Han Li-na, Li Tie-ling, Zhang Ya-jing, Yang Ting-shu, Ding Yu, Guo Shu-li
Department of Cardiovascular Internal Medicine, Chinese PLA General Hospital, Beijing 100853, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2011 Nov;42(6):751-6.
To shed light on changes in the gene expression of T helper lymphocyte (Th) subpopulation, Th1, Th2 and Th17 in autoimmune myocarditis and to gain insight into the immunological mechanisms underlying the essence of myocarditis.
An experimental Lewis rat autoimmune myocarditis model was induced by immunization with cardiac C protein and completed Freund adjuvant in double foot pads and subsequent intraperitoneal injection of pertussis toxin. Two groups of normal rats without immunological injection acted as control group. Transthoracic echocardiography was performed and subsequently hearts and spleens were obtained from EAM rats at 1 week, 2 weeks, 4 weeks, 6 weeks and 8 weeks after immunization. The pathological sections of heart samples were prepared, the inflammatory score was determined by hematoxylin and eosin stain, the fibrosis score was determined by picrosirius red stain. The ratio of Th1, Th2 and Th17 subpopulation in spleen cells were measured by flow cytometry, and enzyme linked immunoabsorption assay (ELISA) was used to determine the serum level of Th1 related cytokine interferon-gamma (IFN-gamma), Th2 related cytokine interleukin (IL)-4 and Th17 related cytokine IL-17.
In EAM rats, cardiac ejection fraction remained normal until 4th week, and left ventricular end systolic diameter and left ventricular end diastolic diameter decreased. However, cardiac ejection fraction decreased obviously and left ventricular end systolic diameter and left ventricular end diastolic diameter rose until 8th week. Inflammatory score increased rapidly at 2nd week after immunization and remained peek level until 4th week and then gradually decreased at 6th and 8th week. Fibrosis score and fibrosis content increased from 4th week and maintained the peek level until 8th week. Ratio of Th1 in spleen cells of EAM rats and its related cytokine in serum, IFN-gamma, increased at 1st week, arrived at the peek level until 4th week and gradually decreased at 6th week. Ratio of Th17 and IL-17 rose from 2nd-4th week and remained until 6th to 8th week. Ratio of Th2 showed no change in the previous four weeks, ratio of IL-4 increased from 4th week, and both rose at 6th week rapidly and remained until 8th week.
In EAM Lewis rats, The time duration from 2nd to 4th week was inflammatory stage of myocarditis while during the period of 4th week to 8th week myocarditis develops into fibrotic stage. Imbalance of Th1/Th2 takes part in the occurrence of ventricular remodeling, cellular immunity mediated by Th1 and Th17 being preponderant at inflammatory myocarditis stage while humoral immunity mediated by Th2 and Th17 being preponderant at fibrotic carditis stage.
揭示自身免疫性心肌炎中辅助性T淋巴细胞(Th)亚群Th1、Th2和Th17的基因表达变化,深入了解心肌炎本质的免疫机制。
通过在双侧足垫注射心脏C蛋白和完全弗氏佐剂,随后腹腔注射百日咳毒素,诱导建立实验性Lewis大鼠自身免疫性心肌炎模型。两组未进行免疫注射的正常大鼠作为对照组。进行经胸超声心动图检查,随后在免疫后1周、2周、4周、6周和8周从实验性自身免疫性心肌炎(EAM)大鼠获取心脏和脾脏。制备心脏样本的病理切片,通过苏木精和伊红染色确定炎症评分,通过天狼星红染色确定纤维化评分。采用流式细胞术检测脾细胞中Th1、Th2和Th17亚群的比例,并用酶联免疫吸附测定(ELISA)法测定血清中Th1相关细胞因子干扰素-γ(IFN-γ)、Th2相关细胞因子白细胞介素(IL)-4和Th17相关细胞因子IL-17的水平。
在EAM大鼠中,心脏射血分数在第4周前保持正常,左心室收缩末期内径和左心室舒张末期内径减小。然而,直到第8周心脏射血分数明显降低,左心室收缩末期内径和左心室舒张末期内径增大。免疫后第2周炎症评分迅速升高,至第4周保持峰值水平,然后在第6周和第8周逐渐降低。纤维化评分和纤维化含量从第4周开始增加,直至第8周保持峰值水平。EAM大鼠脾细胞中Th1的比例及其血清中相关细胞因子IFN-γ在第1周升高,至第4周达到峰值水平,第6周逐渐降低。Th17和IL-17的比例从第2至4周升高,并持续至第6至8周。Th2的比例在前四周无变化,IL-4的比例从第4周开始升高,两者在第6周迅速升高并持续至第8周。
在EAM Lewis大鼠中,第2至4周为心肌炎的炎症阶段,而在第4周至8周期间心肌炎发展为纤维化阶段。Th1/Th2失衡参与心室重塑的发生,在炎症性心肌炎阶段Th1和Th17介导的细胞免疫占优势,而在纤维化性心肌炎阶段Th2和Th17介导的体液免疫占优势。