The mitochondrium as antigen in inflammatory heart disease

After identification and immunochemical characterization of the ADP/ATP carrier of the inner mitochondrial membrane as an organ- and conformation-specific auto-antigen in myocarditis, we were able to demonstrate that auto-antibodies against the ADP/ATP carrier cause an organ- and conformation-specific inhibition of the nucleotide transport in vitro. Furthermore, binding of carboxyatractylate (CAT) to the ADP/ATP carrier was blocked by the auto-antibodies against the ADP/ATP carrier, indicating a specific blockade of the ligand binding site. Based on these results, we discuss recent experimental data indicating that auto-immunity to the ADP/ATP carrier may contribute to the pathophysiology of ‘chronic myocarditis’ or dilated cardiomyopathy by causing an auto-antibody-mediated imbalance between energy delivery and demand.