Summary
In acute perimyocarditis we found that OKIAI-positive cells were increased, and in dilated cardiomyopathy OKMI-positive cells were increased. No significant alteration in suppressor T cell activity was observed in our patients with either disease. The characteristic immunofluorescent pattern in carditis and postmyocarditic heart disease is the presence of antimyolemmal antibodies with intact rat and human cardiocytes in titers of 1:40–1: 320 as antigens. The antimyolemmal fluorescence can be absorbed with the respective causative virus in Coxsackie B, influenza, mumps and EBV-myocarditis, indicating that the antibodies are a cross-reactive. AMLA-positive sera induce cytolysis of vital rat cardiocytes in vitro, suggesting that the antibodies are of pathogenetic relevance. Cytolytic serum activity could be absorbed out with the respective virus.
Immunohistologic specimens obtained from patients with carditis demonstrate the fixation of IgG and IgM antibodies; IgG antibodies also occur in dilated cardiomyopathy and coronary artery disease. In dilated postmyocarditic heart disease both antimyolemmal fluorescence and cytolytic activity are preserved at a lower level when compared to carditis. These antibodies can also fix complement. In the acute phase of carditis circulating immune complexes can be demonstrated. Cellular effector mechanisms against vital cardiocytes were maintained or even slightly enhanced in carditis, postmyocarditic and primary dilated cardiomyopathy. In vitro NK cell activity against K 562, however, was decreased. This is compatible with a sustained target-specific cytotoxicity whereas reduced NK cell activity may indicate impairment of this effector organ.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Anderson JL, Carlquist JF, Hammond EH (1982) Deficient natural killer cell activity in patients with idiopathic dilated cardiomyopathy. Lancet II: 1124–1127
Billingham ME, Mason JW (1984) Endomyocardial biopsy changes in myocarditis treated with immunosuppressives. In: Bolte H-D (ed), Viral heart disease. Springer-Verlag, Berlin Heidelberg New York Tokyo, pp 200–210
Bolte HD, Schultheiss P, Cyran J, Goss F (1980) Binding of immunoglobulins in the myocardium (biopsy). In: Bolte H-D (ed), Myocardial Biopsy, Springer-Verlag Berlin Heidelberg New York, pp 85–92
Bresnihan B, Jasin ME (1977) Suppressor function of peripheral blood mononuclear cells in normal individuals and in patients with systemic lupus erythematosus. J Clin Invest 59: 106–116
Bülowius H, Maisch B, Klopf D, Schmier K, Hiby A, Schunk D, Kochsiek K (1983) Lymphozytensubpopulationen bei akuter Perimyokarditis, sekundären und primären dilatativen Herzmuskelerkrankungen. Z Kardiol 72 (Suppl 1): 16
Burch GE, Giles TD (1972) The role of viruses in the production of heart disease. Am J Cardiol 29: 231–240
Cambridge G, MacArthur CGC, Waterson AP, Goodwin JF, Oakley C (1979) Antibodies to Coxsackie B viruses in congestive cardiomyopathy. Br Heart J 16: 692–696
Cambridge G, Campbell-Blay G, Wilmhurst P, Coltart DJ, Stern CMM (1983) Deficient `natural’ cytotoxicity in patients with congestive cardiomyopathy (Abstr) Br Heart J 49: 623
Daly K, Richardson PJ, Olsen EFJ, Morgan-Capner P, McSorley C, Jackson G, Jewitt DE (1984) Acute myocarditis — Role of histological and virological examination in the diagnosis and assessment of immunosuppressive treatment. Br Heart J 51: 30–35
Dallas criteria for myocarditis (according to a summary from ME Billingham at AHA congress, Miami Beach, 1984)
Das SK, Callen JP, Dodson VN, Cassidy JT (1971) Immunoglobulin binding in cardiomyopathic hearts. Circulation 44: 612–621
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 Baltimore, pp 375–377
Deck WG, Palacios IF, Fallon JT, Aretz HT, Mills J, Lee DCS, Johnson RA (1985) Active myocarditis in the spectrum of acute dilated cardiomyopathies. Engl J Med 342: 885–897
Doerr W (1971) Morphologie der Myokarditis. Verh Dtsch Ges Inn Med 77: 301–335
Eckstein R, Mempel W, Bolte H-D (1982) Reduced suppressor cell activity in congestive cardiomyopathy and in myocarditis. Circulation 65: 1224–1229
