ARVC specific autoantibody identifies cardiac sarcoidosis and correlates with inflammation activity

Abstract Introduction Cardiac sarcoidosis (CS) is an inflammatory granulomatous disease of unknown origin. CS and arrhythmogenic right ventricular cardiomyopathy (ARVC) are overlapping syndromes. With both, patients are at increased risk of ventricular arrhythmias and sudden cardiac death. However,...

Full description

Saved in:
Bibliographic Details
Published in:European heart journal 2020-11, Vol.41 (Supplement_2)
Main Authors: Suna, G, Kolios, A, Chatterjee, D, Fatah, M, Gasperetti, A, Steffel, J, Ruschitzka, F, Duru, F, Hamilton, R.M, Saguner, A.M
Format: Article
Language:English
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page
container_issue Supplement_2
container_start_page
container_title European heart journal
container_volume 41
creator Suna, G
Kolios, A
Chatterjee, D
Fatah, M
Gasperetti, A
Steffel, J
Ruschitzka, F
Duru, F
Hamilton, R.M
Saguner, A.M
description Abstract Introduction Cardiac sarcoidosis (CS) is an inflammatory granulomatous disease of unknown origin. CS and arrhythmogenic right ventricular cardiomyopathy (ARVC) are overlapping syndromes. With both, patients are at increased risk of ventricular arrhythmias and sudden cardiac death. However, the diagnosis of CS is challenging, especially in patients with no extracardiac involvement, but correct diagnosis has large therapeutic impact. Recently, a novel diagnostic autoantibody (anti-DSG2 Ab) was identified in ARVC. We sought to identify this antibody in CS patients and correlate its levels with inflammation activity using cardiac positron-emission-tomography (18-FDG-PET). Methods Recombinant human desmoglein-2 (DSG2) proteins on western blots were exposed to sera as well as purified IgG of 14 patients with sarcoidosis (all confirmed by histology) and 6 controls (1 ARVC patient (positive control) and 5 healthy control subjects (negative control)). Clinical patient characteristics were correlated to detected antibody intensity levels. Results The sarcoidosis cohort comprised 43% (6/14) male patients and the average age was 50±12 years. Anti-DSG2 Abs were identified in 43% (6/14) and were detected faintly (below cut off level) in 21% (3/14) of all sarcoidosis patients. Antibody was also present in the ARVC patient (1/1) and was absent in all control subjects (5/5). Myocardial inflammation was present in 18-FDG PET imaging in all CS patients with positive anti-DSG2 Abs, corresponding to an average SUV (standardized uptake value) of 8.1±4.2. In patients with faint or no antibody, the SUV values were significantly lower with 1.2±2.1 and 3.2±4.0, respectively (P=0.044, one-way ANOVA). The Pearson correlation coefficient (R) was 0.6 (P=0.037) for SUV vs. higher antibody levels assessed by pixel count of the western blot bands for purified IgG. Conclusions Anti-DSG2 Abs are not only a specific biomarker for ARVC, but are also found in CS, suggesting a similar pathophysiological mechanism in these overlapping syndromes, both involving cardiac inflammation and myocyte cell death. Moreover, antibody levels correlate with disease activity on cardiac PET imaging. Larger cohorts are necessary to confirm these findings. Funding Acknowledgement Type of funding source: None
doi_str_mv 10.1093/ehjci/ehaa946.2127
format article
