Receptor-activating autoantibodies and disease: preeclampsia and beyond.

Abstract

The research reviewed in this article provides examples of autoantibody-mediated receptor activation that likely contributes to disease. The classic example is Graves' hyperthyroidism, in which autoantibodies activate the thyroid-stimulating hormone receptor resulting in overproduction of thyroid hormones. Other compelling examples come from the cardiovascular literature and include agonistic autoantibodies targeting the cardiac β(1)-adrenergic receptor, which are associated with dilated cardiomyopathy. Autoantibodies capable of activating α(1)-adrenergic receptors are associated with refractory hypertension and cardiomyopathy. A prominent example is preeclampsia, a hypertensive disease of pregnancy, characterized by the presence of autoantibodies that activate the major angiotensin receptor, AT(1). AT(1) receptor-activating autoantibodies are also observed in kidney transplant recipients suffering from severe vascular rejection and malignant hypertension. AT(1) receptor-activating autoantibodies and antibodies that activate the endothelin-1 receptor, ET(A), are prevalent in individuals diagnosed with systemic sclerosis. Thus, the presence of agonistic autoantibodies directed to G protein-coupled receptors has been observed in numerous cardiovascular disease states. Rapidly emerging evidence indicates that receptor-activating autoantibodies contribute to disease, and that efforts to detect and remove these pathogenic autoantibodies or block their actions will provide promising therapeutic possibilities.

• Authors: Yang Xia, Rodney E Kellems
• Journal: Expert review of clinical immunology (Expert Rev Clin Immunol) Vol. 7 Issue 5 Pg. 659-74 (Sep 2011) ISSN: 1744-8409 [Electronic] England
• PMID: 21895478 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Autoantibodies
• Receptor, Angiotensin, Type 1
• Receptor, Endothelin A

Topics

• Animals
• Autoantibodies (immunology)
• Female
• Humans
• Pre-Eclampsia (immunology, pathology, therapy)
• Pregnancy
• Receptor, Angiotensin, Type 1 (immunology)
• Receptor, Endothelin A (immunology)
• Scleroderma, Systemic (immunology, pathology, therapy)