Potential role of autoantibodies belonging to the immunoglobulin G-3 subclass in cardiac dysfunction among patients with dilated cardiomyopathy

Item Type:	Article
Title:	Potential role of autoantibodies belonging to the immunoglobulin G-3 subclass in cardiac dysfunction among patients with dilated cardiomyopathy
Creators Name:	Staudt, A. and Boehm, M. and Knebel, F. and Grosse, Y. and Bischoff, C. and Hummel, A. and Dahm, J.B. and Borges, A. and Jochmann, N. and Wernecke, K.D. and Wallukat, G. and Baumann, G. and Felix, S.B.
Abstract:	Background- Immunoadsorption capable of removing circulating autoantibodies represents an additional therapeutic approach in dilated cardiomyopathy (DCM). The role played by autoantibodies belonging to the immunoglobulin (Ig) subclass G-3 in cardiac dysfunction remains to be elucidated. Methods and Results- Patients with DCM (left ventricular ejection fraction <30%) participated in this case-control study. Nine patients underwent immunoadsorption with protein A (low affinity to IgG-3), and 9 patients were treated with anti-IgG, which removes all IgG subclasses. Immunoadsorption was performed in 4 courses at 1-month intervals until month 3. In the 2 groups, immunoadsorption induced comparable reduction of total IgG (>80%). IgG-3 was effectively eliminated only by anti-IgG adsorption (eg, during the first immunoadsorption course; protein A, −37±4%; anti-IgG, −89±3%; P<0.001 versus protein A). The {beta}1-receptor autoantibody was effectively reduced only by anti-IgG (P<0.01 versus protein A). Hemodynamics did not change in the protein A group. In the anti-IgG group during the first immunoadsorption course, cardiac index increased from 2.3±0.1 to 3.0±0.1 L · min−1 · m−2 (P<0.01 versus protein A). After 3 months, before the last immunoadsorption course, cardiac index was 2.2±0.1 L · min−1 · m−2 in the protein A group and 3.0±0.2 L · min−1 · m−2 in the anti-IgG group (P<0.01 versus protein A). Left ventricular ejection fraction increased only in the anti-IgG group (P<0.05 versus protein A). Conclusions- Autoantibodies belonging to IgG-3 may play an important role in cardiac dysfunction of DCM. The removal of antibodies of the IgG-3 subclass may represent an essential mechanism of immunoadsorption in DCM.
Keywords:	Cardiomyopathy, Immunoadsorption, Antibodies, Animals, Rats
Source:	Circulation
ISSN:	0009-7322
Publisher:	American Heart Association
Volume:	106
Number:	19
Page Range:	2448-2453
Date:	5 November 2002
Official Publication:	https://doi.org/10.1161/01.CIR.0000036746.49449.64
PubMed:	View item in PubMed

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