Infective endocarditis is characterized by the colonization of endocardium
by microorganisms. Except for Staphylococcus aureus, microorganisms are not
able to adhere to and grow on endocardial cells; prior damage, e.g., by sh
ear stress or other mechanical factors, is necessary. But other causes may
well have a share. This study was, therefore, designed to identify immunolo
gical factors, especially antibodies against endothelial cells, which could
contribute to the initiation of endocardial injury.
Sera of patients with infective endocarditis and healthy controls were inve
stigated for the presence of antibodies against endothelial antigen. As the
antigen source human umbilical vein endothelial cells were used. Antibodie
s against endothelial cells were detected by indirect immunofluorescence, E
LISA, immunoblotting, antibody dependent cellular cytotoxicity, and antibod
y mediated cytotoxicity.
Antibodies against endothelial cells were found in seven out of fifteen pat
ients. These antibodies were directed against cytoplasmic structures and on
ly appeared in the course of the disease. A correlation between the presenc
e of these antibodies and disease activity or the outcome of disease was no
t observed. These antibodies may develop as a consequence of damage to endo
cardial cells (thereby exposing intracellular antigen to the immune system)
and do not seem to play a role in the pathogenesis of infective endocardit
is.