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Dissecting antibody responses to cardiac receptors in patients with myocardial infarction

Siegel, J.; Beer, D.; Janjatovic, S.; Auer, A.; Zipp, L.-S.; Kozuch, E.; Krammer, T.; Bielenberg, M.; Saliba, A.-E.; Cochain, C.; Stoerk, S.; Heuschmann, P.; Morbach, C.; Beyersdorf, N.; Nahrendorf, M.; Nikolaev, V. O.; Hofmann, U.; Frantz, S.; Wardemann, H.; Heinrichs, M.; Heinze, K. G.; Streckfuss-Boemeke, K.; Ashour, D.; Ramos, G.

2025-11-06 cardiovascular medicine
10.1101/2025.11.03.25339371 medRxiv
Show abstract

Myocardial infarction (MI) triggers the production of heart-reactive serum antibodies, but their antigen specificities and impact on cardiomyocyte function remain poorly understood. Using single-cell RNA and B cell receptor sequencing (scRNA/BCRseq) on plasmablasts isolated from patients with MI combined with antibody engineering, we identified B cell clones expanded in response to MI, and generated a panel of 17 recombinant monoclonal antibodies having the same binding domains as those identified in patients scBCR datasets (MI-mAb). This approach enabled us to map antibody specificities and dissect their functional impact on cardiomyocytes. Our findings reveal that post-MI B cell responses target cardiac receptors, including extracellular epitopes mapped to beta adrenergic receptors ({beta}-ARs). Notably, some of the {beta}-AR-specific MI-mAbs induced intracellular cAMP signaling and ultimately modulated cardiomyocyte excitation-contraction coupling. Taken together, these observations provide mechanistic evidence for expanding B cells in the context of MI, with the production of antibodies targeting cardiac receptors that can impact myocardial pathophysiology.

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