Beta 1-adrenergic receptor-directed autoimmunity as a cause of dilated cardiomyopathy in rats

Int J Cardiol. 2006 Sep 10;112(1):7-14. doi: 10.1016/j.ijcard.2006.05.008. Epub 2006 Jul 26.

Abstract

Progressive cardiac dilatation and pump failure of unknown etiology has been termed idiopathic dilated cardiomyopathy (DCM). During recent years a large body of data has accumulated indicating that functionally active antibodies or autoantibodies being able to recognize and to stimulate the cardiac beta(1)-adrenergic receptor (anti-beta(1)-AR) may play an important role in the initiation and/or clinical course of DCM. Recent experiments in rats even point towards a cause-and-effect relation between stimulatory anti-beta(1)-AR antibodies and DCM. Immunization of rats against the second extracellular loop of the human beta(1)-adrenergic receptor (100% sequence-identity between human and rat) resulted in both development of stimulatory anti-beta(1)-AR antibodies and development of progressive cardiac dilatation and dysfunction. Isogenic transfer of stimulatory anti-beta(1)-AR from cardiomyopathic into healthy inbred animals reproduced the disease, hence providing conclusive proof for a beta(1)-receptor-directed autoimmune attack as a possible cause of cardiomyopathy. This kind of cardiomyopathy is now referred to as anti-beta(1)-AR-induced dilated immune-cardiomyopathy (DiCM). The following article reviews recent evidence obtained from experimental animal-models implying a significant role of the cardiac beta(1)-adrenergic receptor as a pathophysiologically and clinically relevant autoantigen also in human DCM.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Animals
  • Autoantibodies / immunology
  • Autoantigens / immunology
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / physiopathology
  • Autoimmunity* / drug effects
  • Cardiomyopathy, Dilated / drug therapy
  • Cardiomyopathy, Dilated / immunology*
  • Cardiomyopathy, Dilated / physiopathology
  • Humans
  • Myocardial Contraction / immunology
  • Rats
  • Receptors, Adrenergic, beta-1 / drug effects
  • Receptors, Adrenergic, beta-1 / immunology*

Substances

  • Adrenergic beta-Antagonists
  • Autoantibodies
  • Autoantigens
  • Receptors, Adrenergic, beta-1