Fenoglio JJ Jr, Ursell PC, Kellogg CF, Drusin RE, Wiss MB (1983) Diagnosis and classification of myocarditis by endomyocardial biopsy. N Engl J Med 308: 12–18
Fletcher GF, Coleman MT, Feorius PM, Marine WM, Wenger NK (1968) Viral antibodies in patients with primary myocardial disease. Am J Cardiol 21: 6–14
Fowles KE, Bieber CP, Stinson EB (1978) Defective in vitro suppressor cell function in idiopathic congestive cardiomyopathy. Circulation 59: 483–491
Francesini R, Petillo A, Corazza M, Nizzo MC, Azzolini A, Gianrossi R (1983) Lymphocyte response in dilated cardiomyopathy. IRCS Med Sci 11: 1019
Grist NR, Boll EJ (1974) A six year study of Coxsackie virus B infections in heart disease. J Hyg 73: 165–174
Gore I, Kline IK (1968) Pericarditis and myocarditis. In: Gould SE (ed), Phatology of the heart and blood vessels 3 rd ed Thomas, Springfield Ill, pp 731–759
Hallgren HM, Yunis EJ (1977) Suppressor lymphocytes in young and aged humans. J Immunol 118: 2004–2008
Huber SA, Jod LP, Woodruff JF (1980) Lysis of infected myofibers by Coxsackie virus B3 immune T-lymphocytes. Am J Pathol 98: 681–694
Huber SA, Lodge PA (1984) Coxsackie virus B-3 myocarditis in Balb/c mice. Am J Pathol 116: 21–29
James TM, Umamura K (1981) Virus-like particles associated with intracardiac ganglionitis in two cases of sudden unexpected death. Jpn Heart J 22: 447–454
James TN (1983) Myocarditis and cardiomyopathy. N Engl J Med 308: 39–41
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: 1–4
Kawai C, Matsumori A, Kitaura Y, Takatsu T (1978) Viruses and the heart: Viral myocarditis and cardiomyopathy. In: Yu PN, Goodwin JF (eds), Progress in Cardiology. Lea and Febiger, Philadelphia, pp 141–162
Kipshidze NN (1983) Some problems of etiology and pathogenesis of cardiomyopathies. Abstracts, Wissenschaftliches Symposium “Kardiomyopathie”. Jena, p 18
Kirsner AB, Hess EV, Fowler NO (1973) Immunologic findings in idiopathic cardiomyopathy. Am Heart J 86: 625–630
Klein R, Maisch B, Kochsiek K, Berg PA (1984) Demonstration of organ specific antibodies against heart mitochondria (anti-M7) in sera from patients with some forms of heart disease. Clin Exp Immunol 58: 283–292
Kline I K, Saphir O (1960) Chronic pernicious myocarditis. Am Heart J 59: 681–684
Kuhn H, Loogen F (1981) Erkrankungen des Myokards. In: Krayenbühl HP, Kübler W (eds), Kardiologie in Klinik and Praxis Voll II. Thieme Stuttgart, pp 48.1–48. 13
Lerner AM, Wilson FM (1973) Virus myocardiopathy. Progr Med Virol 15: 63–91
Longson M, Cole FM, Davies D (1969) Isolation of a Coxsackie virus group B, type 5, from the heart of a fatal case of myocarditis in an adult. J. Clin Pathol 22: 654–658
Lowry PJ, Edwards CW, Nagle RE (1982) Herpes-like virus particles in myocardium of patient progressing to congestive cardiomyopathy. Br Heart J 48: 501–504
Lowry PJ, Thompson RA, Littler WA (1983) Humoral immunity in cardiomyopathy. Br Heart J 50: 390–394
Lowry PJ, Thompson RA, Littler WA (1984) Humoral and cellular mechanisms in congestive cardiomyopathy (Abstr) Br Heart J 51: 109
Maisch B (1984) Humorale immunologische Effektormechanismen bei Perimyokarditis. Internist 25: 155–164
Maisch B (1984) Diagnostic relevance of humoral and cell-mediated immune reactions in patients with acute myocarditis and congestive cardiomyopathy. In: Chazov EL, Smirnov VN, Organov RG (eds), Cardiology. Plenum Press, London, pp 1327–1338
Maisch B (1984) Cytolytic serum activity in patients with carditis. In: Bolte HD (ed), Viral heart disease. Springer-Verlag, Berlin Heidelberg New York Tokyo, pp 121–130
Maisch B, Berg PA, Kochsiek K (1980) Autoantibodies and serum inhibition factors (sif) in patients with myocarditis. Klin Wochenschr 58: 219–225
Maisch B, Büschel G, Izumi T, Eigel P, Regitz V, Deeg P, Pfeifer U, Schmaltz A, Herzum M, Kochsiek K (1985) Four years of experience in endomyocardial biopsy. An immunohistologic approach. Heart and Vessels, Heart and Vessels, Suppl 1: 59–67
Maisch B, Deeg P, Liebau G, Kochsiek K (1983) Diagnostic relevance of humoral and cytotoxic immune reactions in patients with primary and secondary heart muscle disease. Am J Cardiol 52: 1072–1078
Maisch B, Eichstädt H, Kochsiek K (1983) Immune reactions in infective endocarditis. Part I: Clinical data and diagnostic relevance of antimyocardial antibodies. Am Heart J 106: 329–337
