This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Dilated cardiomyopathy (iDCM) currently affects hundreds of thousands of Americans, and costs the healthcare system billions annually. However, despite the immense impact of this disease, the majority (60-70%) of cases are still idiopathic in nature. Recent work evaluating the pathogenesis has shown that as many as two thirds of patients with iDCM have endomyocardial biopsy proven evidence of chronic viral infection. It is speculated that this viral insult may trigger an autoimmune response that instigates the progression to DCM. This idea is supported by findings that cardiac specific autoantibodies have been found in greater then half of patients with DCM, and that the presence of these autoantibodies correlates with an impairment in cardiac function. However, to date there has been little or no published work evaluating the role of cellular mediated autoimmunity in iDCM. This study intends to use enzyme-linked immunosorbent spot (ELISPOT) assays to evaluate for T-cell mediated cardiac autoimmunity in patients with iDCM and healthy controls. Enzyme-linked immunosorbent assays (ELISA) will also be used to correlate the formation of cardiac specific autoantibodies to autoreactive T-cell responses. Further, this study will attempt to delineate if ongoing myocardial damage (indicated by an elevated troponin) or inflammation (indicated by elevated hsCRP or MPO) is correlated with a higher prevalence of cardiac autoimmunity.
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