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Immunoadsorption in Dilated Cardiomyopathy

  • Conference paper
Chronic Viral and Inflammatory Cardiomyopathy

Part of the book series: Ernst Schering Research Foundation Workshop ((SCHERING FOUND,volume 55))

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Abstract

Dilated cardiomyopathy (DCM) is characterized by progressive reduction in contractile function and by dilatation of the right and left ventricles. Abnormalities of the cellular and humoral immune system are present in patients with myocarditis and DCM. Several antibodies against cardiac structures have been detected in DCM patients. The functional significance of cardiac autoantibodies is under debate. For certain antibodies, in vitro data indicate a negative effect on cardiac performance. Furthermore, recent data have provided evidence that cardiac antibodies themselves induce DCM. Cardiac antibodies belong to the IgG fraction and can be eliminated by immunoadsorption therapy. Recent clinical studies showed that removal of antibodies by immunoadsorption improves cardiac function of patients with DCM, indicating that activation of the humoral immune system plays a functional role in DCM.

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References

  • Bruggemann M, Williams GT, Bindon CI, Clark MR, Walker MR, Jefferis R, Waldmann H, Neuberger MS (1987) Comparison of the effector functions of human immunoglobulins using a matched set of chimeric antibodies. J Exp Med 166:1351–1361

    Article  PubMed  CAS  Google Scholar 

  • Bygren P, Freiburghaus C, Lindholm T, Simonsen O, Thysell H, Weislander J (1985) Goodpasture’s syndrome treated with staphylococcal protein A immunoadsorption. Lancet 2:1295–1296

    Article  PubMed  CAS  Google Scholar 

  • Caforio AL, Grazzini M, Mann JM, Feeling PJ, Bottazzo GF, McKenna WJ, Schiaffino S (1992) Identification of alpha-and beta-cardiac myosin heavy chain isoforms as major autoantigens in dilated cardiomyopathy. Circulation 85:1734–1742

    PubMed  CAS  Google Scholar 

  • Dörffel WV, Felix SB, Wallukat G, Brehme S, Bestvater K, Hofmann T, Kleber FX, Baumann G (1997) Short-term hemodynamic effects of immunoadsorption in dilated cardiomyopathy. Circulation 95:1994–1997

    PubMed  Google Scholar 

  • Feldman AM, McNamara DM (2000) Myocarditis. N Engl J Med 343:1388–1398

    Article  PubMed  CAS  Google Scholar 

  • Felix SB, Staudt A, Landsberger M, Grosse Y, Stangl V, Spielhagen T, Wallukat, G, Wernecke K-D, Baumann G, Stangl K (2002) Removal of cardiodepressant antibodies in dilated cardiomyopathy by immunoadsorption. J Am Coll Cardiol 39:646–652

    Article  PubMed  CAS  Google Scholar 

  • Felix SB, Staudt A, Dörffel WV, Stangl V, Merkel K, Pohl M, Döcke WD, Morgera S, Neumayer HM, Wernecke K-D, Wallukat G, Stangl K, Baumann G (2000) Hemodynamic effects of immunoadsorption and subsequent immunoglobulin substitution in dilated cardiomyopathy: three-month results from a randomized study. J Am Coll Cardiol 35:1590–1598

    Article  PubMed  CAS  Google Scholar 

  • Fu LX, Magnusson Y, Bergh CH (1993) Localization of a functional autoimmune epitope on the muscarinic acetylcholine receptor-2 in patients with idiopathic dilated cardiomyopathy. J Clin Invest 91:1964–1968

    Article  PubMed  CAS  Google Scholar 

  • Jahns R, Boivin V, Hein L, Triebel S, Angermann CE, Ertl G, Lohse MJ (2004) Direct evidence for a b1-adrenergic receptor-directed autoimmune attack as a cause of idiopathic dilated cardiomyopathy. J Clin Invest 113:1419–1429

    Article  PubMed  CAS  Google Scholar 

  • Kühl U, Noutsias M, Schultheiss HP (1995) Immunohistochemistry in dilated cardiomyopathy. Eur Heart J 16Suppl O:100–106

    PubMed  Google Scholar 

  • Limas CJ, Goldenberg IF, Limas C (1989) Autoantibodies against betaadrenoceptors in human idiopathic dilated cardiomyopathy. Circ Res 64:97–103

    PubMed  CAS  Google Scholar 

  • Liu PP, Mason JW (2001) Advances in the understanding of myocarditis. Circulation 104:1076–1082

    PubMed  CAS  Google Scholar 

  • Magnusson Y, Wallukat G, Waagstein F, Hjalmarson A, Hoebeke J (1994) Autoimmunity in idiopathic dilated cardiomyopathy. Characterization of antibodies against the beta 1-adrenoceptor with positive chronotropic effect. Circulation 89:2760–2767

