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Immunadsorption: Eine neue intensivmedizinische Methode zur Rekompensation von Patienten mit dilatativer Kardiomyopathie und Herzinsuffizienz [Immunadsorption - a new therapeutic approach in patients with dilated cardiomyopathy]

Item Type:Article
Title:Immunadsorption: Eine neue intensivmedizinische Methode zur Rekompensation von Patienten mit dilatativer Kardiomyopathie und Herzinsuffizienz [Immunadsorption - a new therapeutic approach in patients with dilated cardiomyopathy]
Creators Name:Stangl, V. and Staudt, A. and Doerffel, W.V. and Wallukat, G. and Stangl, K. and Baumann, G. and Felix, S.B.
Abstract:For patients with dilative cardiomyopathy (DCM), the prognosis is highly unfavorable, even under conditions of optimal medication. At present, there is no option for causal therapy. Since there is increasing evidence that modifications of the immune system accompanied by the production of autoantibodies, e.g., against {beta} 1 ad-renergic or muscarinergic receptors, are involved in the pathogenesis of DCM, the elucidation of the possible functional significance of these autoantibodies has attracted increasing interest. In addition to the role of autoantibodies as markers for an autoimmune process, discussion of the possible pathogenetic mechanisms has centered on direct toxicity as well as on negative influencing of myocardial contractility and energy metabolism. The effects gained through removal of autoantibodies by immunoadsorption therapy for DCM patients sheds light on the functional importance of autoantibodies in this syndrome. The principle of this form of therapy is based on the binding of circulating antibodies to sepharose columns, to which polyclonal antibodies against human immunoglobulin are linked. A pilot study conducted among DCM patients disclosed that immunadsorption took place in simultaneous conjunction with a reduction in the immunoglobulin level and with significant hemodynamic and clinical improvement. These results may be interpreted as indicating that autoantibodies play an active role in DCM and that their removal by immunadsorption possibly represents a highly promising future therapeutic concept.
Keywords:Dilative Cardiopulmonary, Autoantibodies, Immunadsorption
Source:Intensivmedizin und Notfallmedizin
ISSN:0303-6251
Publisher:Steinkopff (Germany)
Volume:37
Number:2
Page Range:139-145
Date:March 2000
Official Publication:https://doi.org/10.1007/s003900050314

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