心不全アフェレシス治療の標的自己抗体(<特集>心疾患とアフェレシス)

概要

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Humoral autoimmune disorders such as DCM, HCM, ARVC, doxorubicin, puerperium, or uremic cardiomyopathy have been observed in many heart failure patients. Our roughly 1,000 case measurement of anti-myocardial autoantibodies elucidated that the pathophysiological cardio-depressant autoantibodies could be several IgG3 autoantibodies against myosin, sarcolemmal proteins, or G-protein coupled receptors. Those treatment target autoantibodies were also found frequently in very severe heart failure patients who were attached to VADs. More than 10 years ago European treatment reports made it clear that we could exclude the severe patients from a list of heart transplantation by apheresis, and that breakaway from VADs would be possible. Apheresis treatment such as plasmapheresis or immunoadsorption may become one of the new heart failure therapies by elimination of pathophysiological cardio-depressant agents, and we could break a vicious cycle of repeated aggravation of heart failure.
2010-05-31