title: The humoral immune response in viral heart disease: characterization and pathophysiological significance of antibodies.
abstract: Several lines of evidence suggest a viral infection as the initiating event for the development of myocarditis (MC). Especially enteroviruses like coxsackie B3 virus have been shown to induce MC in humans and strains of MC-prone mice after an infection. The further course of the disease is, however, determined not only by the viral infection but also by the host's immune system. Both the humoral and the cellular immune system can modify the extent of the damage caused by the disease. The humoral immune system mounts an anti-viral immune response immediately after the infection; however, during the course of the disease, autoantibodies against a variety of different autoantigens emerge. The epitopes recognized by the anti-viral antibodies and those of several autoantibodies have been identified using synthetic peptides. The human disease could be transferred into SCID mice using peripheral blood leukocytes of patients, suggesting a pathophysiological significance of the autoimmune reaction. However, the significance of the humoral immune responses needs to be tested in randomized, prospective studies using immunoadsorption of autoantibodies in patients with inflammatory cardiomyopathy.
authors.affiliation: Department of Internal Medicine/Cardiology, Benjamin Franklin Hospital, Charite-Medical School Berlin, Free University of Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. peter.schwimmbeck@charite.de
authors.forename: Peter L
authors.initials: PL
authors.lastname: Schwimmbeck
authors.forename: Boris
authors.initials: B
authors.lastname: Bigalke
authors.forename: Karsten
authors.initials: K
authors.lastname: Schulze
authors.forename: Matthias
authors.initials: M
authors.lastname: Pauschinger
authors.forename: Uwe
authors.initials: U
authors.lastname: Kühl
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schultheiss
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood*; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D004195:Disease Models, Animal; D029822:Enterovirus B, Human / Q000276:immunology*; D004769:Enterovirus Infections / Q000276:immunology / Q000503:physiopathology / Q000821:virology; D018985:Epitopes, B-Lymphocyte; D006801:Humans; D051379:Mice; D016513:Mice, SCID; D008969:Molecular Sequence Data; D009205:Myocarditis / Q000276:immunology* / Q000503:physiopathology* / Q000821:virology; D010455:Peptides / Q000138:chemical synthesis / Q000737:chemistry / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D001323:Autoantibodies; D018985:Epitopes, B-Lymphocyte; D010455:Peptides