Evidence of Cell-Mediated Cardiac Myocyte Injury Involved in the Heart Failure of a Patient With Progressive Systemic Sclerosis
スポンサーリンク
概要
- 論文の詳細を見る
A 54-year-old woman with progressive systemic sclerosis(PSS) was admitted to hospital because of dyspnea and chest pain. Echocardiogram revealed diffuse hypokinesis of the left ventricle(ejection fraction 24%). Methylprednisolone, heparin, and diuretics were administered, without benefit. Anemia, thrombocytopenia, and renal dysfunction rapidly progressed, and she died of heart failure on the 14th hospital day. Immunohistochemical study of the myocardial tissue showed mild to moderate cell infiltration, mainly consisting of natural killer(NK) cells, macrophages, cytotoxic T lymphocytes(CTLs), and T helper cells. Perforin, a cytolytic factor, was expressed in the infiltrating CTLs and NK cells, indicating that these cells were activated killer cells. Furthermore, human leukocyte antigen classes I and II, intercellular adhesion molecule-1, as well as costimulatory molecules B7-1, B7-2, and CD40, all of which are known not to be expressed in cardiac myocytes under normal conditions, were moderately to strongly expressed in cardiac myocytes. There was no detectable level of enterovirus genomes in the polymerase chain reaction products from the myocardial tissue of this patient. These findings strongly suggest that the infiltrating killer cells recognized cardiac myocytes as target cells and directly damaged them by releasing perforin. Enhanced expression of these antigens may have played an important role in the activation and cytotoxicity of the infiltrating killer cells. Absence of enterovirus genomes in the myocardial tissue may suggest that this autoimmune process is primarily induced by PSS.
- 社団法人日本循環器学会の論文
- 1998-12-20
著者
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Takahashi Naoyuki
Department of Cardiology, Nihon University Surugadai Hospital
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Yazaki Y
Department Of Gene Diagnostics And Therapeutics International Medical Center Of Japan
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Yasuda Yoshinari
大阪大学 医学系研究科老年・腎臓内科学
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Seko Yoshinori
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
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Yazaki Yoshio
東京大学 医学系研究科臨床疫学
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Seko Yoshinori
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Seko Yoshinori
The Third Department Of Internal Medicine University Of Tokyo
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Seko Yoshinori
Department Of Cardiology Institute For Adult Diseases Asahi Life Foundation
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Yazaki Yoshio
Department of Gene Diagnostics and Therapeutics, Research Institute, International Medical Center of
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YAGITA Hideo
Department of Immunology, Juntendo University School of Medicine
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OKUMURA KO
Department of Urology, School of Medicine, Jutendo University
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Yoshino S
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Okumura K
Juntendo Univ. School Of Medicine Tokyo Jpn
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Okumura K
Department Of Immunology Juntendo University
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Azuma Miyuki
Department Of Molecular Immunology Tokyo Medical And Dental University
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Azuma Miyuki
Department Of Immunology Juntendo University Medical School
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Yoshino Shinichi
Department Of Joint Disease And Rheumatism Nippon Medical School
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Yagita H
Department Of Immunology Juntendo University
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Yagita Hideo
Department Of Immumology Juntendo University School Of Medicine
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Seko Yoshinori
The Institute For Adult Diseases Asahi Life Foundation
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Takahashi Naoyuki
Department Of Applied Chemistry Tokyo University Of Agriculture And Technology
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Takahashi Naoyuki
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo:institute For
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Yamashita Yoshihisa
Kidney Disease Center Saitama Medical School Hospital
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Yazaki Yoshio
The Third Department Of Internal Medicine University Of Tokyo
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Okumura Ko
Department Of Engineering Physics Chubu University
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Yoshino S
Department Of Joint Disease And Rheumatism Nippon Medical School
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Yazaki Yoshiro
Third Department Of Internal Medicine University Of Tokyo
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Seko Yoshinori
The Third Department Of Internal Medicine Faculty Of Medicine University Of Tokyo
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Seko Yoshinori
Third Department Of Internal Medicine Faculty Of Medicine University Of Tokyo
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Yazaki Yoshio
The Third Dept. Of Medicine University Of Tokyo
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Yazaki Yoshio
Department Of Cardiology University Of Tokyo
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Yui Yoshiki
京都大学 医研究 循病態
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Yoshimasa Yasunao
Division Of Atherosclerosis And Metabolism
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Okumura Ko
School Of Medicine Juntendo University
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Okumura Ko
Department Of Dermatology Juntendo University School Of Medicine
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