Kemeny E, Grieve T, Marcus R, Sareli P, Zabriskie J B
Rockefeller University, New York 10021.
Clin Immunol Immunopathol. 1989 Aug;52(2):225-37. doi: 10.1016/0090-1229(89)90174-8.
The composition of the mononuclear cellular filtrates was investigated in 13 valve specimens from nine patients with rheumatic carditis, some of whom had clinical and laboratory evidence of acute disease at the time of surgery. In acute valvulitis (AV) as well as in chronic active valvulitis (CAV), the cellular infiltrates were primarily composed of T cells and macrophages. In AV the majority of these T cells were of the helper phenotype (Leu 3a). The T cells subsets were more heterogeneous in CAV. In five valves, the helper T cells exceeded the number of suppressor T cells, whereas in three others, helper and cytotoxic/suppressor T cells were present in equal numbers. The HLA-DR antigen was expressed by the majority of the mononuclear cells and by the vascular endothelium. These findings indicate that the valvular injury may at least in part be mediated by delayed-type hypersensitivity mechanisms. Those cells comprising the Aschoff body were primarily positive for the HLA-DR and a novel monoclonal antibody called D8/17 which identifies an antigen known to be present on the B cells of rheumatic fever patients.
对9例风湿性心脏病患者的13个瓣膜标本中的单核细胞滤液成分进行了研究，其中部分患者在手术时具有急性疾病的临床和实验室证据。在急性瓣膜炎（AV）以及慢性活动性瓣膜炎（CAV）中，细胞浸润主要由T细胞和巨噬细胞组成。在AV中，这些T细胞大多数是辅助表型（Leu 3a）。CAV中的T细胞亚群更加异质性。在5个瓣膜中，辅助性T细胞超过抑制性T细胞的数量，而在另外3个瓣膜中，辅助性T细胞和细胞毒性/抑制性T细胞数量相等。大多数单核细胞和血管内皮细胞表达HLA-DR抗原。这些发现表明瓣膜损伤至少部分可能由迟发型超敏反应机制介导。构成阿绍夫小体的那些细胞主要对HLA-DR和一种名为D8/17的新型单克隆抗体呈阳性，该抗体识别已知存在于风湿热患者B细胞上的一种抗原。
