Kathleen E Simpson1, Madeleine W Cunningham2, Caroline K Lee3, Kent Ward2, Alan Tong4, Saar Danon5, Catherine Simon6, Jeffrey W Delaney7, Charles E Canter3. 1. Washington University School of Medicine in St Louis, St Louis, Missouri. Electronic address: simpson_k@kids.wustl.edu. 2. University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. 3. Washington University School of Medicine in St Louis, St Louis, Missouri. 4. Pediatrix Cardiology, Springfield, Missouri. 5. Saint Louis University School of Medicine, St Louis, Missouri. 6. University of Missouri Kansas City School of Medicine, Kansas City, Missouri. 7. University of Nebraska Medical Center, Omaha, Nebraska.
Abstract
BACKGROUND: Host autoimmune activity in myocarditis has been proposed to play a role in development of cardiac disease, but evidence of autoimmunity and relationship to outcomes have not been evaluated in pediatric myocarditis. METHODS: We performed a multi-institutional study of children with clinical myocarditis. Newly diagnosed patients were followed for up to 12 months and previously diagnosed patients at a single follow-up for serum levels of autoantibodies to human cardiac myosin, beta-adrenergic receptors 1 and 2, muscarinic-2 receptors, and antibody-mediated protein kinase A (PKA) activation in heart cells in culture. Results were compared with those of healthy control children. RESULTS: Both previously diagnosed patient at follow-up (P = .0061) and newly diagnosed patients at presentation (P = .0127) had elevated cardiac myosin antibodies compared with control subjects. Antibody levels were not associated with recovery status at follow-up in either group. PKA activation was higher at presentation in the newly diagnosed patients who did not recovery normal function (P = .042). CONCLUSIONS: Children with myocarditis have evidence of autoantibodies against human cardiac myosin at diagnosis and follow-up compared with control subjects. Differences in antibody-mediated cell signaling may contribute to differences in patient outcomes, as suggested by elevated antibody-mediated PKA activation in heart cells by the serum from nonrecovered patients.
BACKGROUND: Host autoimmune activity in myocarditis has been proposed to play a role in development of cardiac disease, but evidence of autoimmunity and relationship to outcomes have not been evaluated in pediatric myocarditis. METHODS: We performed a multi-institutional study of children with clinical myocarditis. Newly diagnosed patients were followed for up to 12 months and previously diagnosed patients at a single follow-up for serum levels of autoantibodies to humancardiac myosin, beta-adrenergic receptors 1 and 2, muscarinic-2 receptors, and antibody-mediated protein kinase A (PKA) activation in heart cells in culture. Results were compared with those of healthy control children. RESULTS: Both previously diagnosed patient at follow-up (P = .0061) and newly diagnosed patients at presentation (P = .0127) had elevated cardiac myosin antibodies compared with control subjects. Antibody levels were not associated with recovery status at follow-up in either group. PKA activation was higher at presentation in the newly diagnosed patients who did not recovery normal function (P = .042). CONCLUSIONS:Children with myocarditis have evidence of autoantibodies against humancardiac myosin at diagnosis and follow-up compared with control subjects. Differences in antibody-mediated cell signaling may contribute to differences in patient outcomes, as suggested by elevated antibody-mediated PKA activation in heart cells by the serum from nonrecovered patients.
Authors: Franziska Seidel; Carmen Scheibenbogen; Harald Heidecke; Bernd Opgen-Rhein; Thomas Pickardt; Karin Klingel; Felix Berger; Daniel Messroghli; Stephan Schubert Journal: Front Pediatr Date: 2022-04-28 Impact factor: 3.418
Authors: Gerardo García-Rivas; Elena Cristina Castillo; Adrian M Gonzalez-Gil; José Luis Maravillas-Montero; Marion Brunck; Alejandro Torres-Quintanilla; Leticia Elizondo-Montemayor; Guillermo Torre-Amione Journal: ESC Heart Fail Date: 2020-06-13