Maisch B, Schwab D, Sandhage K, Schmaltz A A, Wimmer M
Universitätsklinik für Innere Medizin, Würzburg, Bundesrepublik Deutschland.
Wien Klin Wochenschr. 1989 Jan 6;101(1):31-9.
In histologically proven or clinically diagnosed perimyocarditis in children and adults alterations in cellular and humoral effector mechanisms are demonstrable: OKIaI-positive B- or activated T-lymphocytes are increased in the peripheral blood, whereas natural killer cell activity is reduced. Antibodies are directed to the membranes of isolated human atrial myocytes and, to a lesser extent with lesser specificity, to endothelial cells and to the extracellular matrix. AMLAs are of diagnostic relevance if they belong to the IgM class, indicating a recent humoral immune stimulation and, if they fix complement, indicating a functional property which is complement associated lysis of target cells. Immunohistological studies demonstrate fixation of immunoglobulins to the autologous biopsy specimens, which are diagnostic only if they also belong to the IgM class and fix complement. In acute rhythm disturbances in the context of a recent "common cold", similar humoral immune reactions can be found in children, which are compatible with a secondary immunopathogenesis after viral illness involving the myocardium.
在组织学确诊或临床诊断的儿童及成人心肌周围炎中，细胞和体液效应机制存在改变：外周血中OKIa1阳性B淋巴细胞或活化T淋巴细胞增多，而自然杀伤细胞活性降低。抗体作用于分离出的人心房肌细胞膜，对内皮细胞和细胞外基质的作用较弱且特异性较低。如果抗心肌自身抗体（AMLAs）属于IgM类，则具有诊断意义，表明近期有体液免疫刺激；如果它们能固定补体，则表明具有与补体相关的靶细胞溶解功能特性。免疫组织学研究显示免疫球蛋白固定于自体活检标本，只有当它们也属于IgM类且能固定补体时才具有诊断价值。在近期“普通感冒”背景下发生的急性心律失常中，儿童也可发现类似的体液免疫反应，这与病毒感染累及心肌后的继发性免疫发病机制相符。
