How do lupus autoantibodies target the heart?

Inflammation caused by lupus can affect many different body systems such as the skin, kidneys, blood cells, brain, lungs, and heart. Since lupus affects multiple body parts, symptoms tend to differ from person to person. Around 25-50% of lupus patients develop heart issues such as myocarditis—inflammation of the heart. Because of the complexity of the disease, lupus has been difficult to study.

However, a recent study has explored a new method to study how autoantibodies affect the heart in lupus patients. A team of researchers from Columbia University and Harvard developed engineered heart tissues from human stem cells and then exposed them to the autoantibodies derived from lupus patients, both with and without myocarditis.

Through this process, the researchers discovered distinct autoantibody binding patterns that correlated with the type and severity of myocardial damage in the patients. For example, patients with severe myocarditis had autoantibodies that primarily targeted dying cardiac cells, while those with impaired heart pump function had autoantibodies that mostly targeted the surface of live cells. The study also identified four specific autoantibodies that may have a direct impact on heart muscle function.

This discovery could pave the way for identifying lupus patients at higher risk of developing heart disease and inform the development of new therapeutic strategies. Although more research needs to be done, these findings may also have broader implications for studying and treating other autoimmune diseases.

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