Why the study?
Does HLA-DR antigen expression differ between active myocarditis, healed myocarditis, and normal myocardium?
Does HLA-DR antigen expression differ between active myocarditis, healed myocarditis, and normal myocardium?
Aberrant expression of HLA-DR antigens on vascular endothelial cells is increased in active and healed myocarditis, suggesting a local immunological reaction.
May reflect immune activation in myocarditis; leaves open whether HLA-DR expression could guide future diagnostics or therapies.
HLA-DR antigen activity was examined in biopsied heart tissues from patients with pathologically diagnosed myocarditis to determine the relevance of immunoregulation. Biopsied specimens were stained with a monoclonal antibody for HLA-DR antigens using the indirect immunoperoxidase method. Of 39 cases examined, 16 were active myocarditis (M group), 14 were healed myocarditis (HM group), and 9 had normal myocardium (N group) as controls. HLA-DR antigens were mainly observed on the surface of the vascular endothelial cells. In M and HM groups, HLA-DR positive cells per high power field (×400; HPF) were observed more frequently than in the N group (HM: 14.7±5.6, M: 9.7±6.3, N: 4.6±2.3; mean±S.D.) . All specimens were then classified into three groups according to the number of HLA-DR positive cells: negative group (0-5/HPF), positive group (5-10/HPF), and strongly positive group (10-/HPF), and the clinical findings of each group were compared. In the clinical diagnosis, 80% of the acute myocarditis strongly expressed HLA-DR antigens in their healing stage, and 71 % of dysrhythmic diseases expressed positive HLA-DR antigens. The results suggest that aberrant expression of HLA-DR antigens on vascular endothelial cells indicates a local immunological reaction in myocarditis.
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Sakai et al. (1992) studied this question.
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