fullrecord <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_ehjci_ehaa946_2127</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ehjci/ehaa946.2127</oup_id><sourcerecordid>10.1093/ehjci/ehaa946.2127</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1257-fd051533d08fb3ed2cf629da37f84b56030f2cfd51769a5080f92174b3bfd0ec3</originalsourceid><addsrcrecordid>eNqNkNtKAzEQhoMoWKsv4FVeYGsOm-zmshRPUBBExbtlNgc6pd2UJFX69q62D-DNzPDzf3PxEXLL2YwzI-_8am1xnACm1jPBRXNGJlwJURldq3MyYdyoSuv285Jc5bxmjLWa6wmx89ePBc07bzGgpbAvEYaCfXQHis6PZ0CfqYXkECzNkGxEFzNmCoOjNqbkN1DGyjeWFcUhbGC7hYJxoGALfmE5XJOLAJvsb057St4f7t8WT9Xy5fF5MV9WlgvVVMExxZWUjrWhl94JG7QwDmQT2rpXmkkWxswp3mgDirUsGMGbupf9iHorp0Qc_9oUc04-dLuEW0iHjrPuV1P3p6k7aep-NY1QdYTifvef_g8Xf28t</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>ARVC specific autoantibody identifies cardiac sarcoidosis and correlates with inflammation activity</title><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Suna, G ; Kolios, A ; Chatterjee, D ; Fatah, M ; Gasperetti, A ; Steffel, J ; Ruschitzka, F ; Duru, F ; Hamilton, R.M ; Saguner, A.M</creator><creatorcontrib>Suna, G ; Kolios, A ; Chatterjee, D ; Fatah, M ; Gasperetti, A ; Steffel, J ; Ruschitzka, F ; Duru, F ; Hamilton, R.M ; Saguner, A.M</creatorcontrib><description>Abstract Introduction Cardiac sarcoidosis (CS) is an inflammatory granulomatous disease of unknown origin. CS and arrhythmogenic right ventricular cardiomyopathy (ARVC) are overlapping syndromes. With both, patients are at increased risk of ventricular arrhythmias and sudden cardiac death. However, the diagnosis of CS is challenging, especially in patients with no extracardiac involvement, but correct diagnosis has large therapeutic impact. Recently, a novel diagnostic autoantibody (anti-DSG2 Ab) was identified in ARVC. We sought to identify this antibody in CS patients and correlate its levels with inflammation activity using cardiac positron-emission-tomography (18-FDG-PET). Methods Recombinant human desmoglein-2 (DSG2) proteins on western blots were exposed to sera as well as purified IgG of 14 patients with sarcoidosis (all confirmed by histology) and 6 controls (1 ARVC patient (positive control) and 5 healthy control subjects (negative control)). Clinical patient characteristics were correlated to detected antibody intensity levels. Results The sarcoidosis cohort comprised 43% (6/14) male patients and the average age was 50±12 years. Anti-DSG2 Abs were identified in 43% (6/14) and were detected faintly (below cut off level) in 21% (3/14) of all sarcoidosis patients. Antibody was also present in the ARVC patient (1/1) and was absent in all control subjects (5/5). Myocardial inflammation was present in 18-FDG PET imaging in all CS patients with positive anti-DSG2 Abs, corresponding to an average SUV (standardized uptake value) of 8.1±4.2. In patients with faint or no antibody, the SUV values were significantly lower with 1.2±2.1 and 3.2±4.0, respectively (P=0.044, one-way ANOVA). The Pearson correlation coefficient (R) was 0.6 (P=0.037) for SUV vs. higher antibody levels assessed by pixel count of the western blot bands for purified IgG. Conclusions Anti-DSG2 Abs are not only a specific biomarker for ARVC, but are also found in CS, suggesting a similar pathophysiological mechanism in these overlapping syndromes, both involving cardiac inflammation and myocyte cell death. Moreover, antibody levels correlate with disease activity on cardiac PET imaging. Larger cohorts are necessary to confirm these findings. Funding Acknowledgement Type of funding source: None</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/ehjci/ehaa946.2127</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2020-11, Vol.41 (Supplement_2)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids></links><search><creatorcontrib>Suna, G</creatorcontrib><creatorcontrib>Kolios, A</creatorcontrib><creatorcontrib>Chatterjee, D</creatorcontrib><creatorcontrib>Fatah, M</creatorcontrib><creatorcontrib>Gasperetti, A</creatorcontrib><creatorcontrib>Steffel, J</creatorcontrib><creatorcontrib>Ruschitzka, F</creatorcontrib><creatorcontrib>Duru, F</creatorcontrib><creatorcontrib>Hamilton, R.M</creatorcontrib><creatorcontrib>Saguner, A.M</creatorcontrib><title>ARVC specific autoantibody identifies cardiac sarcoidosis and correlates with inflammation activity</title><title>European heart journal</title><description>Abstract Introduction Cardiac sarcoidosis (CS) is an inflammatory granulomatous disease of unknown origin. CS and arrhythmogenic