title: Autoimmunological features in inflammatory cardiomyopathy.
abstract: During recent years, increasing evidence has been obtained that cellular as well as humoral autoimmunity is involved in the pathogenesis of dilated cardiomyopathy (DCM). The immune system is generally activated by viral infections with the objective of virus elimination from the myocardium. However, a relevant number of patients demonstrate viral persistence and/or chronic inflammation in the myocardium. This chronic myocardial inflammation, defined by chronic inflammation, is termed "inflammatory cardiomyopathy" according to the WHO classification of cardiomyopathies. Chronic inflammation is frequently followed by the development of autoimmunity. A breakdown in the control mechanisms protecting against autoimmune reactions by both presentation of normally not accessible self-antigens and bystander- activation, induced by the pathogen, leads to the formation of autoreactive antibodies and T cells. The auto-reactive antibodies interact directly with heart tissue resulting in altered signal transduction or complement activation, whereas the T cell-mediated mechanisms include direct attack by cytotoxic T cells or indirect effects of cytotoxic cytokines released by stimulated T cells or macrophages.
authors.affiliation: Charité - Universitätsmedizin Berlin, Campus Benjamin-Franklin, Medizinische Klinik II, Abteilung für Kardiologie und Pneumologie, Hindenburgdamm 30, 12200 Berlin, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Kallwellis-Opara
authors.forename: Andrea
authors.initials: A
authors.lastname: Dörner
authors.forename: Wolfgang-Christian
authors.initials: WC
authors.lastname: Poller
authors.forename: Michel
authors.initials: M
authors.lastname: Noutsias
authors.forename: Uwe
authors.initials: U
authors.lastname: Kühl
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schultheiss
authors.forename: Mathias
authors.initials: M
authors.lastname: Pauschinger
mesh_terms: D001323:Autoantibodies / Q000276:immunology*; D015551:Autoimmunity / Q000276:immunology*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D009205:Myocarditis / Q000276:immunology* / Q000378:metabolism
chemical_list: D001323:Autoantibodies; D016207:Cytokines