Kaneko K, Kanda T, Yokoyama T, Nakazato Y, Iwasaki T, Kobayashi I, Nagai R
Second Department of Internal Medicine, Gunma University School of Medicine, Japan.
Res Commun Mol Pathol Pharmacol. 1997 Jul;97(1):3-12.
While an overproduction of interleukin-6 (IL-6) has been observed in patients with acute myocardial infarction (AMI), its clinical significance and localization in the ischemic myocardium have not been elucidated. We examined immunohistochemically the expression of IL-6 in 12 autopsied patients with AMI who had died within seven days of the infarction. Twenty sections of ischemic myocardium and nine of the coronary arteries involved were stained with anti-IL-6 and anti-atrial natriuretic peptide (ANP). The diameter of the myocardium was analyzed. The greatest expression of IL-6 in the infarcted myocardium occurred in patients who had died three to four days after the onset (2.7 +/- 0.4), as judged by a scheme for grading IL-6 expression. Patients who died within one to two days (1.0 +/- 0.3) or five to eight days (0.6 +/- 0.4) less frequently showed an overproduction of IL-6. The IL-6-positive myocardium co-expressed ANP and was significantly (p < 0.05) hypertrophied, when compared with the IL-6-negative myocardium. The diameter of IL-6-positive myocardial myocytes was significantly (p < 0.02) increased in patients who died within one to two days (1.6 +/- 0.2), three to four days (1.8 +/- 0.3), or five to eight days (2.0 +/- 0.2) after the AMI. The involved coronary arteries expressed IL-6 in the intimal and smooth muscle cells, as did atherosclerotic coronary arteries not involved in AMI. An overproduction of IL-6 was confirmed in the injured myocardium with hypertrophy in patients who died of AMI within seven days after onset. The hypertrophied injured myocardium co-expressed IL-6 and ANP. The expression of IL-6 in the myocardium in AMI appears to be associated with the mechanism of cardiac hypertrophy.
虽然在急性心肌梗死（AMI）患者中观察到白细胞介素-6（IL-6）产生过多，但其临床意义以及在缺血心肌中的定位尚未阐明。我们对12例在梗死7天内死亡的AMI尸检患者的心肌进行了免疫组织化学检查，以检测IL-6的表达。对20个缺血心肌切片和9个受累冠状动脉切片进行抗IL-6和抗心钠素（ANP）染色，并分析心肌直径。根据IL-6表达分级方案判断，梗死心肌中IL-6表达最高的是发病后3至4天死亡的患者（2.7±0.4）。在发病后1至2天（1.0±0.3）或5至8天（0.6±0.4）死亡的患者中，IL-6产生过多的情况较少见。与IL-6阴性心肌相比，IL-6阳性心肌共表达ANP且显著肥大（p<0.05）。在AMI后1至2天（1.6±0.2）、3至4天（1.8±0.3）或5至8天（2.0±0.2）死亡的患者中，IL-6阳性心肌细胞的直径显著增加（p<0.02）。受累冠状动脉的内膜和平滑肌细胞表达IL-6，未发生AMI的动脉粥样硬化冠状动脉也如此。在发病后7天内死于AMI的患者中，受损心肌伴有肥大，证实有IL-6产生过多。肥大的受损心肌共表达IL-6和ANP。AMI心肌中IL-6的表达似乎与心脏肥大机制有关。
