Baba Akiyasu, Yoshikawa Tsutomu, Fukuda Yukiko, Sugiyama Takashi, Shimada Megumi, Akaishi Makoto, Tsuchimoto Kanji, Ogawa Satoshi, Fu Michael
Department of Medicine, Kitasato Institute Hospital, Tokyo, Japan.
Eur Heart J. 2004 Jul;25(13):1108-15. doi: 10.1016/j.ehj.2004.05.012.
To characterise the clinical significance of M2-muscarinic acetylcholine receptor autoantibodies (M2-AAB) in patients with dilated cardiomyopathy (DCM).
Sera from 104 patients with DCM, age-matched with 104 patients with idiopathic atrial fibrillation (Af) and 104 healthy control subjects, were screened for M2-AAB by enzyme-linked immunosorbent assay (ELISA). IgG purified by Protein-A column was also used as a primary antibody in ELISA. In DCM, M2-AAB were detected in 40% of patients using whole sera and in 36% of patients using purified IgG. M2-AAB were also found in several patients with idiopathic Af (23%, 23%), and these frequencies were significantly higher than those in healthy subjects (8%, 8%). Af was more common in AAB-positive than in AAB-negative patients with DCM. Multivariable analysis confirmed that M2-AAB were independent predictors of the presence of Af in such patients. We determined electrophysiological changes by adding patient purified M2-AAB to chick embryos. Purified IgG from both Af and DCM patients exhibited negative chronotropic effects and induced supraventricular arrhythmias.
M2-AAB may play a role in mediating the development of Af in patients with DCM.
明确M2型毒蕈碱型乙酰胆碱受体自身抗体（M2-AAB）在扩张型心肌病（DCM）患者中的临床意义。
采用酶联免疫吸附测定（ELISA）法对104例DCM患者、104例年龄匹配的特发性心房颤动（Af）患者及104例健康对照者的血清进行M2-AAB筛查。用蛋白A柱纯化的IgG也用作ELISA的一抗。在DCM患者中，使用全血清检测到40%的患者存在M2-AAB，使用纯化IgG检测到36%的患者存在M2-AAB。在部分特发性Af患者中也发现了M2-AAB（23%，23%），这些频率显著高于健康受试者（8%，8%）。Af在DCM的AAB阳性患者中比AAB阴性患者更常见。多变量分析证实，M2-AAB是此类患者中Af存在的独立预测因素。通过将患者纯化的M2-AAB添加到鸡胚中，我们确定了电生理变化。来自Af和DCM患者的纯化IgG均表现出负性变时作用并诱发室上性心律失常。
M2-AAB可能在介导DCM患者Af的发生中起作用。
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