Abstract
We analyzed profiles of IgG autoantibodies to 16 cardiac specific proteins and their main immunogenic region B-epitopes, in the groups of already verified cardiac pathology: acute and chronic lymphocytic myocarditis, ST elevation myocardial infarction, postinfarction remodeling of myocardium, dilated cardiomyopathy and in healthy controls along with patients, suffered from gastritis (to evaluate immune response against cross-reactive B-epitopes). AAB specific patterns allowed us to distinguish cases among themselves by means of multiparametrical canonical discriminant analysis in approximately 95% of cases. Positive predictive value in the group of MYO reached 95%, in the STEMI—89%, in the PIR—99%, in the DCM—99%, in the group of gastritis—88%. Principal component analysis of mentioned cardiac pathologies extended current clinical knowledge of their immunopathogenesis. Obtained data markedly proved a usability of serum AAB profiling for non invasive screening, differential diagnostics and working hypothesis composition.
Highlights
Alongside with direct damaging effect of infection or toxic agent, autoimmune pathology seems to be important in the pathogenesis of myocardium inflammatory diseases
For the cases in ST elevation myocardial infarction (STEMI) and MYO groups the raised profile was significantly higher, than in the control groups, whereas for patients with postinfarction remodeling of myocardium (PIR) and dilated cardiomyopathy (DCM) it essentially did not differ from normal controls
For myocarditis intravital diagnostics it is used from 4 to 6 bioptate specimens, and the standard pathoanatomical research to make a diagnosis of myocarditis, assumed taking not less than 17 samples [39,40]
Summary
Alongside with direct damaging effect of infection or toxic agent, autoimmune pathology seems to be important in the pathogenesis of myocardium inflammatory diseases. Normal microflora of mucous membranes is involved in human homeostasis and plays important role in many physiologic functions. Saprophytes in the gut take part in food digestion and utilization as well as in production of vitamins [9]. It is evident, that the immune system ignores normal microflora, and the primary function of immune system is not so much devoted to eliminate foreign genetic material [10] but to maintain of basic homeostasis of the body [11,12,13,14]. Autoimmunity can be surveyed, on the one hand, as the important instrument of cell death or harmful metabolic yields elimination from an organism, and on another hand—as the instrument of immunochemical regulation
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