title: Diagnostic utility of tenascin-C for evaluation of the activity of human acute myocarditis.
abstract: Tenascin-C (TN-C) is an extracellular matrix protein that is expressed transiently in close association with tissue remodelling in various body sites. In the heart, TN-C is only present during early stages of development, is not expressed in the normal adult, but reappears in pathological states. The purpose of this study was to analyse the expression of TN-C in myocardial tissue from myocarditis patients, and to evaluate the diagnostic value of immunostaining for TN-C in the assessment of inflammatory activity in biopsy specimens. A total of 113 biopsy specimens obtained from 32 patients with a clinical diagnosis of acute myocarditis were examined by immunohistochemistry and in situ hybridization for TN-C. The immunostaining was semi-quantified and compared with histological diagnosis according to the Dallas criteria. Furthermore, serial biopsies from 22 patients were taken during convalescence, and sequential changes in TN-C levels were analysed. Expression of TN-C was specifically detected in endomyocardial biopsy specimens from patients with active-stage inflammation, and disappeared in healed stages. The degree of expression of TN-C correlated with the severity of histological lesions. These data suggest that TN-C reflects disease activity in cases of human myocarditis. Immunostaining for TN-C could enhance the sensitivity and accuracy of diagnosis using biopsy specimens.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Morimoto
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imanaka-Yoshida
authors.forename: Shinya
authors.initials: S
authors.lastname: Hiramitsu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kato
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ohtsuki
authors.forename: Akihisa
authors.initials: A
authors.lastname: Uemura
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Kato
authors.forename: Toshio
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Toyozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hiroe
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000378:metabolism*; D009206:Myocardium / Q000378:metabolism; D019063:Tenascin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D019063:Tenascin