Cardiac beta1-adrenoceptor autoantibodies in human heart disease: rationale and design of the Etiology, Titre-Course, and Survival (ETiCS) Study.
OBJECTIVE
Evidence for a pathophysiologic relevance of autoimmunity in human heart disease has substantially increased over the past years. Conformational autoantibodies stimulating the cardiac beta1-adrenoceptor (beta1-aabs) are considered of importance in heart failure development and clinical pilot studies have shown their prognostic significance in human 'idiopathic' cardiomyopathy.


METHODS
We recently developed a novel highly sensitive fluorescence-based functional assay to detect stimulating beta1-aabs. We will use this method to assess Etiology, Titre-Course, and effect on Survival (ETiCS) of beta1-aabs in a prospective multicentre study with serial follow-up of patients after a first acute myocarditis or myocardial infarction. Several European core laboratories will jointly study the hypothesis that both disorders may trigger autoimmune reactions leading to the generation of beta1-aabs and/or other heart-directed aabs. Further, sera from healthy controls and well-characterized patient cohorts with dilated, ischaemic, or hypertensive cardiomyopathy will be analysed retrospectively for beta1-aab prevalence, incidence, persistence, and/or clearance.


CONCLUSIONS
ETiCS is so far the largest clinical diagnostic study projected to address cardiac autoimmunity. It attempts to unravel the pathophysiology of cardiac autoantibody formation and persistence/clearance. ETiCS will enhance current knowledge on autoimmunity in human heart disease and promote endeavours to develop novel therapies targeting cardiac aabs.
Deubner
Nikolas
N
Department of Internal Medicine I, Centre of Cardiovascular Medicine, University of Würzburg, University Hospital Würzburg, Klinikstrasse 6-8, 97070 Würzburg, Germany.
Berliner
Dominik
D
Schlipp
Angela
A
Gelbrich
Götz
G
Caforio
Alida L P
AL
Felix
Stephan B
SB
Fu
Michael
M
Katus
Hugo
H
Angermann
Christiane E
CE
Lohse
Martin J
MJ
Ertl
Georg
G
Störk
Stefan
S
Jahns
Roland
R
D000918:Antibody Specificity / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology*; D015551:Autoimmunity / Q000276:immunology*; D002311:Cardiomyopathy, Dilated / Q000276:immunology*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000276:immunology*; D009205:Myocarditis / Q000276:immunology*; D009206:Myocardium / Q000276:immunology*; D018579:Patient Selection; D018342:Receptors, Adrenergic, beta-1 / Q000276:immunology*; D012107:Research Design
D001323:Autoantibodies; D018342:Receptors, Adrenergic, beta-1