扩张型心肌病临床免疫治疗进展

袁璟

doi:10.13201/j.issn.1001-1439.2017.02.001

扩张型心肌病临床免疫治疗进展

袁璟^,

- 华中科技大学同济医学院附属协和医院心内科(武汉, 430022)

详细信息

通讯作者: 袁璟,E-mail:yhelen13@163.com

中图分类号: R542.2

收稿日期: 2017-01-16

Clinical progress in the immunotherapy of dilated cardiomyopathy

YUAN Jing^,

- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: YUAN Jing, E-mail: yhelen13@163.com

Received Date: 16 January 2017

摘要

摘要: 扩张型心肌病(DCM)目前仍无特异性治疗方法。DCM患者体内抗心肌自身抗体和炎性因子失调所介导的心肌免疫损伤在DCM的发展中有重要作用,针对相应免疫靶点治疗(如免疫吸附、药物阻断抗心肌抗体作用途径、中药免疫调节和细胞移植等)是近年研究者探索DCM临床免疫治疗的热点,它们将有助于实现在规范化心力衰竭的治疗基础上进一步改善DCM心脏功能和预后的目的。
- 扩张型心肌病 /
- 免疫治疗 /
- 抗心肌抗体 /
- 中药 /
- 细胞移植
Abstract: Currently, there is no specific treatment for dilated cardiomyopathy (DCM). As both anti-heart autoantibodies (AHA) and imbalance of inflammatory cytokines play the important roles in the myocardial injuries of DCM and accelerate the development of this disease, in recent years, most researchers are focusing on exploring immunotherpy options for DCM patients, including immunoadsorption, targeted drugs for blocking AHA, Chinese herbs, cell therapy, etc. The research progress in this field may lead to further improvment in cardiac function and prognosis of patients with DCM in the future.
- dilated cardiomyopathy /
- immunotherapy /
- anti-heart autoantibodies /
- chinese herbs /
- cell therapy

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参考文献(22)

[1]	BROCH K,MURRACH K,ANDREASSEN A K,et al.Contemporary outcome in patients with idiopathic dilated cardiomyopathy[J].Am J Cardiol,2015,116:952-959.
[2]	袁璟,廖玉华.抗心肌抗体对心肌炎心肌病临床诊断、治疗和预后评估的价值[J].临床心血管病杂志,2015,31(2):115-118.
[3]	LAPPéJ M,PELFREY C M,TANG W H.Recent insights into the role of autoimmunity in idiopathic dilated cardiomyopathy[J].J Card Fail,2008,14:521-530.
[4]	WALLUKAT G,REINKE P,DRFFEL W V,et al.Removal of autoantibodies in dilated cardiomyopathy by immunoadsorption[J].Int J Cardiol,1996,54:191-195.
[5]	DOESCH A O,MUELLER S,KONSTANDIN M,et al.Effects of protein A immunoadsorption in patients with chronic dilated cardiomyopathy[J].J Clin Apher,2010,25:315-322.
[6]	STAUDT A,HERDA L R,TRIMPERT C,et al.Fcgamma-receptorⅡapolymorphism and the role of immunoadsorption in cardiac dysfunction in patients with dilated cardiomyopathy[J].Clin Pharmacol Ther,2010,87:452-458.
[7]	DANDEL M,WALLUKAT G,ENGLERT A,et al.Long-term benefits of immunoadsorption in β(1)-adrenoceptor autoantibody-positive transplant candidates with dilated cardiomyopathy[J].Eur J Heart Fail,2012,14:1374-1388.
[8]	OHLOW M A,BRUNELLI M,SCHREIBER M,et al.Therapeutic effect of immunoadsorption and subsequent immunoglobulin substitution in patients with dilated cardiomyopathy:Results from the observational prospective Bad Berka Registry[J].J Cardiol,2017,69:409-416.
[9]	FELIX S B,BEUG D,DRR M.Immunoadsorption therapy in dilated cardiomyopathy[J].Expert Rev Cardiovasc Ther,2014,13:145-152.
[10]	LAPPJ M,PELFREY C M,TANG W H.Recent insights into the role of autoimmunity in idiopathic dilated cardiomyopathy[J].J Card Fail,2008,14:521-530.
[11]	CAFORIO A L,MAHON N G,BAIG M K,et al.Prospective familial assessment in dilated cardiomyopathy:cardiac autoantibodies predict disease development in asymptomatic relatives[J].Circulation,2007,115:76-83.
[12]	HAGHIKIA A,KAYA Z,SCHWAB J,et al.Evidence of autoantibodies against cardiac troponinⅠand sarcomeric myosin in peripartum cardiomyopathy[J].Basic Res Cardiol,2015,110:60.
[13]	PINTO Y M,ELLIOTT P M,ARBUSTINI E,et al.Proposal for a revised definition of dilated cardiomyopathy,hypokinetic non-dilated cardiomyopathy,and its implications for clinical practice:aposition statement of the ESC working group on myocardial and pericardial diseases[J].Eur Heart J,2016,37:1850-1858.
[14]	YOSHIKAWA T,BABA A,AKAISHI M,et al.Immunoadsorption therapy for dilated cardiomyopathy using tryptophan column-A prospective,multicenter,randomized,within-patient and parallel-group comparative study to evaluate efficacy and safety[J].J Clin Apher,2016,31:535-544.
[15]	MüNCH G,BOIVIN-JAHNS V,HOLTHOFF H P,et al.Administration of the cyclic peptide COR-1in humans(phaseⅠstudy):ex vivo measurements of anti-β1-adrenergic receptor antibody neutralization and of immune parameters[J].Eur J Heart Fail,2012,14:1230-1239.
[16]	NAGATOMO Y,YOSHIKAWA T,OKAMOTO H,et al.Presence of autoantibody directed againstβ1-adrenergic receptors is associated with amelioration of cardiac function in response to carvedilol:Japanese Chronic Heart Failure(J-CHF)Study[J].J Card Fail,2015,21:198-207.
[17]	魏晶晶,袁璟,廖玉华,等.β受体阻滞剂/地尔硫治疗扩张型心肌病患者病死率的Meta分析[J].临床心血管病杂志,2016,32(2):128-132.
[18]	ZHU Y S,LI Y L,JU J Q,et al.Oral Chinese Herbal Medicine for Treatment of Dilated Cardiomyopathy:A Systematic Review and Meta-Analysis[J].Evid Based Complement Alternat Med,2016,2016:1819794.
[19]	VRTOVEC B,POGLAJEN G,HADDAD F.Stem cell therapy in patients with heart failure[J].Methodist Debakey Cardiovasc J,2013,9:6-10.
[20]	VRTOVEC B,POGLAJEN G,LEZAIC L,et al.Effects of intracoronary CD34+ stem cell transplantation in nonischemic dilated cardiomyopathy patients:5-year follow-up[J].Circ Res,2013,112:165-173.
[21]	HAMSHERE S,ARNOUS S,CHOUDHURY T,et al.Randomized trial of combination cytokine and adult autologous bone marrow progenitor cell administration in patients with non-ischaemic dilated cardiomyopathy:the REGENERATE-DCM clinical trial[J].Eur Heart J,2015,36:3061-3069.
[22]	MARTINO H,BROFMAN P,GRECO O,et al.Multicentre,randomized,double-blind trial of intracoronary autologous mononuclear bone marrow cell injection in non-ischaemic dilated cardiomyopathy(the dilated cardiomyopathy arm of the MiHeart study)[J].Eur Heart J,2015,36:2898-2904.