CLINICAL STUDY
Decreased oxidative stress in patients with idiopathic dilated cardiomyopathy one year after immunoglobulin adsorption
Ingolf Schimke, PhD*,
Johannes Müller, MD ,
Friedrich Priem ,
Ingrid Kruse*,
Birgit Schön*,
Julia Stein,
Rudolf Kunze, PhD||,
Gerd Wallukat, PhD and
Roland Hetzer, MD
* Medizinische Klinik, Berlin, Germany
Institut für Laboratoriumsmedizin, Humboldt-Universität zu Berlin, Berlin, Germany
Deutsches Herzzentrum Berlin, Berlin, Germany
Max-Delbrück-Centrum Berlin, Berlin, Germany
|| Affina GmbH, Berlin, Germany
Manuscript received November 21, 2000;
revised manuscript received March 7, 2001,
accepted April 2, 2001.
Reprint requests and correspondence: Dr. Ingolf Schimke, Medizinische Klinik, Humboldt-Universität zu Berlin, Schumannstr. 20/21, D-10098 Berlin, Germany
ingolf.schimke{at}charite.de
OBJECTIVES
In a substudy to a recently reported investigation that demonstrated the benefit of immunoglobulin adsorption (immunoadsorption) for patients with idiopathic dilated cardiomyopathy (IDC), we tested whether this benefit is associated with a reduction of oxidative stress.
BACKGROUND
The progression of cardiomyopathy is believed to be related to the increase of oxidative stress. Therefore, reduction of oxidative stress could be one of the effects of immunoadsorption for improvement of cardiac performance and clinical status.
METHODS
Plasma markers for oxidative stress—thiobarbituric acid-reactive substances (TBARS), lipid peroxides (LPO), anti-oxidized low-density lipoprotein-autoantibodies (anti-oxLDL-AB), thiol groups and vitamin E—were compared in 31 patients, of whom 16 underwent immunoadsorption and 15 received conventional treatment (controls). All patients received a daily supplement of vitamins, minerals and trace elements.
RESULTS
After one year, TBARS (p = 0.026), LPO (p = 0.026) and anti-oxLDL-AB (p = 0.044) were decreased in the immunoadsorption group but not in the controls. Thiols were unchanged in the immunoadsorption group but were decreased in the controls (p = 0.001). Vitamin E accumulated in both groups (immunoadsorption: p = 0.001; controls: p = 0.031) with a trend for stronger accumulation after immunoadsorption (p = 0.09). Prior to the study, the anti-oxLDL-AB to left ventricular ejection fraction (LVEF) (p = 0.05) were inversely correlated. After one year, correlations with borderline significance were calculated for TBARS to New York Heart Association functional class (p = 0.081) and inversely for LPO to LVEF (p = 0.083).
CONCLUSIONS
Effective therapy in patients with IDC, such as immunoadsorption which improved cardiac performance and clinical status, is associated with a reduction of oxidative stress.
|
Abbreviations and Acronyms
| | ACE | = angiotensin-converting enzyme | | ANOVA | = analysis of variance | | anti-beta1A-AB | = anti-beta 1-adrenoceptor antibodies | | anti-oxLDL-AB | = anti-oxidized low-density lipoprotein-autoantibodies | | IDC | = idiopathic dilated cardiomyopathy | | IgG | = immunoglobulin G | | LPO | = lipid peroxides | | LVEF | = left ventricular ejection fraction | | LVIDd | = left ventricular internal diameter in diastole | | LVIDs | = left ventricular internal diameter in systole | | NYHA | = New York Heart Association | | TBARS | = thiobarbituric acid-reactive substances |
|
This article has been cited by other articles:
|
|
|
|
 
A. Staudt, M. Bohm, F. Knebel, Y. Grosse, C. Bischoff, A. Hummel, J. B. Dahm, A. Borges, N. Jochmann, K. D. Wernecke, et al.
Potential Role of Autoantibodies Belonging to the Immunoglobulin G-3 Subclass in Cardiac Dysfunction Among Patients With Dilated Cardiomyopathy
Circulation,
November 5, 2002;
106(19):
2448 - 2453.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. L. Mann
Autoimmunity, immunoglobulin adsorption and dilated cardiomyopathy: has the time come for randomized clinical trials?
J. Am. Coll. Cardiol.,
July 1, 2001;
38(1):
184 - 186.
[Full Text]
[PDF]
|
|
|
|
