title: Serum-soluble CD4 as clinical and immunological marker in patients with dilated cardiomyopathy.
abstract: Serological markers of cell-mediated immunity, i.e., soluble CD4, soluble interleukin-2 (Il-2) receptor and beta 2-microglobulin, were determined in 60 patients with dilated cardiomyopathy. Compared with normal healthy donors (n = 30) and controls who had coronary artery disease with preserved left ventricular function (n = 20), significantly increased levels associated with the New York Heart Association functional classes have been found in the cardiomyopathy patients, irrespectively of the etiology. Out of the immunological variables tested, serum-soluble CD4 most closely reflected the clinical and hemodynamic stage, predicted the presence of lymphocytic aggregates in the myocardium and correlated with the CD4/CD8 ratios of endomyocardial lymphocytes (r = 0.6, P < 0.05). Conversely, focal mononuclear infiltration of the myocardium was associated with significantly elevated CD4/CD8 ratios (2.1 +/- 0.6 vs. 1.3 +/- 0.2, P < 0.05), higher total numbers and percentages of endomyocardial lymphocytes expressing the pan T-markers CD2 and CD3, more CD45RO/UCHL1-positive cells and more CD4-positive T-helper cells, compared with non-reactive cases the lymphocytes of which were scattered throughout the myocardium. In conclusion, in a subset of cardiomyopathy patients lymphocytic clusters in the myocardium indicated an enhanced cellular immune response predominantly mediated by CD4-positive T-helper lymphocytes with active memory function. This immunopathological condition in the heart can be monitored by serum-soluble CD4.
authors.affiliation: Department of Clinical Pharmacology, University of Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Klappacher
authors.forename: M
authors.initials: M
authors.lastname: Mehrabi
authors.forename: K
authors.initials: K
authors.lastname: Plesch
authors.forename: G
authors.initials: G
authors.lastname: Mundigler
authors.forename: M
authors.initials: M
authors.lastname: Pec
authors.forename: G
authors.initials: G
authors.lastname: Kramer
authors.forename: R
authors.initials: R
authors.lastname: Pacher
authors.forename: R
authors.initials: R
authors.lastname: Ullrich
authors.forename: W
authors.initials: W
authors.lastname: Kukutschki
authors.forename: M
authors.initials: M
authors.lastname: Imhof
mesh_terms: D015704:CD4 Antigens / Q000097:blood; D016516:CD4-CD8 Ratio; D016827:CD8 Antigens / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D015375:Receptors, Interleukin-2 / Q000032:analysis; D013601:T-Lymphocytes / Q000276:immunology*; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D015704:CD4 Antigens; D016827:CD8 Antigens; D015375:Receptors, Interleukin-2; D001613:beta 2-Microglobulin