Importance of Humoral and Cellular Immunological Parameters for the Pathogenesis of Viral Myocarditis

  • B. Maisch
  • M. Herzum
  • T. Izumi
  • S. Nunoda

Abstract

Problems in the diagnosis and treatment of myocarditis are not new to medicine. Jean Baptiste Senac, physician in ordinary to the French Emperor Louis XV, wrote some 300 years ago: “The inflammation of our heart is difficult to diagnose, and if we have diagnosed it, can we really treat it more safely?” (J. B. Senac quoted by Schramm [54]). Similarly the WHO/ISCF task force definition of dilated cardiomyopathy [47] as “heart muscle disease of unknown cause” which is postulated to be a common end point of different etiopathogenetic entities, which also include myocarditis, more likely describes our lack of knowledge than a disease entity.

Keywords

Influenza Interferon Peri Cardiomyopathy Cardiol 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Anderson JL, Greenwood JH, Kawanishi H (1981) Evaluation of suppressor immune regulatory function in idiopathic congestive cardiomyopathy and rheumatic heart disease. Br Heart J 46: 410–414PubMedCrossRefGoogle Scholar
  2. 2.
    Anderson JL, Carlquist JF, Hammond FH (1982) Deficient natural killer cell activity in patients with idiopathic dilated cardiomyopathy. Lancet 2: 1124–1127PubMedCrossRefGoogle Scholar
  3. 3.
    Aretz HT, Southern JF, Palacios IF, Dec GW Jr, Howard CA, Fallon JT (1987) Morphological and immunological findings in heart biopsies of patients with suspected or treated myocarditis. Eur Heart J 8 [Suppl J]: 187–190Google Scholar
  4. 4.
    Avrameas S (1986) Natural autoreactive B cells and autoantibodies: the know thyself of the immune system. Ann Inst Pasteur/Immunol [Suppl D] 137: 150–156Google Scholar
  5. 5.
    Becker W, Borst U, Maisch B, Epping J, Börner W, Kochsiek K (1987) 111In-labeled granulocytes in inflammatory heart disease. Eur Heart J 8 [Suppl J]: 307–310Google Scholar
  6. 6.
    Bolte HD, Schultheiss P, Cyran J, Goss F (1980) Binding of immunoglobulins in the myocardium (biopsy). In: Bolte HD (ed) Myocardial biopsy. Springer, Berlin Heidelberg New York, pp 85–92Google Scholar
  7. 7.
    Boyden SV (1963). Natural antibodies and the immune response. Adv Immunol 5: 1–28CrossRefGoogle Scholar
  8. 8.
    Breshinhan B, Jasin ME (1977). Suppressor function of peripheral blood mononuclear cells in normal individuals and patients with systemic lupus erythematosus. J Clin Invest 59: 106–116CrossRefGoogle Scholar
  9. 9.
    Cambridge G, Campbell-Blay G, Wilmhurst P, Coltan DJ, Stern CMM (1983). Deficient “natural” cytotoxicity in patients with congestive cardiomyopathy (Abstr). Br Heart J 49: 623Google Scholar
  10. 10.
    Das SK, Petty RE, Meengs WA, Tubergen DG (1980) Studies of cell-mediated immunity in cardiomyopathy. In: Sekiguchi M, Olsen EGJ (eds) Cardiomyopathy. University of Tokyo Press, Tokyo, pp 375–377Google Scholar
  11. 11.
    Eckstein R, Mempel W, Bolte HD (1982) Reduced suppressor cell activity in congestive cardiomyopathy and in myocarditis. Circulation 65: 1224–1229PubMedCrossRefGoogle Scholar
  12. 12.
    Fowles RE, Bieber CP, Stinson EB (1978) Defective in vitro suppressor of cell function in idiopathic congestive cardiomyopathy. Circulation 59: 483–491Google Scholar
  13. 13.
    Frencesini R, Petillo A, Corazza M, Nizzo MC, Azzolini A, Gianrossi R (1983) Lymphocyte response in dilated cardiomyopathy. IRCS Med Sci 11: 1019Google Scholar
  14. 14.
    Gentle TA, Baynham MID, Gammage MD, Lowry PJ, Thompson RA, Littler W A (1987) T cell function in idiopathic congestive cardiomyopathy. Eur Heart J 8 [Suppl J]: 145–146Google Scholar
  15. 15.
    Hallgren HM, Yunis EJ (1977) Suppressor lymphocytes in young and aged humans. J Immunol 118: 2004–2008PubMedGoogle Scholar
  16. 16.
    Herzum M, Maisch B, Kochsiek K (1987) Circulating immune complexes in perimyocarditis and infective endocarditis. Eur Heart J 8 [Suppl J]: 323–325Google Scholar
  17. 17.