Maisch B, Maisch St, Kochsiek K (1982) Immune reactions in tuberculous and chronic constrictive pericarditis. Am J Cardiol 50: 1007–1013
Maisch B, Mayer E, Kochsiek K (1982) Nachweis zirkulierender Immunkomplexe bei kardialen Erkrankungen. Verh Dtsch Ges Inn Med 88: 624–627
Maisch B, Mayer E, Schubert U, Berg PA, Kochsiek K (1983) Immune reactions in infective endocarditis part 2: Relevance of circulating immune complexes, of serum inhibition factors, of lymphocytotoxic reactions, and of antibody dependent cellular cytotoxicity against cardiac target cells. Am Heart J 106: 338–344
Maisch B, Trostel-Soeder R, Berg PA, Kochsiek K (1981) Assessment of antibody mediated cytolysis of adult cardiocytes isolated by centrifugation in a continuous gradient of PercollTM in patients with acute myocarditis. J Immunol Methods 44: 159–169
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: 533–545
Mason JW, Billingham ME, Ricci DR (1980) Treatment of acute inflammatory myocarditis assisted by endomyocardial biopsy. Am J Cardiol 45: 1037–1044
Mills AS, Hastillo A, Hess ML (1984) Lymphocytic infection of the myocardium in idiopathic dilated cardiomyopathy: Underestimation of myocarditis with endomyocardial biopsy. Circulation 70 (Suppl I I ): 401 (Abstr)
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: 161–173
Perlmann P, Perlamnn H (1971) Cytotoxic lymphocytes. Mechanisms of activation and target cell destruction. Int Arch Allergy 41: 36–39
Report of the WHO/ISCF Task force on the definition and classification of cardiomyopathies (1980) Br Heart J 44: 672
Sack W, Scheuring H, Wachsmuth ED (1975) Antikörper gegen Herzmuskelsarkolemm im Serum von Patienten mit primärer Cardiomyopathie. Clin Wochenschr 53: 103–111
Sainani GS, Krompotic E, Slodki SJ (1968) Adult heart disease due to the Coxsackie virus B infection. Medicine 47: 133–137
Saphir O (1971) Myocarditis. Arch Pathol 32: 1000–1007
Schmier K, Klopf D, Maisch B, Schunk D, Hiby A, Bülowius U, Röder A, Auer I (1983) Suppressorzellaktivität bei Perimyokarditis and dilatativen Herzerkrankungen. Z. Kardiol 72 (suppl I): 17
Schroetter P von (1899) Die Insuffizienz des Herzmuskels. Verh Congr Inn Med L, pp 17–23
Schultheiß HP, Bolte HD, Schwimmbeck P (1984) Autoantibodies against the adenine nucleotide translocator in myocarditis and dilated cardiomyopathy. In: Bolte HD (ed), Viral Heart Disease. Springer-Verlag, Berlin, pp 131–143
Waterson AP (1978) Virology investigation in congestive cardiomyopathy. Postgrad Med J 54: 505–509
Weiland DS, Donaldson KP, Isner JM (1984) How well does the endomyocardial biopsy represent the state of the heart. Circulation 70 (Suppl I I ): 501 (Abstr)
Weiss MB, Ursell PC, Scala F, Drusin R, Fenoglio JJ Jr (1982) Immunosuppression therapy in chronic forms of myocarditis. Circulation 66 (Suppl I I ): 215 (Abstr)
Woodruff JF (1980) Viral myocarditis. A review article. Am J Pathol 101: 425–484
Wong Y, Woodruff JJ, Woodruff JF (1977) Generation of cytolytic T-lymphocytes during Coxsakkie virus B3infection. I. Model and viral specificity. J Immunol 118: 1159–1164
Wong Y, Woodruff JJ, Woodruff JF (1977) Generation of cytolytic T-lymphocytes during Coxsakkie virus B3 infections. II. Characterization of effector cells, and demonstration of cytotoxicity against viral infected myofibers. J Immunol 118: 1165–1169
Zinkernagel RM, Doherty PC (1974) Restriction of in vitro T cell-mediated cytotoxicity in lymphocytic choriomeningitis within a syngeneic or semiallogeneic system. Nature 248: 701–702
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 1986 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Maisch, B. (1986). Immunologic regulator and effector functions in perimyocarditis, postmyocarditic heart muscle disease and dilated cardiomyopathy. In: Jacob, R. (eds) Controversial issues in cardiac pathophysiology. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-11374-5_21
Download citation
DOI: https://doi.org/10.1007/978-3-662-11374-5_21
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-662-11376-9
Online ISBN: 978-3-662-11374-5
eBook Packages: Springer Book Archive