title: Expression of tumor necrosis factor-alpha protein in the myocardium in fatal myocarditis.
abstract: BACKGROUND
  Tumor necrosis factor (TNF)-alpha is the most studied cytokine in the failing human heart and in experimental murine myocarditis. We have investigated the expression of TNF-alpha in the myocardium in human myocarditis.
  
  
  METHODS
  We examined endomyocardial biopsy (n = 4) and autopsy (n = 5) tissues obtained from nine patients diagnosed with myocarditis by the Dallas criteria. Expression of TNF-alpha in the hearts was immunohistochemically studied using monoclonal antibodies against human TNF-alpha.
  
  
  RESULTS
  Tumor necrosis factor-alpha protein was expressed in the myocardium of six of the nine patients studied. Four of five fatal patients showed intense immunoreactivity for TNF-alpha compared with survivors. Furthermore, left ventricular systolic function was reduced in patients with TNF-alpha-positive hearts.
  
  
  CONCLUSIONS
  These findings may support the suggestion that TNF-alpha plays an important role in cardiac dysfunction and myocytic damage in fatal human myocarditis.
authors.affiliation: Department of Pediatrics, Chiba University School of Medicine, Japan. heartlab@pediat3.m.chiba-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Jibiki
authors.forename: M
authors.initials: M
authors.lastname: Terai
authors.forename: S
authors.initials: S
authors.lastname: Tateno
authors.forename: T
authors.initials: T
authors.lastname: Toyozaki
authors.forename: H
authors.initials: H
authors.lastname: Horie
authors.forename: H
authors.initials: H
authors.lastname: Nakajima
authors.forename: K
authors.initials: K
authors.lastname: Niwa
authors.forename: H
authors.initials: H
authors.lastname: Niimi
mesh_terms: D000328:Adult; D001706:Biopsy; D002648:Child; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009205:Myocarditis / Q000276:immunology* / Q000473:pathology; D009206:Myocardium / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D014409:Tumor Necrosis Factor-alpha