    Hufnagel G, Pfeifer U, Maisch B (1987) Immunohistological investigations in suspected cardiac sarcoidosis. Eur Heart J 8 [Suppl J]: 59–62Google Scholar
  18. 18.
    Izumi T, Maisch B, Kochsiek K (1987) Experimental murine myocarditis after immunization with cardiac membranous proteins. Eur Hart J 8 [Suppl J]: 419–424Google Scholar
  19. 19.
    Jacobs B, Matsuda Y, Deodhar S, Shirey S (1979) Cell-mediated cytotoxicity to cardiac cells of lymphocytes from patients with primary myocardial disease. Am J Clin Pathol 72: 1–4PubMedGoogle Scholar
  20. 20.
    Jerne NK (1955) The natural selection theory of antibody formation. Proc Natl Acad Sci USA 41: 849–857PubMedCrossRefGoogle Scholar
  21. 21.
    Klein R, Maisch B, Kochsiek K, Berg PA (1984) Demonstration of organ speeific antibodies against heart mitochondria (anti-M7) in sera from patients with some forms of heart disease. Clin Exp Immunol 58: 283–292PubMedGoogle Scholar
  22. 22.
    Klein R, Spiel L, Kleemann U, Hassenstein P, Berg PA (1987) Relevance of antimitochondrial antibodies (anti-M7) in cardiac disease. Eur Heart J 8 [Suppl J]: 223–226Google Scholar
  23. 23.
    Kühl U, Ulrich G, Schultheiss HP (1987) Cross-reactivity of antibodies to the ADP/ATP translocator of the inner mitochondrial membrane with the cell surface of cardiac myocytes. Eur Heart J 8 [Suppl J]: 219–222Google Scholar
  24. 24.
    Kurniek JT, Leary C, Palaeios IF, Fallon JT (1987) Culture and characterization of lymphocytic infiltrates from endomyocardial biopsies of patients with idiopathic myocarditis. Eur Heart J 8 [Suppl J]: 135–144Google Scholar
  25. 25.
    Lowry PJ, Thompson RA, Littler WA (1983) Humoral immunity in cardiomyopathy. Br Heart J 50: 390–394PubMedCrossRefGoogle Scholar
  26. 26.
    Maisch B (1986) Immunologic regulator and effector functions in perimyocarditis, postmyocarditis heart muscle disease and dilated cardiomyopathy. Basie Res Cardiol 81 [Suppl 1]: 217–242Google Scholar
  27. 27.
    Maisch B (1987) Immunological mechanism in human cardiac injury. In: CJF Spry (ed) Immunology and molecular biology of cardiovascular disease. (Current status of clinical cardiology) MTP, London, pp 225–252Google Scholar
  28. 28.
    Maisch B (1987) The sarcolemma as antigen in the secondary immunopathogenesis of myopericarditis. Eur Heart J 8 [Suppl J]: 155–165Google Scholar
  29. 29.
    Maisch B (1988) The use of myocardial biopsy in heart failure. Eur Heart J [Suppl H] 9: 59–71PubMedGoogle Scholar
  30. 30.
    Maisch B, Kochsiek K (1983) Humoral immune reactions in uremic pericarditis. Am J Nephrol 3: 264–271PubMedCrossRefGoogle Scholar
  31. 31.
    Maisch B, Maisch S, Kochsiek K (1982) Immune reactions in tuberculous and chronic constrictive periearditis. Am J Cardiol 50: 1007–1013PubMedCrossRefGoogle Scholar
  32. 32.
    Maisch B, Trostel-Soeder R, Stechemesser E, Berg PA, Kochsiek K (1982) Diagnostic relevance of humoral and cell-mediated immune reactions in patients with acute viral myocarditis. Clin Exp Immunol 48: 533–545PubMedGoogle Scholar
  33. 33.
    Maisch B, Deeg P, Liebau G, Kochsiek K (1983) Diagnostic relevance of humoral and cytotoxic immune reactions in primary and secondary dilated cardiomyopathy. Am J Cardiol 52: 1071–1078CrossRefGoogle Scholar
  34. 34.
    Maisch B, Büschel G, Izumi T, Eigel P, Regitz V, Deeg P, Pfeifer U, Schmaltz A, Herzum M, Liebau G, Kochsiek K (1985) Four years of experience in endomyocardial biopsy — an immunohistologic approach. In: Sekiguchi M, Olsen EGJ, Goodwin JF (eds) Myocarditis and related disorders. Springer, Berlin Heidelberg New York, pp 59–67 and Heart and Vessels [Suppl] 1: 59–67Google Scholar
  35. 35.
    Maisch B, Lotze U, Schneider J, Kochsiek K (1985) Antibodies to human sinus node in sick sinus syndrome. New Trends in Arrhythmias 1: 417–421Google Scholar
  36. 36.
    Maisch B, Lotze U, Schneider J, Kochsiek K (1986) Antibodies to human sinus node in sick sinus syndrome. PACE 9: 1101–1109PubMedGoogle Scholar
