Skip to main content

Immunologic regulator and effector functions in perimyocarditis, postmyocarditic heart muscle disease and dilated cardiomyopathy

  • Conference paper
Controversial issues in cardiac pathophysiology

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anderson JL, Carlquist JF, Hammond EH (1982) Deficient natural killer cell activity in patients with idiopathic dilated cardiomyopathy. Lancet II: 1124–1127

    Article  Google Scholar 

  2. 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

    Chapter  Google Scholar 

  3. 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

    Chapter  Google Scholar 

  4. 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

    Article  PubMed  CAS  Google Scholar 

  5. 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

    Google Scholar 

  6. Burch GE, Giles TD (1972) The role of viruses in the production of heart disease. Am J Cardiol 29: 231–240

    Article  PubMed  CAS  Google Scholar 

  7. 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

    Article  Google Scholar 

  8. 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

    Google Scholar 

  9. 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

    Article  PubMed  CAS  Google Scholar 

  10. Dallas criteria for myocarditis (according to a summary from ME Billingham at AHA congress, Miami Beach, 1984)

    Google Scholar 

  11. Das SK, Callen JP, Dodson VN, Cassidy JT (1971) Immunoglobulin binding in cardiomyopathic hearts. Circulation 44: 612–621

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Google Scholar 

  13. 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

    Article  Google Scholar 

  14. Doerr W (1971) Morphologie der Myokarditis. Verh Dtsch Ges Inn Med 77: 301–335

    PubMed  CAS  Google Scholar 

  15. Eckstein R, Mempel W, Bolte H-D (1982) Reduced suppressor cell activity in congestive cardiomyopathy and in myocarditis. Circulation 65: 1224–1229

    Article  PubMed  CAS  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. Fowles KE, Bieber CP, Stinson EB (1978) Defective in vitro suppressor cell function in idiopathic congestive cardiomyopathy. Circulation 59: 483–491

    Article  Google Scholar 

  19. Francesini R, Petillo A, Corazza M, Nizzo MC, Azzolini A, Gianrossi R (1983) Lymphocyte response in dilated cardiomyopathy. IRCS Med Sci 11: 1019

    Google Scholar 

  20. Grist NR, Boll EJ (1974) A six year study of Coxsackie virus B infections in heart disease. J Hyg 73: 165–174

    Article  CAS  Google Scholar 

  21. 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

    Google Scholar 

  22. Hallgren HM, Yunis EJ (1977) Suppressor lymphocytes in young and aged humans. J Immunol 118: 2004–2008

    PubMed  CAS  Google Scholar 

  23. Huber SA, Jod LP, Woodruff JF (1980) Lysis of infected myofibers by Coxsackie virus B3 immune T-lymphocytes. Am J Pathol 98: 681–694

    PubMed  CAS  Google Scholar 

  24. Huber SA, Lodge PA (1984) Coxsackie virus B-3 myocarditis in Balb/c mice. Am J Pathol 116: 21–29

    PubMed  CAS  Google Scholar 

  25. 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

    Article  PubMed  CAS  Google Scholar 

  26. James TN (1983) Myocarditis and cardiomyopathy. N Engl J Med 308: 39–41

    Article  PubMed  CAS  Google Scholar 

  27. 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

    PubMed  CAS  Google Scholar 

  28. 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

    Google Scholar 

  29. Kipshidze NN (1983) Some problems of etiology and pathogenesis of cardiomyopathies. Abstracts, Wissenschaftliches Symposium “Kardiomyopathie”. Jena, p 18

    Google Scholar 

  30. Kirsner AB, Hess EV, Fowler NO (1973) Immunologic findings in idiopathic cardiomyopathy. Am Heart J 86: 625–630

    Article  PubMed  CAS  Google Scholar 

  31. 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

    PubMed  CAS  Google Scholar 

  32. Kline I K, Saphir O (1960) Chronic pernicious myocarditis. Am Heart J 59: 681–684

    Article  PubMed  CAS  Google Scholar 

  33. 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

    Google Scholar 

  34. Lerner AM, Wilson FM (1973) Virus myocardiopathy. Progr Med Virol 15: 63–91

    CAS  Google Scholar 

  35. 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

    Article  PubMed  CAS  Google Scholar 

  36. 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

    Article  PubMed  CAS  Google Scholar 

  37. Lowry PJ, Thompson RA, Littler WA (1983) Humoral immunity in cardiomyopathy. Br Heart J 50: 390–394

    Article  PubMed  CAS  Google Scholar 

  38. Lowry PJ, Thompson RA, Littler WA (1984) Humoral and cellular mechanisms in congestive cardiomyopathy (Abstr) Br Heart J 51: 109

