Jacobs B, Matsuda Y, Deodhar S, Shirey E
Am J Clin Pathol. 1979 Jul;72(1):1-4. doi: 10.1093/ajcp/72.1.1.
The etiology of primary myocardial disease is unknown. With the advent of immunologic technics, an immune process related to primary myocardial disease has been sought, but none has been elucidated as diagnostic or causative. The authors attempted to study the possibility of a cell-mediated component in the etiology of primary myocardial disease. Cell-mediated immunologic injury of cultured, human myocardial cells was studied in cells from patients with primary myocardial disease and controls by means of a 51chromium-release method. Significant lymphocytic cytotoxicity against myocardial cells was detected in cells from 23 (30%) of 73 patients with primary myocardial disease, compared with two (4%) of 49 normal, healthy control subjects. Significant cytotoxicity was also observed in cells from 36 (24%) of 148 patients who had other cardiac diseases, mainly rheumatic and atherosclerotic diseases. No group showed cytotoxicity against a long-term culture of Chang hepatic cells. No clinical correlation between the severity of the disease and increased cytotoxicity could be found. It is concluded that lymphocytic reactivity against myocardial cells probably results from myocardial damage due to a variety of causes, and that it is not specific for primary myocardial disease.
原发性心肌病的病因尚不清楚。随着免疫技术的出现，人们一直在寻找与原发性心肌病相关的免疫过程，但尚未阐明任何可作为诊断或病因的免疫过程。作者试图研究细胞介导成分在原发性心肌病病因中的可能性。通过51铬释放法，对原发性心肌病患者和对照组的培养人心肌细胞进行细胞介导的免疫损伤研究。在73例原发性心肌病患者中的23例（30%）的细胞中检测到对心肌细胞的显著淋巴细胞细胞毒性，相比之下，49例正常健康对照者中有2例（4%）出现这种情况。在148例患有其他心脏病（主要是风湿性和动脉粥样硬化性疾病）的患者中的36例（24%）的细胞中也观察到显著的细胞毒性。没有一组对长期培养的张氏肝细胞表现出细胞毒性。未发现疾病严重程度与细胞毒性增加之间存在临床相关性。结论是，针对心肌细胞的淋巴细胞反应性可能是由多种原因导致的心肌损伤引起的，并非原发性心肌病所特有。