  37. 37.
    Maisch B, Cirsi M, Gehrke J, Kirschner A (1987) Lectin binding sites of the sarcolemma and the surrounding interstitial tissue, Eur Heart J 8 [Suppl J]: 175–180Google Scholar
  38. 38.
    Maisch B, Dienesch C, Wendl I (1987) Effect of leukotrienes on isolated vital cardiac cells — an in vitro model of cardiocytotoxic mediators in inflammation? Eur Heart J 8 [Suppl J]: 463–465Google Scholar
  39. 39.
    Maisch B, Hauck H, Köninger U, Endter S, Klopf D, Schmier U, Schmier K (1987) T-suppressor cell activity in (peri) myocarditis and infective endocarditis. Eur Heart J 8 [Suppl J]: 147–153Google Scholar
  40. 40.
    Maisch B, Schwab D, Bauer E, Sandhage K, Schmaltz AA (1987) Antimyolemmal antibodies in myocarditis in children. Eur Heart J 8 [Suppl J]: 167–173Google Scholar
  41. 41.
    Maisch B, Selmayer N, Brugger E, Ertl G, Eilles C, Heinrich J, Gerhards W, Hufnagel G, Schmidt M, Kochsiek K (1987) Cardiac sarcoidosis — clinical and immunoserologic study. Eur Heart J 8 [Suppl J]: 63–71Google Scholar
  42. 42.
    Maisch B, Wedeking U, Kochsiek K (1987) Quantitative assessment of antilaminin antibodies in myocarditis and perimyocarditis. Eur Heart J 8 [Suppl J]: 233–235Google Scholar
  43. 43.
    Maisch B, Wittner B, Wiethölter H (1987) Experimental myocarditis in rabbits––cellular effector mechanisms. Eur Heart J 8 [Suppl J]: 425–432Google Scholar
  44. 44.
    Obermayer U, Scheidler J, Maisch B (1987) Antibodies against micro- and intermediate filaments in carditis and dilated cardiomyopathy — are they a diagnostic marker? Eur Heart J 8 [Suppl J]: 181–186Google Scholar
  45. 45.
    Paris S, Fosset M, Samuel D, Ailhaud G (1977) Chick embryo plasma membrane from cardiac muscle and cultured heart cells: isolation procedures and absence of fatty acid-activating enzymes. J Mol Cell Cardiol 9: 161–173PubMedCrossRefGoogle Scholar
  46. 46.
    Perlmann P, Perlmann H (1971) Cytotoxic lymphocytes. Mechanisms of activation and target cell destruction. Int Arch Allergy Appl Immunol 41: 36–39PubMedCrossRefGoogle Scholar
  47. 47.
    Ragosta M, Crabtree J, Sturner WQ, Thrompson PD (1980) Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies. Br Heart J 44: 672CrossRefGoogle Scholar
  48. 48.
    Reinauer KM, Klein R, Seipel L, Berg PA (1987) Heart-specific antimitochondrial antibody (anti-M7) in a patient with virus-associated peri-myocarditis. Eur Heart J 8 [Suppl J]: 227–228Google Scholar
  49. 49.
    Schultheiss HP (1987) The mitochondrium as antigen in inflammatory heart disease. Eur Heart J 8 [Suppl J]: 203–210Google Scholar
  50. 50.
    Schultheiss HP, Bolte HD (1985) Immunological analysis of auto-antibodies against the adenine nucleotide translocatorin dilated cardiomyopathy. J Mol Cell Cardiol 17: 601–617CrossRefGoogle Scholar
  51. 51.
    Schwarz RS (1986) Are natural autoantibodies real? Ann Inst Pasteur/Immunol 137, D, 156–159Google Scholar
  52. 52.
    Seligman M (1986) The origin and nature of autoantibodies. Introduction. Ann Inst Pasteur/Immunol [Suppl D] 137: 149–150Google Scholar
  53. 53.
    Schervish E, O’Connel JB, Kowalczyk D, Robinson JA (1987) Suppressor cell function in dilated cardiomyopathy. Eur Heart J 8 [Suppl J]: 141–143Google Scholar
  54. 54.
    Schramm P (1986) Die Beschwernisse des Herzens und was dagegen dienlich ist. Edition Rarissma, Taunusstein, p 70Google Scholar
  55. 55.
    Yamakawa K, Fukuta S, Yoshinaga T, Umemeto S, Itagaki T, Kusukawa R (1987) Study of immunological mechanisms in dilated cardiomyopathy. Jpn Circ J 51: 665–675PubMedCrossRefGoogle Scholar
  56. 56.
    Yokoyama A, Aoki S, Aizawa Y, Shibata A (1985) Analysis of peripheral lymphocyte subpopulation in patients with dilated cardiomyopathy. J Dev Med 133 (3): 187–188Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • B. Maisch
    • 1
  • M. Herzum
    • 1
  • T. Izumi
    • 1
  • S. Nunoda
    • 1
  1. 1.University Hospital of Internal MedicineWürzburgGermany

Personalised recommendations