title: Pre- and post-transplant anti-myosin and anti-heat shock protein antibodies and cardiac transplant outcome.
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.
authors.affiliation: Division of Immunogenetics, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil. anemorgun@hotmail.com
authors.forename: Andrey
authors.initials: A
authors.lastname: Morgun
authors.forename: Natalia
authors.initials: N
authors.lastname: Shulzhenko
authors.forename: Carmelinda S
authors.initials: CS
authors.lastname: Unterkircher
authors.forename: Rosiane V Z
authors.initials: RV
authors.lastname: Diniz
authors.forename: Aparecido B
authors.initials: AB
authors.lastname: Pereira
authors.forename: Marcelo S
authors.initials: MS
authors.lastname: Silva
authors.forename: Sonia K
authors.initials: SK
authors.lastname: Nishida
authors.forename: Dirceu R
authors.initials: DR
authors.lastname: Almeida
authors.forename: Antonio C C
authors.initials: AC
authors.lastname: Carvalho
authors.forename: Marcello
authors.initials: M
authors.lastname: Franco
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Souza
authors.forename: Maria
authors.initials: M
authors.lastname: Gerbase-DeLima
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D006360:Heat-Shock Proteins; D007074:Immunoglobulin G; D024722:Cardiac Myosins