Abstract

Sudden cardiac death (SCD) is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 h of symptom onset) in a person with known or unknown cardiac disease. Patients with cardiomyopathies, myocarditis, ischemic heart disease and cardiac channelopathies are at risk of SCD. However, a certain percentage of autopsy-negative cases of SCD in the young (<35 years) remain unexplained even after a post-mortem genetic testing. Autoantibodies against cardiac proteins may be potentially involved in the pathogenesis of different heart diseases and in the occurrence of unexplained SCD. In this review we analyze clinical and animal studies that elucidate the prevalence of these autoantibodies in patients with different cardiac diseases and their pathophysiological relevance. We propose a classification of the autoantibodies associated with heart diseases and focus on their molecular and cellular effects. Anti-beta adrenergic receptor antibodies and anti-muscarinic acetylcholine receptor antibodies affect myocardial electrophysiological properties and were reported to be the independent predictors of SCD in patients with different heart diseases. Autoimmune mechanism is proposed for cardiac-related adverse reactions following human papillomavirus (HPV) vaccination. The pentapeptid sharing between HPV's antigens, adrenergic receptors and muscarinic acetylcholine receptors supports this assumption. The dysregulating effects of the autoantibodies against calcium and potassium ion channels can be the basis for autoimmune phenocopies of genetic cardiac channelopathies, which are also associated with SCD.

Original languageEnglish
Pages (from-to)415-425
Number of pages11
JournalAutoimmunity Reviews
Volume18
Issue number4
Early online date1 Jan 2019
DOIs
Publication statusPublished - Apr 2019

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Sudden Cardiac Death
Autoantibodies
Immunoglobulins
Heart Diseases
Channelopathies
Muscarinic Receptors
Antigen Receptors
Adrenergic Antagonists
Potassium Channels
Receptors, Adrenergic, beta
Myocarditis
Genetic Testing
Calcium Channels
Cardiomyopathies
Adrenergic Receptors
Myocardial Ischemia
Anti-Idiotypic Antibodies
Autopsy
Vaccination
Antibodies

Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Immunology and Microbiology(all)

Cite this

@article{d122d32d43844b9b9c2907cc1a9a99e9,
title = "Lethal immunoglobulins: Autoantibodies and sudden cardiac death",
abstract = "Sudden cardiac death (SCD) is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 h of symptom onset) in a person with known or unknown cardiac disease. Patients with cardiomyopathies, myocarditis, ischemic heart disease and cardiac channelopathies are at risk of SCD. However, a certain percentage of autopsy-negative cases of SCD in the young (<35 years) remain unexplained even after a post-mortem genetic testing. Autoantibodies against cardiac proteins may be potentially involved in the pathogenesis of different heart diseases and in the occurrence of unexplained SCD. In this review we analyze clinical and animal studies that elucidate the prevalence of these autoantibodies in patients with different cardiac diseases and their pathophysiological relevance. We propose a classification of the autoantibodies associated with heart diseases and focus on their molecular and cellular effects. Anti-beta adrenergic receptor antibodies and anti-muscarinic acetylcholine receptor antibodies affect myocardial electrophysiological properties and were reported to be the independent predictors of SCD in patients with different heart diseases. Autoimmune mechanism is proposed for cardiac-related adverse reactions following human papillomavirus (HPV) vaccination. The pentapeptid sharing between HPV's antigens, adrenergic receptors and muscarinic acetylcholine receptors supports this assumption. The dysregulating effects of the autoantibodies against calcium and potassium ion channels can be the basis for autoimmune phenocopies of genetic cardiac channelopathies, which are also associated with SCD.",
keywords = "sudden cardiac death, autoantibodies, autoimmunity, Anti-muscarinic acethylcholine receptor antibodies, Anti-β1 adrenergic receptor antibodies, Autoantibodies, Autoimmunity, Channelopathies, HPV vaccine, POTS, Sudden cardiac death, TACHYCARDIA SYNDROME POTS, 2ND EXTRACELLULAR LOOP, DILATED CARDIOMYOPATHY, NA-K-ATPASE, ATRIAL-FIBRILLATION, TROPONIN-I, Anti-beta 1 adrenergic receptor antibodies, ALPHA(1)-ADRENERGIC RECEPTOR, ORTHOSTATIC HYPOTENSION, ANTIMITOCHONDRIAL ANTIBODIES ANTI-M7, LEFT-VENTRICULAR FUNCTION",
author = "Ryabkova, {Varvara A.} and Shubik, {Yuri V.} and Erman, {Mikhail V.} and Churilov, {Leonid P.} and Darja Kanduc and Yehuda Shoenfeld",
year = "2019",
month = "4",
doi = "10.1016/j.autrev.2018.12.005",
language = "English",
volume = "18",
pages = "415--425",
journal = "Autoimmunity Reviews",
issn = "1568-9972",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - Lethal immunoglobulins

T2 - Autoantibodies and sudden cardiac death

AU - Ryabkova, Varvara A.

