HIGH PREVALENCE OF ANTIBODIES AGAINST BETA(1)-ADRENOCEPTORS AND BETA(2)-ADRENOCEPTORS IN PATIENTS WITH PRIMARY ELECTRICAL CARDIAC ABNORMALITIES
HIGH PREVALENCE OF ANTIBODIES AGAINST BETA(1)-ADRENOCEPTORS AND BETA(2)-ADRENOCEPTORS IN PATIENTS WITH PRIMARY ELECTRICAL CARDIAC ABNORMALITIES
复制标题
DOI：
10.1016/0735-1097(95)00262-2
复制
发表时间：
1995-10-01
影响因子：
24
通讯作者：
HOEBEKE, J
中科院分区：
文献类型：
--
作者：
CHIALE, PA;ROSENBAUM, MB;HOEBEKE, J
目标.本研究旨在确定原发性心电图异常（包括房性心律失常、室性心律失常和传导障碍）患者在无任何其他心脏异常的情况下，针对β肾上腺素受体的自身抗体的患病率，背景。使用合成肽对应的预测序列的第二个细胞外环的人β（1）和β（2）-肾上腺素受体作为抗原的目标，针对β-肾上腺素受体的自身抗体最近被证明发生在患者的特发性扩张型心肌病和恰加斯心脏病。86例患者（57例原发性心电异常，29例原发性扩张型心肌病）和101例健康和心脏病对照者进行了研究。在九个选定的结果：在11例血清学阳性的心肌细胞中发现了识别β（1）肽和β（2）肽的抗体21例室性心律失常患者中，（p < 0.01），5（35.7%）的14例传导障碍患者（p < 0.05），3房性心律失常22例，占13.6%（p > 0.05）和11 29例扩张型心肌病患者中，（p < 0.05）与15在101名对照组受试者中，培养的心肌细胞搏动速率的快速增加由来自选定患者组的IgG诱导，表明与功能表位的激动剂样相互作用，结论原发性室性心律失常和传导障碍与原发性心肌病一样，与β-肾上腺素受体功能表位相互作用的抗体普遍存在，提示共同或相似的异常免疫调节过程。
Objectives. This study sought to determine the prevalence of autoantibodies directed against the beta adrenoceptors in patients with primary electrical cardiac abnormalities, including atrial arrhythmias, ventricular arrhythmias and conduction disturbances, in the absence of any other cardiac abnormality,Background. Using synthetic peptides corresponding to the predicted sequences for the second extracellular loop of the human beta(1)- and beta(2)-adrenoceptors as antigenic targets, autoantibodies directed against the beta-adrenoceptors were recently shown to occur in patients with idiopathic dilated cardiomyopathy and Chagas' heart disease.Methods. Eighty-six patients (57 with primary electrical abnormalities, 29 with idiopathic dilated cardiomyopathy) and 101 healthy and cardiopathic control subjects were studied, Antibodies against the beta(1)- and beta(2)-peptides were detected with an enzyme immunoassay performed in blinded manner. In nine selected (seropositive) cases, the immunoglobulin G (IgG) fraction was tested for functional effects on the rate of beating of cultured neonatal rat cardiomyocytes.Results, Antibodies recognizing the beta(1)- and beta(2) peptides were found in 11 (52.3%) of 21 patients with ventricular arrhythmias (p < 0.01), 5 (35.7%) of 14 patients with conduction disturbances (p < 0.05), 3 (13.6%) of 22 patients with atrial arrhythmias (p > 0.05) and 11 (37.9%) of 29 patients with dilated cardiomyopathy (p < 0.05) compared with 15 (14.8%) of 101 control subjects, A rapid increase in the rate of beating of the cultured cardiomyocytes was induced by IgG from a selected group of patients, suggesting an agonist like interaction with a functional epitope, This response was mediated by stimulation of both the beta(1) and beta(2)-adrenoceptors in the patients with primary ventricular arrhythmias but only the beta(1)-adrenoceptors in the patients with idiopathic dilated cardiomyopathy.Conclusions, Primary ventricular arrhythmias and conduction disturbances, like idiopathic cardiomyopathy, show a high prevalence of antibodies interacting with functional epitopes of the beta-adrenoceptors, suggesting a common or similar abnormal immunoregulatory process.