Immunohistochemical analysis of mononuclear cell subsets in inflammatory and non-inflammatory myopathies.

Abstract

HospitalSUMMARY Immunohistochemical procedures were used to analyse the subpopulations of mononuclear cells in muscle biopsies from 24 patients with polymyositis. The character of the cellular infiltrate was similar at the perivascular, perimysial, and endomysial sites, with cytotoxic-suppressor T lymphocytes (T8 +) and macrophages being the dominant elements. Helper T lymphocytes (T4+) and B lymphocytes were present in smaller numbers. A control series of 17 muscle biopsies from normal subjects and patients with non-inflammatory myopathies and neurogenic conditions was also studied: the numbers of mononuclear cells present were much smaller than in polymyositis, but the ratio of T4:T8 lymphocytes was similar to that found in biopsies affected by polymyositis. We conclude that both cytotoxic-suppressor T lymphocytes and macrophages are important in the pathogenesis of inflammatory myopathy. We also used the same techniques to investigate the T cell subsets in various non-inflammatory myopathies. We also investigated any possible correlation between serum creatine kinase concentrations and the intensity of inflammatory infiltrate at different sites in the muscle biopsy. Material and methodsCases of polymyositis during the years [1978][1979][1980][1981][1982][1983][1984] were taken from the surgical pathology files of the London Hospital, and 24 cases fulfilled the diagnostic criteria of Bohan and Peter.' There were five cases of dermatomyositis, and two cases of polymyositis associated with neoplasia (one thymoma and one gastric carcinoma).Seventeen biopsies from patients with noninflammatory myopathies were chosen at random, including seven cases that showed no histological abnormality. Table 1 summarises the patient details. All the biopsies were originally reported histologically by one of us (MS).The biopsy specimens had been stored at -160°C in liquid nitrogen; cryostat sections were cut at 5 microns and left overnight at room temperature. The sections were fixed in acetone for 20 minutes at room temperature, transferred to Tris buffered saline (TBS)

Myositis in mixed connective tissue disease: a unique syndrome characterized by immunohistopathologic elements of both polymyositis and dermatomyositis

“…In fact, Engel and Arahata 24,25 described a PM pattern which is characterized by a progressive positive gradient fro CD8 + T cells from perivascular to endomysial region that was further confirmed by other investigators [26][27][28] .…”

Análise imunocitoquímica do infiltrado inflamatório na miosite com corpos de inclusão citoplasmática e em outras doenças neuromusculares com vacúolos marginados

“…Estudos têm mostrado que biópsias musculares miopáticas ou neuropáticas podem conter pequeno número de linfócitos CD4+ e CD8+, com predomínio de linfócitos CD8+. Além disso, existem relatos da presença de células mononucleares ocasionais na biópsia muscular de pacientes sem doença neuromuscular, mas a importância desse achado ainda não foi determinada 9,11,47 . Também foram encontradas em nossos casos grande proporção de macrófagos no interstício, fibra necrótica perivascular na MCIC, nas miopatias distais e em um dos casos de distrofia muscular de cinturas em todos os locais examinados.…”

“…Arahata e Engel também demonstraram que os macrófagos constituem elemento importante do infiltrado inflamatório da MCIC 9,10 . Os macrófagos são responsáveis pela fagocitose das fibras necróticas e talvez também tenham papel na patogênese da doença, já que são encontrados ao redor de fibras não necróticas, juntamente com linfócitos CD8+ 9,11,47 .…”

The inflammatory process in polymyositis: monoclonal antibody analysis of muscle and peripheral blood immunoregulatory lymphocytes.

“…A loss of the regulatory suppressor T lymphocytes from the peripheral blood in acute cases,2 similar to that found in multiple sclerosis,3 supports this view, while the analysis of the cellular infiltrates in affected muscle has started to reveal the characteristics of the immunological cells concerned.4 -9 Some workers have stressed the involvement of helper T cells,4 5 but others have concluded that cytotoxic-suppressor lymphocytes and macrophages are of most importance,69 with perhaps a local humoral effect also present in dermatomyositis. 6 The problem is compounded by finding the same inflammatory cells, in similar proportions, in inherited muscle diseases such as Duchenne dystrophy, and in non-inflammatory myopathies.6 8 In addition, the number of cases studied is still small, with very few patients from the different clinical subgroups or stages of the disease.…”