Suppressor T lymphocyte function in patients with idiopathic congestive cardiomyopathy.

Abstract

SUMMARY Suppressor T lymphocyte function was examined in 11 patients with idiopathic congestive cardiomyopathy and in 11 age and sex matched patients with a similar degree of heart failure resulting from ischaemic heart disease. Suppressor T lymphocyte function was also assessed in a control population of 11 normal subjects. Suppressor T lymphocyte function was reduced in both groups of patients with heart failure but not significantly, and a wide range of suppression was demonstrated in all groups.These data do not support the hypothesis that there is a defect in T lymphocyte function in patients with congestive cardiomyopathy, but they do suggest that there may be a non-specific reduction in T lymphocyte suppressor function associated with heart failure in general.The aetiology of idiopathic congestive cardiomyopathy is, by definition, unknown and is likely to represent the end stage of several different pathogenic mechanisms."2 The possibility that immunological abnormalities may affect the pathogenesis of some cases has received much attention in recent years.34 There have been reports of impaired suppressor T lymphocyte function in patients with congestive cardiomyopathy and this could be the result of a quantitative or a qualitative abnormality.5'6 Such a defect might be determined genetically by predisposing an individual to viral infection, myocarditis, and subsequent development of cardiomyopathy.7 This hypothesis has not, however, been accepted by all workers8 and some studies have shown no specific abnormality of T lymphocyte function in congestive cardiomyopathy.9These doubts regarding the role of immunological abnormalities in the pathogenesis of congestive cardiomyopathy prompted a study to determine whether patients with congestive cardiomyopathy have a defect of suppressor T lymphocyte function that is specific to their disease.Requests for reprints to Dr Patricia J Lowry, Department of Cardiovascular Medicine, East Birmingham Hospital, Bordesley Green East, Birmingham B9 5ST.Accepted for publication 11 December 1986 Patients and methods PATIENTSEleven patients with idiopathic congestive cardiomyopathy (according to the classification of Goodwin and Oakley)' that was confirmed by cardiac catheterisation, coronary angiography, and left ventricular endomyocardial biopsy were studied and compared with eleven individually age and sex matched patients who had congestive cardiac failure of ischaemic origin, also confirmed at cardiac catheterisation. We also studied eleven healthy controls recruited from hospital staff with no personal or family history of ischaemic heart disease.The severity of congestive cardiac failure and the treatment regimens were similar in the patient groups (table). All patients in the heart failure groups were being treated with digoxin and warfarin. Ejection fractions were determined by volumes derived from end systolic and end diastolic frames acquired at left ventricular cineangiography. o METHODS Lymphocytes were separated from heparinised blood by density gradient cent...

The Number of Regulatory T Cells Correlates with Hemodynamic Improvement in Patients with Inflammatory Dilated Cardiomyopathy After Immunoadsorption Therapy

“…Likewise, mice with a deletion of alpha‐beta T lymphocytes had only minimal myocardial damage after coxsackie viral infection . Regarding Tregs, numerous studies reported decreased levels of Tregs and/or suppressed Treg function in patients with myocarditis or idiopathic cardiomyopathies . In the present study, similar blood levels of Tregs (defined as CD4 + CD25 + CD127 low and expressed as% CD3 + T cells) were observed in patients with iDCM and age‐matched patients with stable and chronic ischaemic cardiomyopathy.…”

Tumor Necrosis Factor, Natural Killer Activity and Other Measures of Immune Function and Inflammation in Elderly Men with Heart Failure

“…We saw a wide range of values in the immune parameters and inflammatory markers in these elderly patients demonstrating diversity or heterogeneity. This is consistent with other investigators who have observed this same phenomenon (wide variability) when studying T-suppressor activity in patients with heart failure [9], Variation in measures of cellular immune function in the elderly is widely reported, and our study is consistent with this observation [30][31][32], It is therefore particularly interesting that in this study we observed a significant correlation between TNF levels and NK activity, such that varia tion in TNF levels accounted for about half the variation in NK activity, and differences in Z)-dimer levels accounted for an additional component of the variation.…”

“…The immune system is among these, though its role has not been fully de fined [3], The heart has clearly been shown to be a target organ of immune injury [4][5][6][7], Increased antibodies, immunoglobins, and complement are found in rheumatic heart disease, viral cardiomyopathy, Lyme carditis, SLE, and sarcoid [4], The role of inflamma tion and immune injury in atherosclerosis has been a topic of increasing interest [8]. An association between heart failure and re duced T-lymphocyte suppressor function has recently been documented [9], Reduced natu ral killer (NK) cell cytotoxicity [7,10], dimin ished lymphocyte responsiveness to mitogens [11] and altered T-cell suppressor activity [12] have all been observed in patients with idiopathic dilated cardiomyopathy. An 'im mune hypothesis' for the pathogenesis of di lated cardiomyopathy has been suggested [4], which proposes the following sequence of events: viral infection with resultant T-lym phocyte system activation, lymphocyte infil tration of the myocardium, subsequent myo cyte necrosis, and ultimately progression to heart failure.…”

Low responder T cell susceptibility to the suppressive function of regulatory T cells in patients with dilated cardiomyopathy

“…However, Lowry et al reported that there was no defect in suppressor T cell function in patients with congestive cardiomyopathy 35. Whatever the finding is, it is very important to define the suppressor cells according to the specific member markers for assessing the cell subset function.…”