University of Wuerzburg, University Clinic, Comprehensive Heart Failure Center, Department of Internal Medicine I, Oberdürrbacherstraße 6, Würzburg, Germany.
Circulation. 2012 Apr 3;125(13):1652-63. doi: 10.1161/CIRCULATIONAHA.111.044164. Epub 2012 Mar 2.
The role of adaptive immunity, especially CD4(+) T-helper cells, has not yet been systematically investigated in wound healing and remodeling after myocardial infarction (MI). Therefore, we studied whether CD4(+) T cells become activated and influence wound healing after experimental MI in mice.
When we compared sham versus MI in wild-type (WT) mice, T-cell receptor-dependent activation of both conventional Foxp3(-) and regulatory Foxp3(+) CD4(+) T cells could be demonstrated in heart-draining lymph nodes within the first week after MI. Concomitantly, we found infiltration of CD4(+) T cells in infarcted myocardium. To study the role of CD4(+) T cells in wound healing and remodeling, CD4(+) T-cell-deficient mice (CD4 knockout [KO], MHCII(Δ/Δ)) and T-cell receptor-transgenic OT-II mice recognizing an irrelevant ovalbumin-derived peptide were studied. Serial echocardiography up to day 56 after MI revealed increased left ventricular dilation in CD4 KO compared with WT mice. Within the infarcted myocardium, CD4 KO mice displayed higher total numbers of leukocytes and proinflammatory monocytes (18.3±3.0 10(4)/mg WT versus 75.7±17.0 10(4)/mg CD4 KO, P<0.05). MHCII(Δ/Δ) and OT-II mice displayed significantly greater mortality (21% WT versus 48% OT-II, P<0.05, and WT 22% versus 52% MHCII(Δ/Δ), P<0.05) and myocardial rupture rates than WT mice. Collagen matrix formation in the infarct zone was severely disturbed in CD4 KO and MHCII(Δ/Δ) mice, as well as in OT-II mice.
The present study provides the first evidence that CD4(+) T cells become activated after MI, presumably driven by recognition of cardiac autoantigens, and facilitate wound healing of the myocardium.
适应性免疫(尤其是 CD4(+)T 辅助细胞)在心肌梗死后的伤口愈合和重塑中的作用尚未得到系统研究。因此,我们研究了 CD4(+)T 细胞在实验性心肌梗死后是否会被激活并影响伤口愈合。
当我们比较假手术组与野生型(WT)小鼠的心肌梗死后,在 MI 后第一周内,可以证明 T 细胞受体依赖性激活常规 Foxp3(-)和调节性 Foxp3(+)CD4(+)T 细胞都存在于心脏引流淋巴结中。同时,我们发现 CD4(+)T 细胞浸润到梗死心肌中。为了研究 CD4(+)T 细胞在伤口愈合和重塑中的作用,我们研究了 CD4(+)T 细胞缺陷小鼠(CD4 敲除[KO],MHCII(Δ/Δ))和识别无关卵清蛋白衍生肽的 T 细胞受体转基因 OT-II 小鼠。MI 后 56 天的连续超声心动图显示,与 WT 小鼠相比,CD4 KO 小鼠的左心室扩张增加。在梗死心肌中,CD4 KO 小鼠显示白细胞和促炎单核细胞总数增加(WT 为 18.3±3.0×10(4)/mg,CD4 KO 为 75.7±17.0×10(4)/mg,P<0.05)。MHCII(Δ/Δ)和 OT-II 小鼠的死亡率(WT 为 21%,OT-II 为 48%,P<0.05,WT 为 22%,MHCII(Δ/Δ)为 52%,P<0.05)和心肌破裂率明显高于 WT 小鼠。CD4 KO 和 MHCII(Δ/Δ)小鼠以及 OT-II 小鼠的梗死区胶原基质形成严重受损。
本研究首次提供证据表明,CD4(+)T 细胞在心肌梗死后被激活,可能是由于心脏自身抗原的识别所致,并促进心肌的伤口愈合。