Wojciechowska Celina, Wodniecki Jan, Wojnicz Romuald, Romuk Ewa, Jacheć Wojciech, Tomasik Andrzej, Skrzep-Poloczek Bronisława, Spinczyk Beata, Nowalany-Kozielska Ewa
Second Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Ulica M.C. Skłodowskiej 10, 41-800 Zabrze, Poland.
Department of Histology and Embryology, School of Medicine with the Division of Dentistry, Medical University of Silesia, 41-800 Zabrze, Poland.
Mediators Inflamm. 2014;2014:585067. doi: 10.1155/2014/585067. Epub 2014 Aug 18.
The aim of the study was to assess the relationships among serum neopterin (NPT), β2-microglobulin (β2-M) levels, clinical status, and endomyocardial biopsy results of dilated cardiomyopathy patients (DCM).
Serum NPT and β-2 M were determined in 172 nonischaemic DCM patients who underwent right ventricular endomyocardial biopsy and 30 healthy subjects (ELISA test). The cryostat biopsy specimens were assessed using histology, immunohistology, and immunochemistry methods (HLA ABC, HLA DR expression, CD3 + lymphocytes, and macrophages counts).
The strong increase of HLA ABC or HLA DR expression was detected in 27.2% patients-group A-being low in 72.8% patients-group B. Neopterin level was increased in patients in group A compared to healthy controls 8.11 (4.50-12.57) versus 4.99 (2.66-8.28) nmol/L (P < 0.05). β-2 microglobulin level was higher in DCM groups A (2.60 (1.71-3.58)) and B (2.52 (1.51-3.72)) than in the control group 1.75 (1.28-1.96) mg/L, P < 0.001. Neopterin correlated positively with the number of macrophages in biopsy specimens (P < 0.05) acute phase proteins: C-reactive proteins (P < 0.05); fibrinogen (P < 0.01); and NYHA functional class (P < 0.05) and negatively with left ventricular ejection fraction (P < 0.05).
Neopterin but not β-2 microglobulin concentration reflected immune response in biopsy specimens. Neopterin correlated with acute phase proteins and stage of heart failure and may indicate a general immune and inflammatory activation in heart failure.
本研究旨在评估扩张型心肌病患者（DCM）血清新蝶呤（NPT）、β2-微球蛋白（β2-M）水平、临床状况与心内膜心肌活检结果之间的关系。
对172例行右心室心内膜心肌活检的非缺血性DCM患者和30名健康受试者测定血清NPT和β-2M（酶联免疫吸附测定法）。使用组织学、免疫组织学和免疫化学方法（HLA ABC、HLA DR表达、CD3 +淋巴细胞和巨噬细胞计数）评估低温恒温器活检标本。
在27.2%的患者（A组）中检测到HLA ABC或HLA DR表达显著增加，72.8%的患者（B组）表达较低。与健康对照组相比，A组患者的新蝶呤水平升高，分别为8.11（4.50 - 12.57）nmol/L和4.99（2.66 - 8.28）nmol/L（P < 0.05）。DCM的A组（2.60（1.71 - 3.58））和B组（2.52（1.51 - 3.72））的β-2微球蛋白水平高于对照组1.75（1.28 - 1.96）mg/L，P < 0.001。新蝶呤与活检标本中巨噬细胞数量呈正相关（P < 0.05）、急性期蛋白：C反应蛋白（P < 0.05）；纤维蛋白原（P < 0.01）；以及纽约心脏协会（NYHA）心功能分级（P < 0.05），与左心室射血分数呈负相关（P < 0.05）。
新蝶呤而非β-2微球蛋白浓度反映了活检标本中的免疫反应。新蝶呤与急性期蛋白和心力衰竭阶段相关，可能表明心力衰竭中存在全身性免疫和炎症激活。
