Serum-soluble CD4 as clinical and immunological marker in patients with dilated cardiomyopathy

• Published in: Immunology letters Vol. 38; no. 2; pp. 103 - 109
• Main Authors: Klappacher, Günter, Mehrabi, Mohammad, Plesch, Karina, Mundigler, Gerald, Pec, Martina, Kramer, Gero, Pacher, Richard, Ullrich, Robert, Kukutschki, Wolfgang, Imhof, Martin, Laufer, Günter, Dietmar Glogar, H.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.10.1993; Elsevier
• Subjects: AIDS/HIV; beta 2-Microglobulin - analysis; Biological and medical sciences; Cardiology. Vascular system; Cardiomyopathy, Dilated - immunology; Cardiomyopathy, Dilated - pathology; CD4; CD4 Antigens - blood; CD4-CD8 Ratio; CD8 Antigens - blood; Chronic heart failure; Dilated cardiomyopathy; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Myocarditis. Cardiomyopathies; Myocardium - pathology; Predictive Value of Tests; Receptors, Interleukin-2 - analysis; Soluble T-cell marker; T-cell activation; T-Lymphocytes - immunology; CD4; Chronic heart failure; Dilated cardiomyopathy; Soluble T-cell marker; T-cell activation; Heart; Human; Correlation; Cardiomyopathy; Cytokine; Biological marker; Soluble form; Myocardial disease; Assay; Membrane receptor; Interleukin 2; Serum; β2-Microglobulin
• ISSN: 0165-2478; 1879-0542
• DOI: 10.1016/0165-2478(93)90174-Z

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.