Shevelev A Y, Kostiukevich M V, Efremov E E, Vlasik T N, Mironova N A, Zykov K A, Kashirina N M, Kuznetsova I B, Sharf T V, Mamochkina E N, Lipatova L N, Peklo M M, Rutkevich P N, Yanushevskaya E V, Rybalkin I N, Stukalova O V, Malkina T A, Belyaeva M M, Kuznetsova T V, Tkachev G A, Zinchenko L V, Gupalo E M, Agapova O Y, Yureneva-Tkhorzhevskaya T V, Rvacheva A V, Sidorova M V, Sadgyan A S, Tereshchenko S N, Golitsyn S P
Russian Cardiology Scientific and Production Complex, Moscow, Russia.
Evdokimov Moscow State University of Medicine and Dentistry, Laboratory of Pulmonology, Moscow, Russia.
Kardiologiia. 2016 Dec;56(11):61-70. doi: 10.18565/cardio.2016.11.61-70.
This study aimed to assess the level of anti-1-adrenergic receptor autoantibodies in patients with ventricular arrhythmias with no signs of organic heart disease and with presence of cardiovascular pathology in comparison with a group of healthy volunteers.
The study included 44 patients with ventricular arrhythmias with no signs of organic heart disease ("idiopathic"), 34 patients with diagnosed dilated cardiomyopathy (DCM) of inflammatory origin, 35 patients with coronary heart disease and ventricular arrhythmias, 12patients with coronary heart disease with no ventricular arrhythmias, and 19 healthy volunteers (control group). The level of autoantibodies against the 1-adrenergic receptor was determined by the developed competitive cell-based enzyme-linked immunosorbent assay (ELISA) and by the standard ELISA using peptides corresponding to the second extracellular loop of the 1-adrenergic receptor.
Elevated level of autoantibodies detected by a competitive cell-based ELISA was observed in 62% of patients with DCM compared to 21% of healthy volunteers (p=0.0006). In patients with "idiopathic" ventricular arrhythmias, the level of 1-adrenergic receptor autoantibodies was lower than in healthy subjects (p=0.003). Coronary heart disease patients with or without ventricular arrhythmias exhibited no differences from the control group. The number of significantly positive signals in peptide-based ELISA did not exceed 10% in any of the groups. No correlation between the data from competitive cell-based ELISA and peptide-based ELISA was found.
This study demonstrated that competitive cell-based ELISA technique can be applied for detection of 1-adrenergic receptor autoantibodies. The results in DCM patients generally correspond to the expected. Decreased level of autoantibodies in patients with "idiopathic" ventricular arrhythmias indicates that this disease is related to changes in the immune system. Such relation is not observed in the case of coronary heart disease patients.
本研究旨在评估无器质性心脏病迹象但存在心血管病变的室性心律失常患者与一组健康志愿者相比，抗β1-肾上腺素能受体自身抗体的水平。
本研究纳入了44例无器质性心脏病迹象（“特发性”）的室性心律失常患者、34例诊断为炎症性扩张型心肌病（DCM）的患者、35例冠心病合并室性心律失常的患者、12例无室性心律失常的冠心病患者以及19名健康志愿者（对照组）。采用基于细胞的竞争性酶联免疫吸附测定（ELISA）以及使用与β1-肾上腺素能受体第二个细胞外环对应的肽段的标准ELISA来测定抗β1-肾上腺素能受体自身抗体的水平。
与21%的健康志愿者相比，基于细胞的竞争性ELISA检测发现62%的DCM患者自身抗体水平升高（p = 0.0006）。在“特发性”室性心律失常患者中，β1-肾上腺素能受体自身抗体水平低于健康受试者（p = 0.003）。有或无室性心律失常的冠心病患者与对照组相比无差异。基于肽段的ELISA中，任何一组中显著阳性信号的数量均未超过10%。未发现基于细胞的竞争性ELISA与基于肽段的ELISA数据之间存在相关性。
本研究表明基于细胞的竞争性ELISA技术可用于检测β1-肾上腺素能受体自身抗体。DCM患者的结果总体上符合预期。“特发性”室性心律失常患者自身抗体水平降低表明该疾病与免疫系统变化有关。冠心病患者未观察到这种关系。
