Nussinovitch Udi, Shoenfeld Yehuda
Department of Medicine B, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Arch Immunol Ther Exp (Warsz). 2009 Mar-Apr;57(2):95-104. doi: 10.1007/s00005-009-0013-1. Epub 2009 Mar 31.
Autoimmunity may evolve in predisposed individuals following an exogenous trigger. Autoimmunity is affected by genetic, immune, hormonal, and environmental factors. Immune mechanisms in heart diseases are complex and often not completely understood. Several cardiac disorders are believed to be mediated by an immune reaction. Both humoral and cellular immunity are associated with the development of myocarditis, dilated cardiomyopathy, heart failure, rheumatic fever, and atherosclerosis. Here the diagnostic criteria and autoimmune aspects of autoimmune-mediated cardiac disorders are reviewed. New diagnostic criteria for "autoimmune dilated cardiomyopathy" were recently suggested by the authors. They presume that establishing a dominant autoimmune etiology in some patients will have clinical significance because these patients will potentially gain the greatest benefit from immunosuppressive and immunomodulating treatments.
自身免疫可能在易患个体受到外源性触发后演变而来。自身免疫受遗传、免疫、激素和环境因素影响。心脏病中的免疫机制复杂，常常未被完全理解。几种心脏疾病被认为是由免疫反应介导的。体液免疫和细胞免疫均与心肌炎、扩张型心肌病、心力衰竭、风湿热和动脉粥样硬化的发展相关。本文综述了自身免疫介导的心脏疾病的诊断标准及自身免疫方面。作者最近提出了“自身免疫性扩张型心肌病”的新诊断标准。他们推测，在一些患者中确立主要的自身免疫病因具有临床意义，因为这些患者可能从免疫抑制和免疫调节治疗中获益最大。
