Maisch B, Drude L, Hengstenberg C, Hufnagel G, Schönian U, Schwab D
Department of Internal Medicine-Cardiology, Philipps-University Marburg, Germany.
Postgrad Med J. 1992;68 Suppl 1:S11-6.
Antisarcolemmal (ASAs) and antimyolemmal antibodies (AMLAs) are serological hallmarks of inflammatory heart muscle disease. They occur in a similar incidence in postcardiac injury syndromes, sarcoid heart disease or in dilated and hypertrophic cardiomyopathy. Rarely but still notably they are found with increasing age or in coronary artery disease. We therefore examined whether they are truly pathogenetic or whether they also possess properties of 'natural antibodies'. AMLAs and ASAs, like natural antibodies, have specificity for preserved structures on the membrane; they possess cross-reactivity and increase with age. In contrast to natural antibodies, however, they occur frequently after viral stimulation or other forms of trauma, are more often of the IgG and IgA than of the IgM isotype and fix complement in the acute stage of the disease. They also possess cytolytic and cytotoxic properties when incubated in vitro with isolated heart muscle cells. Antigenic mimicry has been demonstrated to be operative, since they are cross-reactive to viral proteins.
抗肌膜抗体（ASAs）和抗肌层膜抗体（AMLAs）是炎症性心肌病的血清学标志。它们在心脏损伤后综合征、结节病性心脏病或扩张型和肥厚型心肌病中的发生率相似。在年龄增长或冠状动脉疾病中，它们虽罕见但仍较为显著地出现。因此，我们研究了它们是否真的具有致病性，或者它们是否也具有“天然抗体”的特性。AMLAs和ASAs与天然抗体一样，对膜上保存的结构具有特异性；它们具有交叉反应性且随年龄增长而增加。然而，与天然抗体不同的是，它们在病毒刺激或其他形式的创伤后频繁出现，IgG和IgA型比IgM型更常见，并且在疾病急性期可固定补体。当它们在体外与分离的心肌细胞一起孵育时，还具有溶细胞和细胞毒性特性。由于它们与病毒蛋白具有交叉反应性，已证明存在抗原模拟现象。
