Induction of major histocompatibility complex antigens within the myocardium of patients with active myocarditis

A nonhistologic marker of myocarditis

Ahvie Herskowitz, Aftab Ahmed-ansari, David A. Neumann, William E. Beschorner, Noel R. Rose, Lisa M. Soule, C. Lynne Burek, Kenneth W. Sell, Kenneth L. Baughman

Research output: Contribution to journalArticle

Abstract

The histologic diagnosis of active myocarditis is frequently difficult to establish. A nonhistologic marker of immune activation would be clinically useful in identifying cases of immune-mediated myocarditis. A viral etiology with subsequent autoimmunity to cardiac antigens has been implicated in human myocarditis. Because autoimmunity and viral disease are commonly associated with increased expression of major histocompatibility complex (MHC) antigens on targeted tissue, we examined endomyocardial biopsy samples from patients with active myocarditis for abnormal levels of MHC antigen expression. Thirteen patients with active myocarditis and eight control patients with other well-defined cardiac diagnoses (coronary disease, amyloidosis or neoplasm) were studied. A sensitive radioimmunoassay was developed that utilized monoclonal antibodies to human MHC class I and class II antigens in order to quantitate the expression of both of these antigens within each biopsy. Abnormal MHC class I and class II antigen expression was present in 11 of 13 myocarditis specimens and 1 of 8 control samples (specificity 88%, sensitivity 84.6%). Active myocarditis samples had approximately a 10-fold increase in MHC class I and class II expression. Immunoperoxidase staining localized abnormal MHC expression primarily within microvascular endothelium and along myocyte surfaces (11 of 13). This study is the first to demonstrate a marked increase in major histocompatibility complex antigen expression within the myocardium of patients with active myocarditis. The identification of abnormal histocompatibility antigen expression within an endomyocardial biopsy may prove a useful adjunct to the histologic diagnosis of myocarditis.

Original languageEnglish (US)
Pages (from-to)624-632
Number of pages9
JournalJournal of the American College of Cardiology
Volume15
Issue number3
DOIs
StatePublished - Mar 1 1990

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Histocompatibility Antigens
Myocarditis
Major Histocompatibility Complex
Myocardium
Histocompatibility Antigens Class II
Autoimmunity
Biopsy
Antigens
Amyloidosis
Virus Diseases
Muscle Cells
Endothelium
Radioimmunoassay
Coronary Disease
Biomarkers
Monoclonal Antibodies
Staining and Labeling
Sensitivity and Specificity

ASJC Scopus subject areas

  • Nursing(all)

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Induction of major histocompatibility complex antigens within the myocardium of patients with active myocarditis : A nonhistologic marker of myocarditis. / Herskowitz, Ahvie; Ahmed-ansari, Aftab; Neumann, David A.; Beschorner, William E.; Rose, Noel R.; Soule, Lisa M.; Lynne Burek, C.; Sell, Kenneth W.; Baughman, Kenneth L.

In: Journal of the American College of Cardiology, Vol. 15, No. 3, 01.03.1990, p. 624-632.

Research output: Contribution to journalArticle

Herskowitz, A, Ahmed-ansari, A, Neumann, DA, Beschorner, WE, Rose, NR, Soule, LM, Lynne Burek, C, Sell, KW & Baughman, KL 1990, 'Induction of major histocompatibility complex antigens within the myocardium of patients with active myocarditis: A nonhistologic marker of myocarditis', Journal of the American College of Cardiology, vol. 15, no. 3, pp. 624-632. https://doi.org/10.1016/0735-1097(90)90637-5
Herskowitz, Ahvie ; Ahmed-ansari, Aftab ; Neumann, David A. ; Beschorner, William E. ; Rose, Noel R. ; Soule, Lisa M. ; Lynne Burek, C. ; Sell, Kenneth W. ; Baughman, Kenneth L. / Induction of major histocompatibility complex antigens within the myocardium of patients with active myocarditis : A nonhistologic marker of myocarditis. In: Journal of the American College of Cardiology. 1990 ; Vol. 15, No. 3. pp. 624-632.
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