Sanchez J A, Milei J, Yu Z X, Storino R, Wenthold R, Ferrans V J
Hospital Juan A. Fernandez, Buenos Aires, Argentina.
Am Heart J. 1993 Dec;126(6):1392-401. doi: 10.1016/0002-8703(93)90539-l.
Histologic, ultrastructural, and immunohistochemical studies were made of endomyocardial biopsy specimens from 10 patients with chronic chagasic cardiomyopathy. Histologic and electron microscopic observation disclosed marked thickening of the basement membranes of the myocytes, endothelial cells, and vascular smooth muscle cells in all patients. Light (peroxidase-labeled antibodies) and electron (gold-conjugated antibody) microscopic immunohistochemical methods revealed a positive reaction for laminin in these thickened basement membranes. This thickening of basement membranes may develop as a consequence of: (1) an immunologic reaction that is triggered by the presence of a laminin-like molecule on the surfaces of Trypanosoma cruzi amastigotes and trypomastigotes; (2) an immunologic response to direct injury of basement membranes causing some of their components to become antigenic; (3) myocardial fibrosis, with synthesis of new connective tissue components; and (4) a combination of the preceding factors. The relationship of these changes to antilaminin antibodies requires clarification.
对10例慢性恰加斯病性心肌病患者的心肌内膜活检标本进行了组织学、超微结构和免疫组织化学研究。组织学和电子显微镜观察发现，所有患者的心肌细胞、内皮细胞和血管平滑肌细胞的基底膜均显著增厚。光镜（过氧化物酶标记抗体）和电镜（金标抗体）免疫组织化学方法显示，这些增厚的基底膜中存在层粘连蛋白阳性反应。基底膜增厚可能是由于以下原因：（1）克氏锥虫无鞭毛体和上鞭毛体表面存在类层粘连蛋白分子引发的免疫反应；（2）对基底膜直接损伤的免疫反应，导致其某些成分具有抗原性；（3）心肌纤维化，伴有新的结缔组织成分合成；（4）上述因素的综合作用。这些变化与抗层粘连蛋白抗体的关系尚需阐明。
