Raizada V, Williams R C, Chopra P, Gopinath N, Prakash K, Sharma K B, Cherian K M, Panday S, Arora R, Nigam M, Zabriskie J B, Husby G
Am J Med. 1983 Jan;74(1):90-6. doi: 10.1016/0002-9343(83)91124-5.
Fresh cardiac valvular tissues and atrial appendages removed from 106 Indian patients with rheumatic heart disease at the time of corrective cardiac surgery were examined to determine the characteristics of valvular interstitial lymphocytic infiltrates using conventional histologic staining along with indirect immunofluorescent techniques. Precise identification of the phenotypic profiles of inflammatory mononuclear cells was attempted using anti-IgG, anti-Ia, and monoclonal mouse hybridoma reagents identifying T cells (OKT3) as well as T cell subsets (OKT4 helper/inducer and OKT8 suppressor/cytotoxic cells). A similar group of 21 patients undergoing cardiac valvular resection in Albuquerque was studied. The mean age of Indian patients providing valve tissues was 27.7, whereas in those in Albuquerque, it was 52 years. Twenty-five percent of rheumatic heart valves in Indian patients showed significant interstitial lymphoid infiltrates, and one third of the rheumatic valves from patients in Albuquerque showed similar mononuclear cell collections. Lymphoid infiltrates contained a predominance of T cells (70 to 80 percent) and only occasional B cells. Most of the T cells were OKT4-positive, with only a minor representation of suppressor/cytotoxic OKT8-positive T cells. In many instances, OKT4-positive helper T cell collections were closely juxtaposed to fibroblasts and collagen fibrils. These findings suggest that the chronic rheumatic scarring process may involve helper/inducer T cells as an ancillary factor in the indolent contracture and fibrosis of deformed cardiac valvular structures. Attempts to demonstrate residual streptococcal antigens by indirect immunofluorescence using a wide panel of heterologous rabbit F(ab')2 reagents with specificity for group A streptococcal membranes, cell wall mucopeptide, or group A carbohydrate gave negative results.
对106例印度风湿性心脏病患者在心脏矫正手术时切除的新鲜心脏瓣膜组织和心耳进行检查，采用传统组织学染色及间接免疫荧光技术来确定瓣膜间质淋巴细胞浸润的特征。尝试使用抗IgG、抗Ia以及识别T细胞（OKT3）和T细胞亚群（OKT4辅助/诱导细胞和OKT8抑制/细胞毒性细胞）的单克隆小鼠杂交瘤试剂精确鉴定炎性单核细胞的表型特征。对阿尔伯克基一组21例接受心脏瓣膜切除的患者进行了类似研究。提供瓣膜组织的印度患者的平均年龄为27.7岁，而阿尔伯克基的患者平均年龄为52岁。印度患者中25%的风湿性心脏瓣膜显示出明显的间质淋巴浸润，阿尔伯克基患者中三分之一的风湿性瓣膜有类似的单核细胞聚集。淋巴浸润中T细胞占主导（70%至80%），只有偶尔的B细胞。大多数T细胞为OKT4阳性，只有少量抑制/细胞毒性OKT8阳性T细胞。在许多情况下，OKT4阳性辅助性T细胞聚集与成纤维细胞和胶原纤维紧密相邻。这些发现表明，慢性风湿性瘢痕形成过程可能涉及辅助/诱导性T细胞，作为变形心脏瓣膜结构慢性挛缩和纤维化的辅助因素。使用一系列对A组链球菌膜、细胞壁粘肽或A组碳水化合物具有特异性的异源兔F(ab')2试剂，通过间接免疫荧光法试图证明残留的链球菌抗原，结果均为阴性。
