Alida L P Caforio1, Anna Baritussio1, Renzo Marcolongo2, Chun-Yan Cheng1, Elena Pontara1, Elisa Bison1, Maria Grazia Cattini1, Nicoletta Gallo3, Mario Plebani3, Sabino Iliceto1, Gianpietro Semenzato2, Lisa Maier4, Nabeel Hamzeh5. 1. Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences and Public Health, University of Padova, 35100 Padova, Italy. 2. Hematology and Clinical Immunology, Department of Medicine, University of Padova, 35100 Padova, Italy. 3. Department of Laboratory Medicine, University of Padova, 35100 Padova, Italy. 4. Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, Denver, CO 80206, USA. 5. Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa, Iowa City, IA 52242, USA.
Abstract
BACKGROUND: Sarcoidosis is an immune-mediated disease. Cardiac involvement, a granulomatous form of myocarditis, is under-recognized and prognostically relevant. Anti-heart autoantibodies (AHAs) and anti-intercalated disk autoantibodies (AIDAs) are autoimmune markers in nonsarcoidosis myocarditis forms. OBJECTIVE: The aim was to assess serum AHAs and AIDAs as autoimmune markers in cardiac sarcoidosis. METHODS: This is a cross-sectional study on AHA and AIDA frequency in: 29 patients (aged 46 ± 12, 20 male) with biopsy-proven extracardiac sarcoidosis and biopsy-proven or clinically suspected and confirmed by 18-fluorodeoxyglucose positron emission tomography and/or cardiovascular magnetic resonance (CMR) cardiac involvement; 30 patients (aged 44 ± 11, 12 male) with biopsy-proven extracardiac sarcoidosis without cardiac involvement (no cardiac symptoms, normal 12-lead electrocardiogram, echocardiography and CMR), and control patients with noninflammatory cardiac disease (NICD) (n = 160), ischemic heart failure (IHF) (n = 141) and normal blood donors (NBDs) (n = 270). Sarcoidosis patients were recruited in two recruiting tertiary centers in the USA and Italy. AHAs and AIDAs were detected by indirect immunofluorescence on the human myocardium and skeletal muscle. RESULTS: AHA and AIDA frequencies were higher in sarcoidosis with cardiac involvement (86%; 62%) than in sarcoidosis without cardiac involvement (0%; 0%), NICD (8%; 4%), IHF (7%; 2%) and NBD (9%; 0%) (p = 0.0001; p = 0.0001, respectively). Sensitivity and specificity for cardiac sarcoidosis were 86% and 92% for positive AHAs and 62% and 98% for positive AIDAs, respectively. AIDAs in cardiac sarcoidosis were associated with a higher number of involved organs (p = 0.04). CONCLUSIONS: Serum AHAs and AIDAs provide novel noninvasive diagnostic autoimmune markers for cardiac sarcoidosis.
BACKGROUND:Sarcoidosis is an immune-mediated disease. Cardiac involvement, a granulomatous form of myocarditis, is under-recognized and prognostically relevant. Anti-heart autoantibodies (AHAs) and anti-intercalated disk autoantibodies (AIDAs) are autoimmune markers in nonsarcoidosis myocarditis forms. OBJECTIVE: The aim was to assess serum AHAs and AIDAs as autoimmune markers in cardiac sarcoidosis. METHODS: This is a cross-sectional study on AHA and AIDA frequency in: 29 patients (aged 46 ± 12, 20 male) with biopsy-proven extracardiac sarcoidosis and biopsy-proven or clinically suspected and confirmed by 18-fluorodeoxyglucose positron emission tomography and/or cardiovascular magnetic resonance (CMR) cardiac involvement; 30 patients (aged 44 ± 11, 12 male) with biopsy-proven extracardiac sarcoidosis without cardiac involvement (no cardiac symptoms, normal 12-lead electrocardiogram, echocardiography and CMR), and control patients with noninflammatory cardiac disease (NICD) (n = 160), ischemic heart failure (IHF) (n = 141) and normal blood donors (NBDs) (n = 270). Sarcoidosispatients were recruited in two recruiting tertiary centers in the USA and Italy. AHAs and AIDAs were detected by indirect immunofluorescence on the human myocardium and skeletal muscle. RESULTS: AHA and AIDA frequencies were higher in sarcoidosis with cardiac involvement (86%; 62%) than in sarcoidosis without cardiac involvement (0%; 0%), NICD (8%; 4%), IHF (7%; 2%) and NBD (9%; 0%) (p = 0.0001; p = 0.0001, respectively). Sensitivity and specificity for cardiac sarcoidosis were 86% and 92% for positive AHAs and 62% and 98% for positive AIDAs, respectively. AIDAs in cardiac sarcoidosis were associated with a higher number of involved organs (p = 0.04). CONCLUSIONS: Serum AHAs and AIDAs provide novel noninvasive diagnostic autoimmune markers for cardiac sarcoidosis.
Authors: Basheer Khassawneh; Chengsong Zhu; Briana Barkes; Brian Vestal; Sarah Shrock; May Gillespie; Karin Pacheco; Kevin D Deane; Lisa A Maier; Quan-Zhen Li; Nabeel Hamzeh Journal: PLoS One Date: 2022-10-20 Impact factor: 3.752
Authors: Agata Tymińska; Krzysztof Ozierański; Aleksandra Skwarek; Agnieszka Kapłon-Cieślicka; Anna Baritussio; Marcin Grabowski; Renzo Marcolongo; Alida Lp Caforio Journal: J Pers Med Date: 2022-01-30