Stull L B, DiIulio N A, Yu M, McTiernan C F, Ratliff N B, Tuohy V K, Moravec C S
Center for Anesthesiology Research, The Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.
J Mol Cell Cardiol. 2000 Nov;32(11):2035-49. doi: 10.1006/jmcc.2000.1235.
Although myocarditis has been implicated in the pathogenesis of heart failure, a definitive relationship between myocardial inflammation, cardiac dysfunction, and changes in myocyte gene expression has not been established. In this study, we examined the hypothesis that myocardial inflammation and replacement fibrosis following an autoimmune response can progress to cardiac dysfunction and may result in progression to the heart failure phenotype. SWXJ mice were immunized with cardiac myosin on day 0 and day 7, in order to induce an autoimmune response to the myosin protein. Cardiac catheterization via the right carotid artery was performed on days 14, 21, 28, 35, and 42, using a 1.4F Millar transducer-tipped catheter. Hearts were weighed, and cross-sections were cut and stained with either haematoxylin and eosin or Masson's trichrome, in order to identify areas of inflammation and/or fibrosis. Myocardial gene expression was determined by Northern blot analysis. In mice with histological evidence of myocarditis, the heart weight/body weight ratio increased beginning on day 14, and cardiac function decreased beginning on day 21. Myocardial inflammation was accompanied by significant fibrosis beginning on day 21. Quantitation of mRNA showed expression of ventricular atrial naturietic factor, as well as a decrease in myosin heavy chain alpha, beginning on day 21. These data demonstrate that autoimmune inflammation of the heart results in significant cardiac dysfunction, leading to phenotypic alterations similar to those demonstrated in human heart failure and animal models of heart failure.
尽管心肌炎被认为与心力衰竭的发病机制有关,但心肌炎症、心脏功能障碍和心肌细胞基因表达变化之间的明确关系尚未确立。在本研究中,我们检验了这样一个假设:自身免疫反应后的心肌炎症和替代性纤维化可进展为心脏功能障碍,并可能导致进展为心力衰竭表型。在第0天和第7天用心肌肌球蛋白免疫SWXJ小鼠,以诱导对肌球蛋白蛋白的自身免疫反应。在第14、21、28、35和42天,使用1.4F Millar换能器尖端导管经右颈动脉进行心脏导管插入术。称取心脏重量,将心脏横切,并用苏木精和伊红或Masson三色染色,以识别炎症和/或纤维化区域。通过Northern印迹分析确定心肌基因表达。在有心肌炎组织学证据的小鼠中,心脏重量/体重比从第14天开始增加,心脏功能从第21天开始下降。心肌炎症从第21天开始伴有明显的纤维化。mRNA定量显示,从第21天开始,心室心房钠尿肽表达以及肌球蛋白重链α减少。这些数据表明,心脏的自身免疫性炎症会导致显著的心脏功能障碍,导致与人类心力衰竭和心力衰竭动物模型中所显示的类似的表型改变。