急性心肌炎和慢性扩张型心肌病患者的B19微小病毒情况

Parvovirus B19 profiles in patients presenting with acute myocarditis and chronic dilated cardiomyopathy.

作者信息

Escher Felicitas, Modrow Susanne, Sabi Titus, Kühl Uwe, Lassner Dirk, Schultheiss Heinz-Peter, Noutsias Michel

机构信息

Department of Cardiology and Pneumonology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.

出版信息

Med Sci Monit. 2008 Dec;14(12):CR589-97.

DOI:
Abstract

BACKGROUND

Parvovirus B19 (B19V) is the most prevalent cardiotropic virus in endomyocardial biopsies (EMBs) from patients presenting with acute myocarditis (AMC) and chronic dilated cardiomyopathy (DCM). We elucidated the role of B19V specific IgG and IgM antibodies against native VP2-capsids and denatured VP1-, VP2- and NS1-proteins, which discriminate disease acuity in other B19V related diseases, in patients presenting with clinically suspected AMC and DCM for the determination of the viral infection stage.

MATERIAL/METHODS: n=62 prospectively enrolled AMC (n=33) and DCM (n=29) patients were investigated. B19V genomes were amplified in EMBs by nested PCR (nPCR). B19V-specific IgG and IgM were investigated by recomLine blots in the sera.

RESULTS

B19V genomes were detectable by nPCR with comparable frequencies in AMC (63.6%) and DCM patients (51.7%), respectively. IgM antibodies were detectable in 18.1% of the AMC, but not in DCM patients. In patients with myocardial B19V infection, antibody profiles indicating recent infections were more frequent in AMC (47.6%) compared with DCM patients (6.7%), while persistent/reactivating profiles were significantly more prevalent in DCM (20.0%) compared with AMC (0%) patients (p<0.05).

CONCLUSIONS

IgM B19V antibodies can be detected primarily in AMC, but not in DCM patients. The discrimination of the B19V specific IgG antibodies using recomLine blots may be suitable to distinguish acute versus chronic, and persistent/reactivating infection status in patients with myocardial B19V infection.

摘要

背景

细小病毒B19(B19V)是急性心肌炎(AMC)和慢性扩张型心肌病(DCM)患者心内膜心肌活检(EMB)中最常见的嗜心肌病毒。我们阐明了针对天然VP2衣壳以及变性的VP1、VP2和NS1蛋白的B19V特异性IgG和IgM抗体在临床疑似AMC和DCM患者中的作用,这些抗体在其他B19V相关疾病中可区分疾病的急性期,用于确定病毒感染阶段。

材料/方法:对前瞻性纳入的62例AMC患者(n = 33)和DCM患者(n = 29)进行了研究。通过巢式PCR(nPCR)在EMB中扩增B19V基因组。通过重组免疫印迹法检测血清中的B19V特异性IgG和IgM。

结果

通过nPCR可检测到B19V基因组,在AMC患者(63.6%)和DCM患者(51.7%)中的频率相当。18.1%的AMC患者可检测到IgM抗体,而DCM患者中未检测到。在心肌B19V感染患者中,与DCM患者(6.7%)相比,AMC患者中指示近期感染的抗体谱更为常见(47.6%),而与AMC患者(0%)相比,DCM患者中持续性/再激活谱明显更为普遍(20.0%)(p<0.05)。

结论

IgM B19V抗体主要在AMC患者中可检测到,而在DCM患者中未检测到。使用重组免疫印迹法区分B19V特异性IgG抗体可能适合区分心肌B19V感染患者的急性与慢性以及持续性/再激活感染状态。

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