Pre- and post-transplant anti-myosin and anti-heat shock protein antibodies and cardiac transplant outcome
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2004-02-01
Autores
Morgun, Andrey [UNIFESP]
Shulzhenko, Natalia [UNIFESP]
Unterkircher, Carmelinda Schmidt [UNIFESP]
Diniz, Rosiane Viana Zuza [UNIFESP]
Pereira, Aparecido Bernardo [UNIFESP]
Silva, Marcelo de Souza [UNIFESP]
Nishida, Sonia Kiyomi [UNIFESP]
Almeida, Dirceu Rodrigues de [UNIFESP]
Carvalho, Antonio Carlos de Camargo [UNIFESP]
Franco, Marcello Fabiano de [UNIFESP]
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Background: the purpose this study was to investigate the relationship of anti-myosin and anti-heat shock protein immunoglobulin G (IgG) serum antibodies to the original heart disease of cardiac transplant recipients, and also to rejection and patient survival after cardiac transplantation.Methods: Anti-myosin and anti-heat shock protein (anti-hsp) IgG antibodies were evaluated in pre-transplant sera from 41 adult cardiac allograft recipients and in sequential post-transplant serum samples from 11 recipients, collected at the time of routine endomyocardial biopsies during the first 6 months after transplantation. in addition, the levels of these antibodies were determined from the sera of 28 healthy blood donors.Results: Higher anti-myosin antibody levels were observed in pre-transplant sera than in sera from normal controls. Moreover, patients with chronic Chagas heart disease showed higher anti-myosin levels than patients with ischemic heart disease, and also higher levels, although not statistically significant, than patients with dilated cardiomyopathy. Higher anti-hsp levels were also observed in patients compared with healthy controls, but no significant differences were detected among,the different types of heart diseases. Higher pre-transplant anti-myosin, but not anti-hsp, levels were associated with lower 2-year post-transplant survival. in the post-transplant period, higher anti-myosin IgG levels were detected in sera collected during acute rejection than in sera collected during the rejection-free period, whereas anti-hsp IgG levels showed no difference between these periods.Conclusions: the present findings are of interest for post-transplant management and, in addition, suggest a pathogenic role for anti-myosin antibodies in cardiac transplant rejection, as has been proposed in experimental models of cardiac transplantation.
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Journal of Heart and Lung Transplantation. New York: Elsevier B.V., v. 23, n. 2, p. 204-209, 2004.