Humoral immune response to cardiac conducting tissue

Lotze, Ulrich; Maisch, Bernhard

doi:10.1007/bf00201879

Cited by 9 publications

(4 citation statements)

References 44 publications

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“…In contrast to the study by Obiassi et al [41], we found ACPCab associated with either anticross striated or anti-cytoplasmatic antibodies not only in 27% of patients with AV block, but also in a similar range in the age-matched and disease control population. Therefore, from our data the ACPCab cannot be considered as specific diagnostic or prognostic markers in AV conduction disturbances [33,37].…”

Section: Anti-cardiac Purkinje Cell Autoantibodies In Ox False Tendonmentioning

confidence: 85%

“…IgG autoantibodies to adrenergic and muscarinic receptors have been described in babies with congenital heart block [33]. These antibodies were completely independent of Ro/La antibodies and activated only the receptors in the neonatal tissue.…”

Section: Autoimmunity To Adrenergic and Muscarinic Cholinergic Receptorsmentioning

confidence: 99%

“…ASNab could be detected in 24% of the patients with AV block. In 54% of the patients with both AV block and ASNab binodal disease was present [33,37].…”

Section: Autoantibodies To Endogenous Retrovirus-3 Endogenous Retrovimentioning

confidence: 99%

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

Ristić

Maisch

2000

Herz

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The immunopathogenesis of cardiac rhythm and conduction disorders has been underestimated. Therefore, the aim of this review is to analyze the current data and controversial issues in this area. The incidence of autoantibodies to human conducting tissue has been analyzed in sick sinus syndrome, bradyarrhythmia, and hypersensitive carotid sinus syndrome. Patients with anti-sinus node antibodies (ASNab) have a 10-fold higher risk of developing sick sinus syndrome, compared to age-matched controls. The risk of acquiring an atrioventricular block was up to 3-fold in patients with anti-atrioventricular node antibodies (AAVNab) in comparison to controls. The incidence of anti His antibodies (AHISab) was low both in patients and controls. Anti-cardiac Purkinje cell antibodies (ACPCab) seemed to be an epiphenomenon and not a pathogenetic marker of conduction disorders. In congenital heart block association with HLA-B27 and HLA-DR3 is a possible prerequisite in the pathophysiology of the disease, although transplacental passage of various antibodies and immune complexes is widely recognized. The main autoantibodies detected both in children with congenital heart block and their mothers are anti-Ro/SS-A and anti-La/SS-B antibodies. The cross-reactivity of laminin with anti-La antibodies could be important in the initiation of the autoimmune process. Autoantibodies against adrenoceptors and muscarinic cholinergic receptors of neonatal heart and human endogenous retrovirus-3 expressed in fetal cardiac tissue could also play a role in the pathogenesis of the congenital heart block. Of note, apoptosis could be one of the possible mechanisms of the progression of the congenital conduction disturbances to the complete heart block. In addition, evidence is compiling that cellular activation and cellular cytotoxicity specific for a given target tissue appears to be at least equally important in the pathogenesis of the disease as the humoral response. In conclusion, the immunopathogenesis of certain cardiac rhythm and conduction disorders is well established in sick sinus syndrome, congenital heart block, and connective tissue diseases. ASNab, AAVNab, anti-Ro/SS-A, and anti-La/SS-B antibodies can be regarded as diagnostic and prognostic markers.

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Section: Anti-cardiac Purkinje Cell Autoantibodies In Ox False Tendonmentioning

confidence: 85%

Section: Autoimmunity To Adrenergic and Muscarinic Cholinergic Receptorsmentioning

confidence: 99%

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

Ristić

Maisch

2000

Herz

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“…Of particular interest was also the antibody response to the beta-receptor in the sera of patients with myocarditis and dilated cardiomyopathy (38, 39) and the muscarinic acetylcholine receptor (40). Of note, also the cardiac conduction tissue was addressed by the humoral immune response to the sinus and atrioventricular nodes and Purkinje fibers (41, 42) (Figures 3, 4, Table 2).…”

Section: Autoantibody—mediated Immune Response In Human Myocarditismentioning

confidence: 99%

Cardio-Immunology of Myocarditis: Focus on Immune Mechanisms and Treatment Options

Maisch

2019

Front. Cardiovasc. Med.

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Myocarditis and inflammatory cardiomyopathy are syndromes, not aetiological disease entities. From animal models of cardiac inflammation we have detailed insight of the strain specific immune reactions based on the genetic background of the animal and the infectiosity of the virus. Innate and adaptive immunity also react in man. An aetiological diagnosis of a viral vs. a non-viral cause is possible by endomyocardial biopsy with histology, immunohistology and PCR for microbial agents. This review deals with the different etiologies of myocarditis and inflammatory cardiomyopathy on the basis of the genetic background and the predisposition for inflammation. It analyses the epidemiologic shift in cardiotropic viral agents in the last 30 years. Based on the understanding of the interaction between infection and the players of the innate and adaptive immune system it summarizes pathogenetic phases and clinical faces of myocarditis. It gives an up-to-date information on specific treatment options beyond symptomatic heart failure and antiarrhythmic therapy. Although inflammation can resolve spontaneously, specific treatment directed to the causative etiology is often required. For fulminant, acute, and chronic autoreactive myocarditis without viral persistence immunosuppressive treatment can be life-saving, for viral inflammatory cardiomyopathy ivIg treatment can resolve inflammation and often eradicate the virus.

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Sick Sinus Syndrome

Shetty¹,

Scott

2015

Clinical Cardiac Electrophysiology in the Young

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Humoral immune response to cardiac conducting tissue

Cited by 9 publications

References 44 publications

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

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

Cardio-Immunology of Myocarditis: Focus on Immune Mechanisms and Treatment Options

Sick Sinus Syndrome

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