AU - Shubik, Yuri V.

AU - Erman, Mikhail V.

AU - Churilov, Leonid P.

AU - Kanduc, Darja

AU - Shoenfeld, Yehuda

PY - 2019/4

Y1 - 2019/4

N2 - Sudden cardiac death (SCD) is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 h of symptom onset) in a person with known or unknown cardiac disease. Patients with cardiomyopathies, myocarditis, ischemic heart disease and cardiac channelopathies are at risk of SCD. However, a certain percentage of autopsy-negative cases of SCD in the young (<35 years) remain unexplained even after a post-mortem genetic testing. Autoantibodies against cardiac proteins may be potentially involved in the pathogenesis of different heart diseases and in the occurrence of unexplained SCD. In this review we analyze clinical and animal studies that elucidate the prevalence of these autoantibodies in patients with different cardiac diseases and their pathophysiological relevance. We propose a classification of the autoantibodies associated with heart diseases and focus on their molecular and cellular effects. Anti-beta adrenergic receptor antibodies and anti-muscarinic acetylcholine receptor antibodies affect myocardial electrophysiological properties and were reported to be the independent predictors of SCD in patients with different heart diseases. Autoimmune mechanism is proposed for cardiac-related adverse reactions following human papillomavirus (HPV) vaccination. The pentapeptid sharing between HPV's antigens, adrenergic receptors and muscarinic acetylcholine receptors supports this assumption. The dysregulating effects of the autoantibodies against calcium and potassium ion channels can be the basis for autoimmune phenocopies of genetic cardiac channelopathies, which are also associated with SCD.

AB - Sudden cardiac death (SCD) is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 h of symptom onset) in a person with known or unknown cardiac disease. Patients with cardiomyopathies, myocarditis, ischemic heart disease and cardiac channelopathies are at risk of SCD. However, a certain percentage of autopsy-negative cases of SCD in the young (<35 years) remain unexplained even after a post-mortem genetic testing. Autoantibodies against cardiac proteins may be potentially involved in the pathogenesis of different heart diseases and in the occurrence of unexplained SCD. In this review we analyze clinical and animal studies that elucidate the prevalence of these autoantibodies in patients with different cardiac diseases and their pathophysiological relevance. We propose a classification of the autoantibodies associated with heart diseases and focus on their molecular and cellular effects. Anti-beta adrenergic receptor antibodies and anti-muscarinic acetylcholine receptor antibodies affect myocardial electrophysiological properties and were reported to be the independent predictors of SCD in patients with different heart diseases. Autoimmune mechanism is proposed for cardiac-related adverse reactions following human papillomavirus (HPV) vaccination. The pentapeptid sharing between HPV's antigens, adrenergic receptors and muscarinic acetylcholine receptors supports this assumption. The dysregulating effects of the autoantibodies against calcium and potassium ion channels can be the basis for autoimmune phenocopies of genetic cardiac channelopathies, which are also associated with SCD.

KW - sudden cardiac death, autoantibodies, autoimmunity

KW - Anti-muscarinic acethylcholine receptor antibodies

KW - Anti-β1 adrenergic receptor antibodies

KW - Autoantibodies

KW - Autoimmunity

KW - Channelopathies

KW - HPV vaccine

KW - POTS

KW - Sudden cardiac death

KW - TACHYCARDIA SYNDROME POTS

KW - 2ND EXTRACELLULAR LOOP

KW - DILATED CARDIOMYOPATHY

KW - NA-K-ATPASE

KW - ATRIAL-FIBRILLATION

KW - TROPONIN-I

KW - Anti-beta 1 adrenergic receptor antibodies

KW - ALPHA(1)-ADRENERGIC RECEPTOR

KW - ORTHOSTATIC HYPOTENSION

KW - ANTIMITOCHONDRIAL ANTIBODIES ANTI-M7

KW - LEFT-VENTRICULAR FUNCTION

UR - http://www.scopus.com/inward/record.url?scp=85061634062&partnerID=8YFLogxK

UR - http://www.mendeley.com/research/lethal-immunoglobulins-autoantibodies-sudden-cardiac-death

U2 - 10.1016/j.autrev.2018.12.005

DO - 10.1016/j.autrev.2018.12.005

M3 - Review article

AN - SCOPUS:85061634062

VL - 18

SP - 415

EP - 425

JO - Autoimmunity Reviews

JF - Autoimmunity Reviews

SN - 1568-9972

IS - 4

ER -