Arrhythmogenic effects of anti-Ro/SSA antibodies on the adult heart: more than expected?
The arrhythmogenicity of anti-Ro/SSA antibodies for the foetal heart and their crucial role in the development of congenital heart block is now well established, representing a paradigmatic model of passively acquired autoimmunity. Recently, intriguing data suggest that also the adult heart may represent a possible target of anti-Ro/SSA antibody-mediated autoimmune injury. The prolongation of the QTc interval, possibly resulting from a direct inhibitory interaction between the anti-Ro/SSA antibodies and the potassium current I(Kr) in the heart seems the abnormality more frequently observed in adults with anti-Ro/SSA-positive CTD. Although the possibility that anti-Ro/SSA positivity may be considered a risk factor for arrhythmic sudden death in adults has not been demonstrated as yet, preliminary data suggest a relationship among anti-Ro/SSA antibodies, QTc prolongation, and the prevalence of ventricular arrhythmias, also life threatening, in adult patients.
Lazzerini
Pietro Enea
PE
Department of Clinical Medicine and Immunological Sciences, Division of Clinical Immunology, University of Siena, Italy. pietroenea@yahoo.it
Capecchi
Pier Leopoldo
PL
Acampa
Maurizio
M
Selvi
Enrico
E
Guideri
Francesca
F
Bisogno
Stefania
S
Rossi
Pier Carlo
PC
Galeazzi
Mauro
M
Pasini
Franco Laghi
FL
D000328:Adult; D000920:Antibody-Dependent Cell Cytotoxicity / Q000276:immunology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D001323:Autoantibodies / Q000276:immunology* / Q000378:metabolism; D001324:Autoantigens / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000276:immunology; D009200:Myocardial Contraction / Q000276:immunology*; D015221:Potassium Channels / Q000276:immunology / Q000378:metabolism*; D011247:Pregnancy; D011379:Prognosis; D020733:RNA, Small Cytoplasmic / Q000276:immunology* / Q000378:metabolism; D012261:Ribonucleoproteins / Q000276:immunology* / Q000378:metabolism; D012307:Risk Factors; D016019:Survival Analysis; D000099207:SS-A Antigen
D001323:Autoantibodies; D001324:Autoantigens; D015221:Potassium Channels; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins; C116006:RO60 protein, human; D000099207:SS-A Antigen