    PubMed  CAS  Google Scholar 

  • Matsui S, Fu MLX, Katsuda S, Teraoka K, Kurihara I, Takekoshi N, Murakami E, Hoebeke J, Hjalmarson A (1997) Peptides derived from cardiovascular Gproteincoupled receptors induce morphological cardiomyopathic changes in immunized rabbits. J Mol Cell Cardiol 29:641–655

    Article  PubMed  CAS  Google Scholar 

  • Müller J, Wallukat G, Dandel M, Bieda H, Brandes K, Spiegelsberger S, Nissen E, Kunze R, Hetzer R (2000) Immunoglobulin adsorption in patients with idiopathic dilated cardiomyopathy. Circulation 101:385–391

    PubMed  Google Scholar 

  • Nishimura H, Okazaki T, Tanaka Y, Nakatani K, Hara M, Matsumori A, Sasayama S, Mizoguchi A, Hiai H, Minato N, Honjo1 T (2001) Autoimmune dilated cardiomyopathy in PD-1 receptor-deficient mice. Science 291:319–322

    Article  PubMed  CAS  Google Scholar 

  • Noutsias M, Seeberg B, Schultheiss HP, Kühl U (1999) Expression of cell adhesion molecules in dilated cardiomyopathy: evidence for endothelial activation in inflammatory cardiomyopathy. Circulation 99:2124–2131

    PubMed  CAS  Google Scholar 

  • Okazaki T, Tanaka Y, Nishio R, Mitsuiye T, Mizoguchi A, Wang J, Ishida M, Hiai H, Matsumori A, Minato N, Honjo T (2003) Autoantibodies against cardiac troponin I are responsible for dilated cardiomyopathy in PD-1-deficient mice. Nat Med 9:1477–1483

    Article  PubMed  CAS  Google Scholar 

  • Palmer A, Gjorstrup P, Severn A, Welsh K, Traube D (1988) Treatment of systemic lupus erythematodes by extracorporeal immunoadsorption. Lancet 2:272

    Article  PubMed  CAS  Google Scholar 

  • Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, O’Connel J, Olsen E, Thiene G, Goodwin J, Gyarfas I, Martin I, Nordet P (1996) Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies. Circulation 93:841–842

    PubMed  CAS  Google Scholar 

  • Schultheiss HP, Kuhl U, Janda I, Melzner B, Ulrich G, Morad M (1988) Antibody-mediated enhancement of calcium permeability in cardiac myocytes. J Exp Med 168:2102–2119

    Article  Google Scholar 

  • Staudt A, Schaper F, Stangl V, Plagemann A, Böhm M, Merkel K, Wallukat G, Wernecke K-D, Stangl K, Baumann G, Felix SB (2001) Immunohistological changes in dilated cardiomyopathy induced by immunoadsorption therapy and subsequent immunoglobulin substitution. Circulation 103:2681–2686

    PubMed  CAS  Google Scholar 

  • Staudt A, Bohm M, Knebel F, Grosse Y, Bischoff C, Hummel A, Dahm JB, Borges A, Jochmann N, Wernecke KD, Wallukat G, Baumann G, Felix SB (2002) Potential role of autoantibodies belonging to the immunoglobulin G-3 subclass in cardiac dysfunction among patients with dilated cardiomyopathy. Circulation 106:2448–2453

    Article  PubMed  CAS  Google Scholar 

  • Staudt A, Staudt Y, Dörr M, Böhm M, Knebel F, Hummel A, Wunderle L, Tiburcy M, Wernecke K-D, Baumann G, Felix SB (2004) Potential role of humoral immunity in cardiac dysfunction of patient suffering from dilated cardiomyopathy. J Am Coll Cardiol 44:829–836

    Article  PubMed  Google Scholar 

  • Warraich RS, Noutsias M, Kazak I, Seeberg B, Dunn MJ, Schultheiss HP, Yacoub MH, Kuhl U, Kasac I (2002) Immunoglobulin G3 cardiac myosin autoantibodies correlate with left ventricular dysfunction in patients with dilated cardiomyopathy: immunoglobulin G3 and clinical correlates. Am Heart J 143:1076–1084

    Article  PubMed  CAS  Google Scholar 

  • Wojnicz R, Nowalany-Kozielska E, Wodniecki J, Szczurek-Katanski K, Nozynski J, Zembala M, Rozek MM (1998) Immunohistological diagnosis of myocarditis. Potential role of sarcolemmal induction of the MHC and ICAM-1 in the detection of autoimmune mediated myocyte injury. Eur Heart J 19:1564–1572

    Article  PubMed  CAS  Google Scholar 

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© 2006 Springer-Verlag Berlin Heidelberg

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Felix, S.B. (2006). Immunoadsorption in Dilated Cardiomyopathy. In: Schultheiss, H.P., Kapp, J.F., Grötzbach, G. (eds) Chronic Viral and Inflammatory Cardiomyopathy. Ernst Schering Research Foundation Workshop, vol 55. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-30822-9_20

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  • DOI: https://doi.org/10.1007/3-540-30822-9_20

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-23971-0

  • Online ISBN: 978-3-540-30822-5

  • eBook Packages: MedicineMedicine (R0)

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