Maternal antibodies against fetal cardiac antigens in congenital complete heart block.
Maternal antibodies against fetal cardiac antigens in congenital complete heart block.
复制标题
先天性完全性心脏传导阻滞中针对胎儿心脏抗原的母体抗体。
DOI：
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发表时间：
1986
影响因子：
158.5
通讯作者：
O. Scott
中科院分区：
文献类型：
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作者：
P. Taylor;J. Scott;L. Gerlis;E. Esscher;O. Scott
先天性心脏传导阻滞的免疫学基础已被提出。为了探讨先天性心脏传导阻滞与母体抗体穿过胎盘的关系，我们用免疫荧光法检测了41名母亲和8名患病儿童的血清样本，以及对照组的血清，以检测胎儿心脏组织的抗体。21名母亲(51%)与胎儿心脏组织有免疫球蛋白抗体反应，而94名对照组中只有9人(10%；P<0.001)。8名受影响的婴儿中有3名，但50名健康婴儿中没有一名有类似的抗体。这些抗体与所有心肌组织发生反应，并不针对传导系统。它们还与其他胎儿组织发生反应，并可与核和平滑肌自身抗体区分开来。我们还观察到，在这些母亲中，巨细胞病毒抗体的发生率较高，但对Epstein-Barr病毒的抗体没有。先天性心脏传导阻滞患儿尸检标本免疫过氧化物酶染色显示免疫球蛋白和补体成分在所有心脏组织中沉积。这些发现加强了与母体抗体相关的免疫反应性在某些(但不是所有)先天性心脏传导阻滞病例中的作用。
An immunologic basis for congenital heart block has been proposed previously. To investigate the association between congenital heart block and maternal antibodies capable of crossing the placenta, we used immunofluorescence to examine serum samples from 41 mothers and 8 affected children, together with serum from controls, for antibodies to fetal cardiac tissue. Twenty-one mothers (51 percent) had IgG antibody reactive with fetal heart tissue, as compared with only 9 of 94 controls (10 percent; P less than 0.001). Three of 8 affected babies, but none of 50 healthy babies, had similar antibodies. The antibodies reacted with all myocardial tissue and were not directed specifically to the conduction system. They also reacted with other fetal tissues and could be distinguished from nuclear and smooth-muscle autoantibodies. We also observed a higher occurrence of antibodies to cytomegalovirus, but not to Epstein-Barr virus, in these mothers. Autopsy specimens from babies with congenital heart block examined by immunoperoxidase staining showed deposition of immunoglobulin and complement components in all cardiac tissues. These findings strengthen the case implicating immune reactivity related to maternal antibody in the development of some but not all cases of congenital heart block.