Increases in Serum Autoantibodies After Left Ventricular Assist Device Implantation

J Card Fail. 2019 Apr;25(4):301-306. doi: 10.1016/j.cardfail.2019.01.002. Epub 2019 Jan 7.

Abstract

Background: Left ventricular assist devices (LVADs) can serve as a bridge to transplant or destination therapy for patients with advanced heart failure. Implantation of LVADs is known to be associated with increases in anti-HLA antibodies, but less is known about how autoantibody levels change with the use of these devices.

Methods and results: Autoantibody levels were quantified with the use of customized antigen microarrays in 22 patients both before and after LVAD. We observed an increase (1.5- to 2-fold) in 14 IgG autoantibodies in the serum of patients after LVAD, including autoantibodies against cardiac proteins (myosin, troponin I, tropomyosin), DNA, and structural proteins (collagen, laminin). There was also a small but significant rise in total serum IgG after LVAD. Increases in autoantibodies after LVAD were positively associated with increases in calculated panel-reactive antibody class II (P = .05) and negatively correlated with age (r = -0.45; P < .05). Cytokines were evaluated to gain insights into the mechanism of antibody generation, and we observed a positive correlation between total IgG levels after LVAD and the level of monocyte chemoattractant protein 1 (r = 0.60; P < .05).

Conclusions: LVAD implantation is associated with increases in IgG autoantibodies, anti-HLA antibodies, and total IgG. Increases in IgG after LVAD implantation may relate to an inflammatory response triggered by these devices.

Keywords: Left ventricular assist device; autoantibody; cytokines; sensitization.

MeSH terms

  • Autoantibodies / blood*
  • Biomarkers / blood
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • HLA Antigens / immunology
  • Heart Failure / blood
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Ventricles / physiopathology*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Ventricular Function, Left / physiology

Substances

  • Autoantibodies
  • Biomarkers
  • HLA Antigens