Lethal autoantibodies: Do they exist?*

Abstract

Heart rhythm disturbances belong to the most complex and pressing problems of cardiology. Sudden cardiac death (SCD) is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 hour of acute manifestations’ onset). Tanatogenesis in this case is linked to ventricular arrhythmias. Patients with cardiomyopathies, myocarditis, ischemic heart disease and inherited cardiac channelopathies are at risk of SCD. However,a certain percentage of autopsy-negative cases of SCD in children and young adults remain unexplained even after a post-mortem genetic testing. Autoantibodies against cardiac proteins may be potentially involved in the pathogenesis of different heart diseases and in the occurrence of cardiac arrhythmias, including those, which can lead to SCD. In this review the prevalence of some antimyocardial autoantibodies in patients with different heart diseases and their mechanistical relevance are addressed. A classification of these autoantibodies is proposed, and their molecular and cellular effects are discussed.

Keywords:

autoantibodies, autoimmunity, arrhythmia, sudden cardiac death, channelopathies, G-protein coupled receptors