Document Detail


Specificity and effector mechanisms of autoantibodies in congenital heart block.
MedLine Citation:
PMID:  17011766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Complete congenital atrio-ventricular (AV) heart block develops in 2-5% of fetuses of Ro/SSA and La/SSB autoantibody-positive pregnant women. During pregnancy, the Ro/SSA and La/SSB antibodies are transported across the placenta and affect the fetus. Emerging data suggest that this happens by a two-stage process. In the first step, maternal autoantibodies bind fetal cardiomyocytes, dysregulate calcium homestasis and induce apoptosis in affected cells. This step might clinically correspond to a first-degree heart block, and be reversible. La/SSB antibodies can bind apoptotic cardiomyocytes and thus increase Ig deposition in the heart. The tissue damage could, as a second step, lead to spread of inflammation in genetically pre-disposed fetuses, progressing to fibrosis and calcification of the AV-node and subsequent complete congenital heart block. Early intrauterine treatment of an incomplete AV-block with fluorinated steroids has been shown to prevent progression of the heart block, making it clinically important to find specific markers to identify the high-risk pregnancies.
Authors:
Marie Wahren-Herlenius; Sven-Erik Sonesson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2006-09-29
Journal Detail:
Title:  Current opinion in immunology     Volume:  18     ISSN:  0952-7915     ISO Abbreviation:  Curr. Opin. Immunol.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-10-30     Completed Date:  2007-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8900118     Medline TA:  Curr Opin Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  690-6     Citation Subset:  IM    
Affiliation:
Rheumatology Unit, Department of Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden. marie.wahren@ki.se
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MeSH Terms
Descriptor/Qualifier:
Animals
Autoantibodies / immunology*
Autoantigens / immunology*
Female
Fetal Diseases / immunology*
Fetal Therapies
Heart Block / congenital*,  immunology*,  prevention & control
Humans
Myocytes, Cardiac / immunology,  pathology
Pregnancy
Steroids, Fluorinated / therapeutic use
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Autoantigens; 0/Steroids, Fluorinated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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