Zhao Yu-Hui, Huang Hai-Xia, Liu Ping, Du Yun-Hui, Wang Peng, Wang Wen, Wu Ye, Wang Li, Ma Chang-Sheng, Liu Hui-Rong
Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Exp Physiol. 2017 Jan 1;102(1):25-33. doi: 10.1113/EP085778. Epub 2016 Dec 15.
What is the central question of this study? High titres of autoantibodies against the second extracellular loop of the β -adrenergic receptor (β -AAs) can be detected in the sera of patients with ventricular arrhythmias, but a causal relationship between β -AAs and ventricular arrhythmias has not been established. What is the main finding and its importance? Monoclonal β -AAs (β -AR mAbs) were used in the experiments. We showed that β -AR mAbs increased susceptibility to ventricular arrhythmias and induced repolarization abnormalities. Antibody adsorption of β -AAs will be a potential new therapeutic strategy for ventricular arrhythmias in patients with high titres of β -AAs. High titres of autoantibodies against the second extracellular loop of the β -adrenergic receptor (β -AAs) can be detected in sera from patients with ventricular arrhythmias, but a causal relationship between β -AAs and ventricular arrhythmias has not been established. In this work, ECGs of guinea-pigs and isolated guinea-pig hearts were recorded. Ventricular tachycardia (VT) and ventricular fibrillation (VF) were evoked by programmed electrical stimulation of the left ventricular epicardium of isolated guinea-pig hearts. The monophasic action potential and effective refractory period of the left ventricle were recorded in paced isolated guinea-pig hearts. Furthermore, to increase the specificity, monoclonal autoantibodies against the second extracellular loop of the β -adrenergic receptor (β -AR mAbs) were used in all experiments. The results showed that β -AR mAbs induced premature ventricular contractions in guinea-pigs and isolated guinea-pig hearts. In addition, β -AR mAbs decreased the threshold of VT/VF and prolonged the duration of VT/VF. Furthermore, β -AR mAbs shortened the corrected QT interval and effective refractory period, and prolonged late-phase repolarization of the monophasic action potential (MAPD ). These changes in electrophysiological parameters might be attributed, at least in part, to the arrhythmogenicity of β -AR mAbs.
本研究的核心问题是什么?在室性心律失常患者的血清中可检测到高滴度的抗β-肾上腺素能受体第二细胞外环自身抗体(β-AAs),但β-AAs与室性心律失常之间的因果关系尚未确立。主要发现及其重要性是什么?实验中使用了单克隆β-AAs(β-AR单克隆抗体)。我们发现β-AR单克隆抗体增加了对室性心律失常的易感性并诱发复极异常。对于高滴度β-AAs患者,抗体吸附β-AAs将是一种潜在的室性心律失常新治疗策略。在室性心律失常患者的血清中可检测到高滴度的抗β-肾上腺素能受体第二细胞外环自身抗体(β-AAs),但β-AAs与室性心律失常之间的因果关系尚未确立。在这项工作中,记录了豚鼠和离体豚鼠心脏的心电图。通过对离体豚鼠心脏左心室心外膜进行程控电刺激诱发室性心动过速(VT)和心室颤动(VF)。在起搏的离体豚鼠心脏中记录左心室的单相动作电位和有效不应期。此外,为提高特异性,所有实验均使用了抗β-肾上腺素能受体第二细胞外环的单克隆自身抗体(β-AR单克隆抗体)。结果显示,β-AR单克隆抗体在豚鼠和离体豚鼠心脏中诱发室性早搏。此外,β-AR单克隆抗体降低了VT/VF的阈值并延长了VT/VF的持续时间。此外,β-AR单克隆抗体缩短了校正QT间期和有效不应期,并延长了单相动作电位的晚期复极化(MAPD)。这些电生理参数的变化可能至少部分归因于β-AR单克隆抗体的致心律失常性。