A histological study on experimental autoimmune myocarditis with special reference to initiation of the disease and cardiac dendritic cells.

The precise mechanism of myosin-induced autoimmune myocarditis is unknown. The purpose of the present study was to define the immunohistological and ultrastructural characteristics of the infiltrating cells, especially in the initial phase of the myocarditis. It was demonstrated that OX6-positive dendritic cells first infiltrated the cardiocytes on day 13 after immunization. After day 17, OX6-positive cells, which possessed elongated irregular-shaped processes on the cell surface but contained few phago-lysosomes in the cytoplasm, were located at the margin of an inflammatory field and inserted their processes into the sarcoplasm of cardiocytes. The central portion of the inflammatory field was occupied by ED1-positive inflammatory macrophages, which were rich in phagosomes and which were in contact with degenerating cardiocytes. No evidence was obtained which suggested that lymphocytes directly injured the cardiocytes. These results demonstrated ultrastructural evidence that the type of infiltrating cell that first injures cardiocytes is the cardiac dendritic cell. Inflammatory macrophages thereafter serve as scavengers of degenerating cardiocytes.