Pre- and post-transplant anti-myosin and anti-heat shock protein antibodies and cardiac transplant outcome.

TitlePre- and post-transplant anti-myosin and anti-heat shock protein antibodies and cardiac transplant outcome.
Publication TypeJournal Article
Year of Publication2004
AuthorsMorgun A, Shulzhenko N, Unterkircher CS, Diniz RVZ, Pereira AB, Silva MS, Nishida SK, Almeida DR, Carvalho ACC, Franco M, Souza MM, Gerbase-DeLima M
JournalThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Volume23
Issue2
Pagination204-9
Date Published2004 Feb
ISSN1053-2498
KeywordsAdult, Autoantibodies, Cardiac Myosins, Cardiomyopathy, Dilated, Case-Control Studies, Chagas Cardiomyopathy, Enzyme-Linked Immunosorbent Assay, Female, Graft Rejection, Heart Transplantation, Heat-Shock Proteins, Humans, Immunoglobulin G, Male, Myocardial Ischemia, Time Factors
Abstract

BACKGROUND: The purpose this study was to investigate the relationship of anti-myosin and anti-heat shock protein immunoglobulin G (IgG) serum antibodies to the original heart disease of cardiac transplant recipients, and also to rejection and patient survival after cardiac transplantation.

METHODS: Anti-myosin and anti-heat shock protein (anti-hsp) IgG antibodies were evaluated in pre-transplant sera from 41 adult cardiac allograft recipients and in sequential post-transplant serum samples from 11 recipients, collected at the time of routine endomyocardial biopsies during the first 6 months after transplantation. In addition, the levels of these antibodies were determined from the sera of 28 healthy blood donors.

RESULTS: Higher anti-myosin antibody levels were observed in pre-transplant sera than in sera from normal controls. Moreover, patients with chronic Chagas heart disease showed higher anti-myosin levels than patients with ischemic heart disease, and also higher levels, although not statistically significant, than patients with dilated cardiomyopathy. Higher anti-hsp levels were also observed in patients compared with healthy controls, but no significant differences were detected among the different types of heart diseases. Higher pre-transplant anti-myosin, but not anti-hsp, levels were associated with lower 2-year post-transplant survival. In the post-transplant period, higher anti-myosin IgG levels were detected in sera collected during acute rejection than in sera collected during the rejection-free period, whereas anti-hsp IgG levels showed no difference between these periods.

CONCLUSIONS: The present findings are of interest for post-transplant management and, in addition, suggest a pathogenic role for anti-myosin antibodies in cardiac transplant rejection, as has been proposed in experimental models of cardiac transplantation.

DOI10.1016/S1053-2498(03)00114-1
Alternate JournalJ. Heart Lung Transplant.