Determination of autoantibody repertoire in the mouse model of viral myocarditis and in patients with non-ischemic cardiomyopathy by PhIP-Seq

Abstract Various infectious and non-infectious agents can cause myocarditis that may lead to cardiomyopathy with viruses being the most common suspects. Mechanistically, autoantibodies have been demonstrated for various antigens, in animal models and dilated cardiomyopathy patients, but their role continues to be enigmatic. First, by using the Coxsackievirus B3 (CVB3) infection model in A/J mice, we applied PhIP-Seq, a high-throughput platform to evaluate antibodies for various antigens. The data revealed the identification of antibodies to 32 antigens that were not previously reported. By investigating the biological significance of a few select antigens, we noted that cytochrome c oxidase assembly factor 4 homolog (COA4)-reactive antibodies were generated only in mice infected with CVB3 but not in influenza-infected animals proving virus specificity for antibody reactivity to COA4. Further immunogenicity studies revealed that animals immunized with COA4 did not develop myocarditis, nor was the T cell response generated, implying that COA4 is unlikely to act as a bonafide autoantigen. Alternatively, the COA4-reactive antibodies may represent biomarkers of viral myocarditis. Second, using the PhIP-Seq platform, we investigated the antibody profiles of human sera obtained from 25 age-matched non-ischemic cardiomyopathy patients and healthy controls. The analysis revealed significantly elevated levels of antibodies to 33 antigens, and the detection of the major candidates is being analyzed by ELISA as a secondary assay. Overall, our data suggest that the PhIP-Seq allows us to comprehensively analyze antibody repertoires that may lead to the identification of novel autoantibodies or their use as biomarkers. This work was supported in part by the institutional funds from the University of Nebraska-Lincoln (J.R.), the Transformational Grant 18TPA34170206 from the American Heart Association (J.R.), and the National Institutes of Health grants R01 HL114669 (J.R), R01 GM136724 (H.B.L.).