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Eur J Heart Fail. 2013 Jul;15(7):724-9. doi: 10.1093/eurjhf/hft065. Epub 2013 May 2.

Targeting anti-beta-1-adrenergic receptor antibodies for dilated cardiomyopathy.

Author information

1
Duke Clinical Research Institute, Durham, NC, USA. patel.priyesha@gmail.com

Abstract

Anti-beta-1-adrenergic receptor antibodies (anti-β1AR Abs) have long been implicated in the pathogenesis of dilated cardiomyopathy (DCM). It is believed that these autoantibodies bind to and constitutively stimulate the β1AR to promote pathological cardiac remodelling and β1AR desensitization and downregulation. The prevalence of anti-β1AR Abs in patients with DCM ranges from 26% to 60%, and the presence of these autoantibodies correlates with a poor prognosis. Several small studies have shown improvements in functional status, haemodynamics, and biomarkers of heart failure upon removal or neutralization of these antibodies from the sera of affected patients. Traditionally, removal of anti-β1AR Abs required immunoadsorption therapy with apheresis columns directed against human immunoglobulins (Igs) and subsequent i.v. Ig infusion, thereby essentially performing a plasma exchange transfusion. However, recent advances have allowed the development of small peptides and nucleotide sequences that specifically target and neutralize anti-β1AR Abs, providing a hopeful avenue for future drug development to treat DCM. Herein, we briefly review the clinical literature of therapy directed against anti-β1AR Abs and highlight the opportunity for further research and development in this area.

KEYWORDS:

Antibodies; Beta-1-adrenergic receptors; Cardiomyopathy; Immunoadsorption; Immunoglobulins

PMID:
23639780
PMCID:
PMC3707431
DOI:
10.1093/eurjhf/hft065
[Indexed for MEDLINE]
Free PMC Article

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