anti-Ro/SS-A and anti-La/SS-B antibodies and the pathogenesis of the valvular lesions in SLE patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac involvement in patients with systemic lupus erythematosus and correlation of valvular lesions with anti-Ro/SS-A and anti-La/SS-B antibody levels

Shahin

Hamid

et al. 2004

Mod Rheumatol

View full text Add to dashboard Cite

show abstract

“…Persistent fetal bradycardias associated with CHB are also potentially dangerous, whereas bradyarrhythmia because of blocked ectopy is well tolerated in pregnancy. CHB can be associated with maternal anti-Ro/SS-A (anti-Ro)/antiLa/SS-B (anti-La) autoantibodies or develop in fetuses with left atrial isomerism or with malformations involving the AV junction [74,75].…”

Section: Embryology Anatomy and Pathophysiology Of Fetal Heart And mentioning

confidence: 99%

“…1). With the introduction of the latest myocardial deformation methodology, fetal tachyarrhythmias can be diagnosed more accurately [75]. Tachyarrhythmias can occur at any age from the developing fetus through adulthood.…”

Section: Embryology Anatomy and Pathophysiology Of Fetal Heart And mentioning

confidence: 99%

Advances in fetal cardiology

Comparetto

Borruto

2014

Evidence Based Womenʼs Health Journal

View full text Add to dashboard Cite

The prevalence of congenital heart malformations as a whole (including diseases of little clinical significance) is 0.8% (8 of 1000 live births). The most frequent pathologies are malformations that prevent blood from reaching the lungs to take oxygen or block the normal supply of oxygenated blood to the body. The transposition of the great vessels (the aorta and pulmonary artery originate from the 'wrong' ventricles) is important as it represents the most severe neonatal heart disease. A separate issue, instead, is that of arrhythmias. The diagnosis is made around the 20th-21st week of gestation through a targeted ultrasound examination of fetal heart. This enables the recognition of the vast majority (around 85%) of clinically important congenital heart diseases (CHD) at birth. Nevertheless, targeted examinations are not possible for all pregnancies: the costs would not allow it. They are still available for patients who have recognized risk factors (they had children with previous CHD, they took teratogenic drugs, or they have diabetes), whereas pregnant women who have a very low risk are subjected to basic ultrasound examinations. An ultrasound examination allows at least suspicion of a significant proportion (30-40%) of important heart diseases. Progresses in the diagnostic field are continuous and the development of visualization techniques provides great opportunities. Four-dimensional (4-D) ultrasound that allows volumetrical viewing of the fetus, moving, to the most detailed facial expressions, appears to be promising in the diagnosis of CHD, which often escape the traditional ultrasound examination. Enabling better visualization of the heart, thanks to the ability to view it from different points and angles, volumetric ultrasound could aid the diagnosis of more heart diseases. Recognition of fetuses with heart disease may be useful for planning targeted interventions. The purpose of prenatal diagnosis is, first, to improve the prognosis without serious damages in the neonatal period. If necessary, there is the possibility of interventions on the fetus (which mainly consists of aortic or pulmonary valve and foramen ovale dilation), but they are still experimental cardiac procedures. In general, the first interventions take place on the newborn baby; therefore, the birth can be arranged at a cardiology and cardiac surgery unit, thus avoiding delays and dangerous transfers. Thanks to the timely diagnosis, today, 90% of operated babies survive and reach adulthood with a normal life expectancy (only for patients with univentricular heart, we impose limits on physical and working activity). Today, complex operations are possible even in low-birth-weight babies, with very good results, attempting to prioritize corrective radical rather than palliative solutions, which until recently were often the only options. As medical therapies play a marginal role in heart malformations, they are instead essential in the treatment of fetal tachyarrhythmias: these are quite rare diseases, which are also detectable by echoc...

show abstract

Anti‐La/SSB antibodies transported across the placenta bind apoptotic cells in fetal organs targeted in neonatal lupus

Tran

Macardle

Hiscock

et al. 2002

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. To determine whether La and/or Ro epitopes on apoptotic cells in fetal organs that are targeted in neonatal lupus syndrome (NLS) are accessible for binding by autoantibodies in vivo, we traced the fate of transplacental autoantibodies in a murine passive transfer model.Methods. Pregnant mice at day 15 of gestation (E15) were injected intraperitoneally with human antiRo/La-positive sera or control sera, and transplacental transfer of human autoantibodies was tested by enzymelinked immunosorbent assay with recombinant antigens. Multiple cryostat sections at the level of the heart of E17 fetuses were visualized simultaneously for human IgG binding and apoptosis (TUNEL) under confocal microscopy. Serial paraffin sections of E17 and E19 fetuses were examined for histologic evidence of inflammation.Results. Human IgG anti-52-kd Ro, anti-60-kd Ro, and anti-La autoantibodies were transported efficiently into the fetal circulation. Human IgG-apoptotic cell complexes were detected in the heart (atrial trabeculae and atrioventricular node), skin, liver, and newly forming bone of fetuses from mothers injected with anti-Ro/La sera but not control sera. The IgG binding was fetal-specific and organ-specific; transplacental autoantibodies did not bind to apoptotic cells in the fetal thymus, lung, brain, or gut. The complexes were not associated with an inflammatory reaction. Injection of mothers with affinity-purified anti-La autoantibodies (but not anti-Ro/La Ig depleted of anti-La) revealed an identical location of IgG binding to apoptotic cells in the fetuses.Conclusion. This is the first study to demonstrate that transplacental anti-La autoantibodies bind specifically to apoptotic cells in selected fetal organs in vivo, similar to the organ involvement in NLS. We hypothesize that additional factors are required to promote proinflammatory clearance of IgG-apoptotic cell complexes and subsequent tissue damage.

show abstract

Cardiac Rhythm and Conduction Disturbances: What is the Role of Autoimmune Mechanisms?

Cited by 15 publications

References 42 publications

Cardiac involvement in patients with systemic lupus erythematosus and correlation of valvular lesions with anti-Ro/SS-A and anti-La/SS-B antibody levels

Cardiac involvement in patients with systemic lupus erythematosus and correlation of valvular lesions with anti-Ro/SS-A and anti-La/SS-B antibody levels

Advances in fetal cardiology

Anti‐La/SSB antibodies transported across the placenta bind apoptotic cells in fetal organs targeted in neonatal lupus

Contact Info

Product

Resources

About