Review
Autoimmunity in heart disease: mechanisms and genetic susceptibility

https://doi.org/10.1016/1357-4310(96)81799-0Get rights and content

Abstract

Recent studies of heart disease suggest that immunologically mediated processes often accompany cardiac injury and can contribute to pathogenesis. Murine models of myocarditis have provided insight into the mechanisms by which autoimmune responses to cardiac antigens arise and cause tissue pathology. It is now evident that T cells, cytokines and antibodies can all contribute to cardiac injury. Furthermore, murine models have demonstrated that both the propensity to develop autoreactivity following cardiac injury and the vulnerability of the heart to these responses are under genetic control. Continued studies will help to identify susceptibility genes and might aid in the development of strategies to protect individuals at risk from immunologically mediated damage following cardiac injury.

References (43)

  • K.A. Krolick et al.

    Examination of characteristics that may distinguish disease-causing from benign AChR-reactive antibodies in experimental autoimmune myasthenia gravis

    Adv. Neuroimmunol.

    (1994)
  • H.T. Aretz

    Myocarditis: a histopathologic definition and classification

    Am. J. Cardiovasc. Pathol.

    (1987)
  • K.W. Beisel et al.

    Autoimmune myocarditis: a murine model

    Immunol. Ser.

    (1990)
  • U. Kuhl

    The Ca2+-channel as cardiac autoantigen

    Eur. Heart J.

    (1991)
  • G. Wallukat

    Autoantibodies against the β-adrenergic receptor in human myocarditis and dilated cardiomyopathy: β-adrenergic agonism without desensitization

    Eur. Heart J.

    (1991)
  • H.P. Schultheiss

    The significance of autoantibodies against the ADP/ATP carrier for the pathogenesis of myocarditis and dilated cardiomyopathy — clinical and experimental data

    Springer Semin. Immunopathol.

    (1989)
  • L. Drude et al.

    Impaired myocyte function in vitro incubated with sera from patients with myocarditis

    Eur. Heart J.

    (1991)
  • L.H. Chow et al.

    Phenotypic analysis of infiltrating cells in human myocarditis: an immunohistochemical study in paraffin-embedded tissue

    Arch. Pathol. Lab. Med.

    (1989)
  • S.C. Smith et al.

    Myosin-induced acute myocarditis is a T-cell mediated disease

    J. Immunol.

    (1991)
  • C.S. Via et al.

    B-cell and T-cell function in systemic lupus erythematosus

    Curr. Opin. Rheumatol.

    (1993)
  • M.K. Racke

    Cytokine-induced immune deviation as a therapy for inflammatory autoimmune disease

    J. Exp. Med.

    (1994)
  • Cited by (41)

    • Overview of pediatric myocarditis and pericarditis

      2022, Progress in Pediatric Cardiology
      Citation Excerpt :

      In auto-immune disease and auto-immune reactions, there is damage due to antibodies exhibiting reactivity to cardiac antigens (for example Hashimoto thyroiditis and Grave's disease) and/or T cells targeting the myocardium [10,12]. These autoantibodies occur secondary to exposure to cardiac antigens, particularly in patients with a genetic predisposition to auto-immune disease [15]. In one recent study of 117 Lupus patients, the prevalence of myocarditis was assessed at 1.6% suggesting a significantly higher myocarditis risk for patients with auto-immune disease compared to the general population [16].

    • Molecular mapping of autoimmune B cell responses in experimental myocarditis

      2007, Journal of Autoimmunity
      Citation Excerpt :

      The SEREX approach is not only well-suited for the identification of potential target antigens during autoimmune myocarditis, but permits as well a first fine mapping of the distinct seroepitopes. Our analysis indicates that the region between aa 600–1000, which encompasses the majority of the clones found (see Fig. 2), is most immunogenic and thereby corroborates the previously reported mapping of both B and Th cell epitopes in this region [11,19,44]. Taken together, the detailed molecular mapping of self-specific antibody responses during experimental myocarditis provides further evidence for the notion that virus infection-associated myocardial damage may trigger and perpetuate antibody formation against etiologically significant autoantigens.

    • Ca<sup>2+</sup> currents in cardiac myocytes: Old story, new insights

      2006, Progress in Biophysics and Molecular Biology
      Citation Excerpt :

      But an intriguing question remains: why do autoantibodies have deleterious effects on children while most mothers do not exhibit cardiac symptoms? A number of antibodies have been identified in sera from patients with myocarditis/dilated cardiomyopathy (for reviews see Malkiel et al., 1996; Caforio et al., 2002) and myocarditis/Chagas’ cardiomyopathy (reviewed by Kierszenbaum, 2003). Myocarditis is an inflammatory disease of the myocardium, and idiopathic, autoimmune, and infectious forms of inflammatory cardiomyopathy are recognized.

    View all citing articles on Scopus
    View full text