Pre- and post-transplant anti-myosin and anti-heat shock protein antibodies and cardiac transplant outcome.
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.
Morgun
Andrey
A
Division of Immunogenetics, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil. anemorgun@hotmail.com
Shulzhenko
Natalia
N
Unterkircher
Carmelinda S
CS
Diniz
Rosiane V Z
RV
Pereira
Aparecido B
AB
Silva
Marcelo S
MS
Nishida
Sonia K
SK
Almeida
Dirceu R
DR
Carvalho
Antonio C C
AC
Franco
Marcello
M
Souza
Marcia M
MM
Gerbase-DeLima
Maria
M
D000328:Adult; D001323:Autoantibodies / Q000276:immunology*; D024722:Cardiac Myosins / Q000276:immunology*; D002311:Cardiomyopathy, Dilated / Q000276:immunology / Q000601:surgery; D016022:Case-Control Studies; D002598:Chagas Cardiomyopathy / Q000276:immunology / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D016027:Heart Transplantation / Q000276:immunology / Q000401:mortality; D006360:Heat-Shock Proteins / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D017202:Myocardial Ischemia / Q000276:immunology / Q000601:surgery; D013997:Time Factors
D001323:Autoantibodies; D006360:Heat-Shock Proteins; D007074:Immunoglobulin G; D024722:Cardiac Myosins