right ventricular cardiomyopathy (ARVC) are overlapping syndromes. With both, patients are at increased risk of ventricular arrhythmias and sudden cardiac death. However, the diagnosis of CS is challenging, especially in patients with no extracardiac involvement, but correct diagnosis has large therapeutic impact. Recently, a novel diagnostic autoantibody (anti-DSG2 Ab) was identified in ARVC. We sought to identify this antibody in CS patients and correlate its levels with inflammation activity using cardiac positron-emission-tomography (18-FDG-PET). Methods Recombinant human desmoglein-2 (DSG2) proteins on western blots were exposed to sera as well as purified IgG of 14 patients with sarcoidosis (all confirmed by histology) and 6 controls (1 ARVC patient (positive control) and 5 healthy control subjects (negative control)). Clinical patient characteristics were correlated to detected antibody intensity levels. Results The sarcoidosis cohort comprised 43% (6/14) male patients and the average age was 50±12 years. Anti-DSG2 Abs were identified in 43% (6/14) and were detected faintly (below cut off level) in 21% (3/14) of all sarcoidosis patients. Antibody was also present in the ARVC patient (1/1) and was absent in all control subjects (5/5). Myocardial inflammation was present in 18-FDG PET imaging in all CS patients with positive anti-DSG2 Abs, corresponding to an average SUV (standardized uptake value) of 8.1±4.2. In patients with faint or no antibody, the SUV values were significantly lower with 1.2±2.1 and 3.2±4.0, respectively (P=0.044, one-way ANOVA). The Pearson correlation coefficient (R) was 0.6 (P=0.037) for SUV vs. higher antibody levels assessed by pixel count of the western blot bands for purified IgG. Conclusions Anti-DSG2 Abs are not only a specific biomarker for ARVC, but are also found in CS, suggesting a similar pathophysiological mechanism in these overlapping syndromes, both involving cardiac inflammation and myocyte cell death. Moreover, antibody levels correlate with disease activity on cardiac PET imaging. Larger cohorts are necessary to confirm these findings. Funding Acknowledgement Type of funding source: None</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNkNtKAzEQhoMoWKsv4FVeYGsOm-zmshRPUBBExbtlNgc6pd2UJFX69q62D-DNzPDzf3PxEXLL2YwzI-_8am1xnACm1jPBRXNGJlwJURldq3MyYdyoSuv285Jc5bxmjLWa6wmx89ePBc07bzGgpbAvEYaCfXQHis6PZ0CfqYXkECzNkGxEFzNmCoOjNqbkN1DGyjeWFcUhbGC7hYJxoGALfmE5XJOLAJvsb057St4f7t8WT9Xy5fF5MV9WlgvVVMExxZWUjrWhl94JG7QwDmQT2rpXmkkWxswp3mgDirUsGMGbupf9iHorp0Qc_9oUc04-dLuEW0iHjrPuV1P3p6k7aep-NY1QdYTifvef_g8Xf28t</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Suna, G</creator><creator>Kolios, A</creator><creator>Chatterjee, D</creator><creator>Fatah, M</creator><creator>Gasperetti, A</creator><creator>Steffel, J</creator><creator>Ruschitzka, F</creator><creator>Duru, F</creator><creator>Hamilton, R.M</creator><creator>Saguner, A.M</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20201101</creationdate><title>ARVC specific autoantibody identifies cardiac sarcoidosis and correlates with inflammation activity</title><author>Suna, G ; Kolios, A ; Chatterjee, D ; Fatah, M ; Gasperetti, A ; Steffel, J ; Ruschitzka, F ; Duru, F ; Hamilton, R.M ; Saguner, A.M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1257-fd051533d08fb3ed2cf629da37f84b56030f2cfd51769a5080f92174b3bfd0ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suna, G</creatorcontrib><creatorcontrib>Kolios, A</creatorcontrib><creatorcontrib>Chatterjee, D</creatorcontrib><creatorcontrib>Fatah, M</creatorcontrib><creatorcontrib>Gasperetti, A</creatorcontrib><creatorcontrib>Steffel, J</creatorcontrib><creatorcontrib>Ruschitzka, F</creatorcontrib><creatorcontrib>Duru, F</creatorcontrib><creatorcontrib>Hamilton, R.M</creatorcontrib><creatorcontrib>Saguner, A.M</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suna, G</au><au>Kolios, A</au><au>Chatterjee, D</au><au>Fatah, M</au><au>Gasperetti, A</au><au>Steffel, J</au><au>Ruschitzka, F</au><au>Duru, F</au><au>Hamilton, R.M</au><au>Saguner, A.M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ARVC