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. (Jpn Circ J 1999; 63: 68 - 72)
- 社団法人 日本循環器学会の論文
社団法人 日本循環器学会 | 論文
- Adenosine Triphosphate Exposes Dormant Pulmonary Vein Conduction Responsible for Recurrent Atrial Tachyarrhythmias : Importance of Evaluating the Dormant Conduction During the Re-Do Ablation Procedure
- Impact of Diabetes Mellitus on Rehospitalization for Heart Failure Among Survivors of Acute Myocardial Infarction in the Percutaneous Coronary Intervention Era
- N-Acetylcysteine Reduces the Severity of Atherosclerosis in Apolipoprotein E-Deficient Mice by Reducing Superoxide Production
- Incremental Effects of Eicosapentaenoic Acid on Cardiovascular Events in Statin-Treated Patients With Coronary Artery Disease : Secondary Prevention Analysis From JELIS
- Risk of Smoking and Metabolic Syndrome for Incidence of Cardiovascular Disease : Comparison of Relative Contribution in Urban Japanese Population : The Suita Study