The Role Of Anti-M₂ Muscarinic Receptor Autoantibody And Anti-M₃ Muscarinic Receptor Autoantibody In The Pathogenesis Of Chronic Cor Pulmonale

Objective:To detect anti-M₂ muscarinic receptor autoantibody and anti-M₃ muscarinic receptor autoantibody in the sera from chronic cor pulmonale,study the effect of both autoantibodies to the cardiac function.It was deeply investigated that relationship between both autoantibodies and structure of cor dextrum in chronic cor pulmonale.Methods:Medical examination,blood gas analysis,Doppler color echocardiogram examination were measured in 108 patients with chronic cor pulmonale and 30 control group. The sera from the subjects was assessed with SA-ELISA immunoassay.According to effect of determination,the patients were divided into 3 kinds:(1)positive and negative group of anti-M₂ muscarinic receptor autoantibody,(2)positive and negative group of anti-M₃ muscarinic receptor autoantibody,(3)only positive group of anti-M₂ muscarinic receptor autoantibody,only positive group of anti-M₃ muscarinic receptor autoantibody,double positive group of both autoantibodies, and to compare respectively to effects of blood gas analysis and Doppler color echocardiogram examination.Results:(1)The rate of positive and the mean geometric titers of the autoantibodies against M₂-muscarinic and M₃-muscarinic receptor of the patients[48.15%,80(1.846±0.351);40.74 %,53(1.725±0.273)]were significantly higher than that of control group[13.33%,40(1.602±0.369);10%,20(1.301±0.000)](P＜0.05).(2)Comparison index between positive group and negative group of anti-M₂ muscarinic receptor autoantibody and control group:PaO2 increased gradually.PaCO2 and right ventricular outflow tract inner diameter and right ventricular inner diameter decreased gradually.The tendency also occur in positive group and negative group of anti-M₃ muscarinic receptor autoantibody and control group(P＜0.05).(3)only positive group of anti-M₂ muscarinic receptor autoantibody,only positive group of anti-M₃ muscarinic receptor autoantibody and double positive group of both autoantibodies increased gradually in cardiac index(P＜0.05).Conclusion:(1)the rate of positive and the antibody titer of both autoantibodies of the patients were obviously higher than that of control group,which indicates that there was a close relationship between both autoantibodies and the pathogenesis of chronic cor pulmonale.(2)The heart damage of the patients with the positive autoantibodies against M₂-muscarinic receptor and M₃-muscarinic receptor were more serious than that of the patients with the negative ones.(3) Anti-M₂ muscarinic receptor autoantibody maybe plays a more important role than anti-M₃ muscarinic receptor autoantibody in the pathogenesis of chronic cor pulmonale.Both autoantibodies possibly have synergistic effect in heart morphology change.