specific autoantibody identifies cardiac sarcoidosis and correlates with inflammation activity</atitle><jtitle>European heart journal</jtitle><date>2020-11-01</date><risdate>2020</risdate><volume>41</volume><issue>Supplement_2</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Introduction Cardiac sarcoidosis (CS) is an inflammatory granulomatous disease of unknown origin. CS and arrhythmogenic right ventricular cardiomyopathy (ARVC) are overlapping syndromes. With both, patients are at increased risk of ventricular arrhythmias and sudden cardiac death. However, the diagnosis of CS is challenging, especially in patients with no extracardiac involvement, but correct diagnosis has large therapeutic impact. Recently, a novel diagnostic autoantibody (anti-DSG2 Ab) was identified in ARVC. We sought to identify this antibody in CS patients and correlate its levels with inflammation activity using cardiac positron-emission-tomography (18-FDG-PET). Methods Recombinant human desmoglein-2 (DSG2) proteins on western blots were exposed to sera as well as purified IgG of 14 patients with sarcoidosis (all confirmed by histology) and 6 controls (1 ARVC patient (positive control) and 5 healthy control subjects (negative control)). Clinical patient characteristics were correlated to detected antibody intensity levels. Results The sarcoidosis cohort comprised 43% (6/14) male patients and the average age was 50±12 years. Anti-DSG2 Abs were identified in 43% (6/14) and were detected faintly (below cut off level) in 21% (3/14) of all sarcoidosis patients. Antibody was also present in the ARVC patient (1/1) and was absent in all control subjects (5/5). Myocardial inflammation was present in 18-FDG PET imaging in all CS patients with positive anti-DSG2 Abs, corresponding to an average SUV (standardized uptake value) of 8.1±4.2. In patients with faint or no antibody, the SUV values were significantly lower with 1.2±2.1 and 3.2±4.0, respectively (P=0.044, one-way ANOVA). The Pearson correlation coefficient (R) was 0.6 (P=0.037) for SUV vs. higher antibody levels assessed by pixel count of the western blot bands for purified IgG. Conclusions Anti-DSG2 Abs are not only a specific biomarker for ARVC, but are also found in CS, suggesting a similar pathophysiological mechanism in these overlapping syndromes, both involving cardiac inflammation and myocyte cell death. Moreover, antibody levels correlate with disease activity on cardiac PET imaging. Larger cohorts are necessary to confirm these findings. Funding Acknowledgement Type of funding source: None</abstract><pub>Oxford University Press</pub><doi>10.1093/ehjci/ehaa946.2127</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0195-668X
ispartof European heart journal, 2020-11, Vol.41 (Supplement_2)
issn 0195-668X
1522-9645
language eng
recordid cdi_crossref_primary_10_1093_ehjci_ehaa946_2127
source Oxford University Press Journals All Titles (1996-Current)
title ARVC specific autoantibody identifies cardiac sarcoidosis and correlates with inflammation activity
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T09%3A37%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=ARVC%20specific%20autoantibody%20identifies%20cardiac%20sarcoidosis%20and%20correlates%20with%20inflammation%20activity&rft.jtitle=European%20heart%20journal&rft.au=Suna,%20G&rft.date=2020-11-01&rft.volume=41&rft.issue=Supplement_2&rft.issn=0195-668X&rft.eissn=1522-9645&rft_id=info:doi/10.1093/ehjci/ehaa946.2127&rft_dat=%3Coup_cross%3E10.1093/ehjci/ehaa946.2127%3C/oup_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c1257-fd051533d08fb3ed2cf629da37f84b56030f2cfd51769a5080f92174b3bfd0ec3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/ehjci/ehaa946.2127&rfr_iscdi=true