PMID- 36717981 OWN - NLM STAT- MEDLINE DCOM- 20230330 LR - 20230406 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 10 IP - 2 DP - 2023 Apr TI - Receptor autoantibodies: Associations with cardiac markers, histology, and function in human non-ischaemic heart failure. PG - 1258-1269 LID - 10.1002/ehf2.14293 [doi] AB - AIMS: A causal link between non-ischaemic heart failure (HF) and humoral autoimmunity against G-protein-coupled receptors (GPCR) remains unclear except for Chagas' cardiomyopathy. Uncertainty arises from ambiguous reports on incidences of GPCR autoantibodies, spurious correlations of autoantibody levels with disease activity, and lack of standardization and validation of measuring procedures for putatively cardio-pathogenic GPCR autoantibodies. Here, we use validated and certified immune assays presenting native receptors as binding targets. We compared candidate GPCR autoantibody species between HF patients and healthy controls and tested associations of serum autoantibody levels with serological, haemodynamic, metabolic, and functional parameters in HF. METHODS: Ninety-five non-ischaemic HF patients undergoing transcatheter endomyocardial biopsy and 60 healthy controls were included. GPCR autoantibodies were determined in serum by IgG binding to native receptors or a cyclic peptide (for beta1AR autoantibodies). In patients, cardiac function, volumes, and myocardial structural properties were assessed by cardiac magnetic resonance imaging; right heart catheterization served for determination of cardiac haemodynamics; endomyocardial biopsies were used for histological assessment of cardiomyopathy and determination of cardiac mitochondrial oxidative function by high-resolution respirometry. RESULTS: Autoantibodies against beta(1) adrenergic (beta(1) AR()) , M5-muscarinic (M5AR), and angiotensin II type 2 receptors (AT2R) were increased in HF (all P < 0.001). Autoantibodies against alpha(1) -adrenergic (alpha(1) AR) and angiotensin II type 1 receptors (AT1R) were decreased in HF (all P < 0.001). Correlation of alterations of GPCR autoantibodies with markers of cardiac or systemic inflammation or cardiac damage, haemodynamics, myocardial histology, or left ventricular inflammation (judged by T2 mapping) were weak, even when corrected for total IgG. beta(1) AR autoantibodies were related inversely to markers of left ventricular fibrosis indicated by T1 mapping (r = -0.362, P < 0.05) and global longitudinal strain (r = -0.323, P < 0.05). AT2R autoantibodies were associated with improved myocardial mitochondrial coupling as measured by high-resolution respirometry in myocardial biopsies (r = -0.352, P < 0.05). In insulin-resistant HF patients, AT2R autoantibodies were decreased (r = -.240, P < 0.05), and AT1R autoantibodies were increased (r = 0.212, P < 0.05). CONCLUSIONS: GPCR autoantibodies are markedly altered in HF. However, they are correlated poorly or even inversely to haemodynamic, metabolic, and functional markers of disease severity, myocardial histology, and myocardial mitochondrial efficiency. These observations do not hint towards a specific cardio-pathogenic role of GPCR autoantibodies and suggest that further investigations are required before specific therapies directed at GPCR autoantibodies can be clinically tested in non-ischaemic HF. CI - (c) 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Zweck, Elric AU - Zweck E AUID- ORCID: 0000-0001-6739-476X AD - Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Dusseldorf, Germany. AD - German Center for Diabetes Research (DZD e.V.), Partner Dusseldorf, Munchen-Neuherberg, Germany. AD - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Karschnia, Maximilian AU - Karschnia M AD - Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Dusseldorf, Germany. AD - German Center for Diabetes Research (DZD e.V.), Partner Dusseldorf, Munchen-Neuherberg, Germany. AD - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Scheiber, Daniel AU - Scheiber D AD - Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Dusseldorf, Germany. AD - German Center for Diabetes Research (DZD e.V.), Partner Dusseldorf, Munchen-Neuherberg, Germany. AD - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Heidecke, Harald AU - Heidecke H AD - Cell Trend GmbH, Luckenwalde, Germany. FAU - Dechend, Ralf AU - Dechend R AD - Experimental and Clinical Research Center, University and Max Delbruck Center for Molecular Medicine; Departments of Cardiology and Nephrology, Helios Clinic Berlin-Buch, Berlin, Germany. FAU - Barthuber, Carmen AU - Barthuber C AD - Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, Heinrich Heine University and University Hospital, Dusseldorf, Germany. FAU - Kaufmann, Sina AU - Kaufmann S AD - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Kelm, Malte AU - Kelm M AD - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. AD - Cardiovascular Research Institute Dusseldorf, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Roden, Michael AU - Roden M AD - Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Dusseldorf, Germany. AD - German Center for Diabetes Research (DZD e.V.), Partner Dusseldorf, Munchen-Neuherberg, Germany. AD - Cardiovascular Research Institute Dusseldorf, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. AD - Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Westenfeld, Ralf AU - Westenfeld R AD - Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Szendrodi, Julia AU - Szendrodi J AD - Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Dusseldorf, Germany. AD - German Center for Diabetes Research (DZD e.V.), Partner Dusseldorf, Munchen-Neuherberg, Germany. AD - Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Boege, Fritz AU - Boege F AD - Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, Heinrich Heine University and University Hospital, Dusseldorf, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230130 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 RN - 0 (Autoantibodies) RN - 11128-99-7 (Angiotensin II) RN - 0 (Receptors, G-Protein-Coupled) RN - 0 (Immunoglobulin G) SB - IM MH - Humans MH - *Autoantibodies MH - Angiotensin II MH - *Heart Failure/pathology MH - Receptors, G-Protein-Coupled/metabolism MH - Inflammation MH - Immunoglobulin G PMC - PMC10053254 OTO - NOTNLM OT - Autoimmunity OT - Chronic non-ischaemic heart failure OT - Heart failure OT - Pathophysiology COIS- None of the authors have a conflict of interest with respect to the content of this manuscript to declare. EDAT- 2023/02/01 06:00 MHDA- 2023/03/30 06:11 PMCR- 2023/01/30 CRDT- 2023/01/31 00:22 PHST- 2022/10/17 00:00 [revised] PHST- 2022/09/26 00:00 [received] PHST- 2022/11/08 00:00 [accepted] PHST- 2023/03/30 06:11 [medline] PHST- 2023/02/01 06:00 [pubmed] PHST- 2023/01/31 00:22 [entrez] PHST- 2023/01/30 00:00 [pmc-release] AID - EHF214293 [pii] AID - 10.1002/ehf2.14293 [doi] PST - ppublish SO - ESC Heart Fail. 2023 Apr;10(2):1258-1269. doi: 10.1002/ehf2.14293. Epub 2023 Jan 30.