{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:26:32Z","timestamp":1784967992161,"version":"3.55.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Cardiac dysfunction and myocarditis have emerged as serious complications of multisystem inflammatory syndrome in children (MIS-C) and vaccines against SARS-CoV-2. Understanding the role of autoantibodies in these conditions is essential for guiding MIS-C management and vaccination strategies in children.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate the presence of anticardiac autoantibodies in MIS-C or COVID-19 vaccine-induced myocarditis.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This diagnostic study included children with acute MIS-C or acute vaccine myocarditis, adults with myocarditis or inflammatory cardiomyopathy, healthy children prior to the COVID-19 pandemic, and healthy COVID-19 vaccinated adults. Participants were recruited into research studies in the US, United Kingdom, and Austria starting January 2021. Immunoglobulin G (IgG), IgM, and IgA anticardiac autoantibodies were identified with immunofluorescence staining of left ventricular myocardial tissue from 2 human donors treated with sera from patients and controls. Secondary antibodies were fluorescein isothiocyanate\u2013conjugated antihuman IgG, IgM, and IgA. Images were taken for detection of specific IgG, IgM, and IgA deposits and measurement of fluorescein isothiocyanate fluorescence intensity. Data were analyzed through March 10, 2023.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>IgG, IgM and IgA antibody binding to cardiac tissue.<\/jats:p><\/jats:sec>Results<\/jats:title>By cohort, there were a total of 10 children with MIS-C (median [IQR] age, 10 [13-14] years; 6 male), 10 with vaccine myocarditis (median age, 15 [14-16] years; 10 male), 8 adults with myocarditis or inflammatory cardiomyopathy (median age, 55 [46-63] years; 6 male), 10 healthy pediatric controls (median age, 8 [13-14] years; 5 male), and 10 healthy vaccinated adults (all older than 21 years, 5 male). No antibody binding above background was observed in human cardiac tissue treated with sera from pediatric patients with MIS-C or vaccine myocarditis. One of the 8 adult patients with myocarditis or cardiomyopathy had positive IgG staining with raised fluorescence intensity (median [IQR] intensity, 11\u202f060 [10\u202f223-11\u202f858] AU). There were no significant differences in median fluorescence intensity in all other patient cohorts compared with controls for IgG (MIS-C, 6033 [5834-6756] AU; vaccine myocarditis, 6392 [5710-6836] AU; adult myocarditis or inflammatory cardiomyopathy, 5688 [5277-5990] AU; healthy pediatric controls, 6235 [5924-6708] AU; healthy vaccinated adults, 7000 [6423-7739] AU), IgM (MIS-C, 3354 [3110-4043] AU; vaccine myocarditis, 3843 [3288-4748] AU; healthy pediatric controls, 3436 [3313-4237] AU; healthy vaccinated adults, 3543 [2997-4607] AU) and IgA (MIS-C, 3559 [2788-4466] AU; vaccine myocarditis, 4389 [2393-4780] AU; healthy pediatric controls, 3436 [2425-4077] AU; healthy vaccinated adults, 4561 [3164-6309] AU).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This etiological diagnostic study found no evidence of antibodies from MIS-C and COVID-19 vaccine myocarditis serum binding cardiac tissue, suggesting that the cardiac pathology in both conditions is unlikely to be driven by direct anticardiac antibody\u2013mediated mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.14291","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T15:04:10Z","timestamp":1684422250000},"page":"e2314291","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of Autoantibody Binding to Cardiac Tissue in Multisystem Inflammatory Syndrome in Children and COVID-19 Vaccination\u2013Induced Myocarditis"],"prefix":"10.1001","volume":"6","author":[{"given":"Harsita","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Section of Paediatric Infectious Disease, Imperial College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Sintou","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Faculty of Medicine, Imperial College London, United 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Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Prasad","sequence":"additional","affiliation":[{"name":"Royal Brompton & Harefield hospitals, Guy\u2019s and St Thomas\u2019 National Health Service Foundation Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter P.","family":"Rainer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Graz, Graz, Austria"},{"name":"BioTechMed Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Martin\u00f3n-Torres","sequence":"additional","affiliation":[{"name":"Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigaci\u00f3n Sanitaria de Santiago, Santiago de Compostela, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Translational 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