    Google Scholar 

  39. Maisch B (1984) Humorale immunologische Effektormechanismen bei Perimyokarditis. Internist 25: 155–164

    PubMed  CAS  Google Scholar 

  40. 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

    Google Scholar 

  41. 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

    Chapter  Google Scholar 

  42. Maisch B, Berg PA, Kochsiek K (1980) Autoantibodies and serum inhibition factors (sif) in patients with myocarditis. Klin Wochenschr 58: 219–225

    Article  PubMed  CAS  Google Scholar 

  43. 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

    CAS  Google Scholar 

  44. 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

    Article  PubMed  CAS  Google Scholar 

  45. 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

    Article  PubMed  CAS  Google Scholar 

  46. Maisch B, Maisch St, Kochsiek K (1982) Immune reactions in tuberculous and chronic constrictive pericarditis. Am J Cardiol 50: 1007–1013

    Article  PubMed  CAS  Google Scholar 

  47. Maisch B, Mayer E, Kochsiek K (1982) Nachweis zirkulierender Immunkomplexe bei kardialen Erkrankungen. Verh Dtsch Ges Inn Med 88: 624–627

    Google Scholar 

  48. 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

    Article  PubMed  CAS  Google Scholar 

  49. 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

    Article  PubMed  CAS  Google Scholar 

  50. 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

    PubMed  CAS  Google Scholar 

  51. Mason JW, Billingham ME, Ricci DR (1980) Treatment of acute inflammatory myocarditis assisted by endomyocardial biopsy. Am J Cardiol 45: 1037–1044

    Article  PubMed  CAS  Google Scholar 

  52. 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)

    Google Scholar 

  53. 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

    Article  PubMed  CAS  Google Scholar 

  54. Perlmann P, Perlamnn H (1971) Cytotoxic lymphocytes. Mechanisms of activation and target cell destruction. Int Arch Allergy 41: 36–39

    Article  PubMed  CAS  Google Scholar 

  55. Report of the WHO/ISCF Task force on the definition and classification of cardiomyopathies (1980) Br Heart J 44: 672

    Google Scholar 

  56. Sack W, Scheuring H, Wachsmuth ED (1975) Antikörper gegen Herzmuskelsarkolemm im Serum von Patienten mit primärer Cardiomyopathie. Clin Wochenschr 53: 103–111

    Article  CAS  Google Scholar 

  57. Sainani GS, Krompotic E, Slodki SJ (1968) Adult heart disease due to the Coxsackie virus B infection. Medicine 47: 133–137

    Article  PubMed  CAS  Google Scholar 

  58. Saphir O (1971) Myocarditis. Arch Pathol 32: 1000–1007

    Google Scholar 

  59. 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

    Google Scholar 

  60. Schroetter P von (1899) Die Insuffizienz des Herzmuskels. Verh Congr Inn Med L, pp 17–23

    Google Scholar 

  61. 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

    Chapter  Google Scholar 

  62. Waterson AP (1978) Virology investigation in congestive cardiomyopathy. Postgrad Med J 54: 505–509

    Article  PubMed  CAS  Google Scholar 

  63. 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)

    Google Scholar 

  64. 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)

    Google Scholar 

  65. Woodruff JF (1980) Viral myocarditis. A review article. Am J Pathol 101: 425–484

    PubMed  CAS  Google Scholar 

  66. 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

    PubMed  CAS  Google Scholar 

  67. 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

    PubMed  CAS  Google Scholar 

  68. 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

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

R. Jacob

Rights and permissions

Reprints 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

Publish with us

Policies and ethics