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The Diagnostic and Clinical Significance of Anti-Muscarinic Receptor Autoantibodies

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Abstract

The role of autoimmunity in cardiovascular diseases has become one of the focal points of research studies. Autoimmune response and autoreactive autoantibodies have been found in dilated cardiomyopathy, heart failure, rheumatic fever, myocarditis, atherosclerosis, and other diseases. Autoantibodies may appear due to tissue injury and exposure of autoantigens, in addition to molecular mimicry and cross-reactivity with antigens found in infectious agents in predisposed individuals. In the early 1990s, autoantibodies reacting with the M2 muscarinic receptor were found in patients with dilated cardiomyopathy and subsequently, in patients with Chagas heart disease and arrhythmic disorders. Immunization of animals with the corresponding antigen triggered cardiac abnormalities also appearing in dilated cardiomyopathy of humans. It has been suggested that antibodies against M2 muscarinic receptors play a role in the pathogenesis of cardiac diseases and may also alter the electrophysiological properties of cardiac tissue. Herein, we review the current knowledge of antibodies against M2 muscarinic receptors and the possible use of a targeted therapy against these autoantibodies.

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Acknowledgment

We wish to thank Phyllis Curchack Kornspan for her editorial assistance.

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Authors and Affiliations

  1. Department of Internal Medicine B and Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Ramat-Gan, 52621, Israel

    Udi Nussinovitch & Yehuda Shoenfeld

  2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Udi Nussinovitch

  3. Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Tel-Aviv University, Tel-Aviv, Israel

    Yehuda Shoenfeld

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  1. Udi Nussinovitch
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  2. Yehuda Shoenfeld
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Correspondence to Yehuda Shoenfeld.

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Nussinovitch, U., Shoenfeld, Y. The Diagnostic and Clinical Significance of Anti-Muscarinic Receptor Autoantibodies. Clinic Rev Allerg Immunol 42, 298–308 (2012). https://doi.org/10.1007/s12016-010-8235-x

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