Autoimmunity Against the Heart and Cardiac Myosin in Children With Myocarditis

Kathleen E. Simpson, Madeleine W. Cunningham, Caroline K. Lee, Kent Ward, Alan Tong, Saar Danon, Catherine Simon, Jeffrey W. Delaney, Charles E. Canter

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background Host autoimmune activity in myocarditis has been proposed to play a role in development of cardiac disease, but evidence of autoimmunity and relationship to outcomes have not been evaluated in pediatric myocarditis. Methods We performed a multi-institutional study of children with clinical myocarditis. Newly diagnosed patients were followed for up to 12 months and previously diagnosed patients at a single follow-up for serum levels of autoantibodies to human cardiac myosin, beta-adrenergic receptors 1 and 2, muscarinic-2 receptors, and antibody-mediated protein kinase A (PKA) activation in heart cells in culture. Results were compared with those of healthy control children. Results Both previously diagnosed patient at follow-up (P = .0061) and newly diagnosed patients at presentation (P = .0127) had elevated cardiac myosin antibodies compared with control subjects. Antibody levels were not associated with recovery status at follow-up in either group. PKA activation was higher at presentation in the newly diagnosed patients who did not recovery normal function (P = .042). Conclusions Children with myocarditis have evidence of autoantibodies against human cardiac myosin at diagnosis and follow-up compared with control subjects. Differences in antibody-mediated cell signaling may contribute to differences in patient outcomes, as suggested by elevated antibody-mediated PKA activation in heart cells by the serum from nonrecovered patients.

Original languageEnglish (US)
Pages (from-to)520-528
Number of pages9
JournalJournal of Cardiac Failure
Issue number7
StatePublished - Jul 1 2016


  • Myocarditis
  • autoantibody
  • autoimmunity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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