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Perforin-mediated myocardial damage in acute myocarditis.
Lancet.Oct 27, 1990;336(8722):1019-21.
Young LH, Joag SV, Zheng LM, Lee CP, Lee YS, Young JD.
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
Endomyocardial specimens were obtained from 7 patients with acute myocarditis. Immunohistochemical examination of the mononuclear infiltrate showed mainly cytotoxic T lymphocytes and natural killer cells. Perforin (a pore-forming protein found in cytotoxic lymphocytes) was identified in this myocardial lymphocytic infiltrate and electron microscopy showed myocardial cell damage that may have been associated with these perforin containing lymphocytes. The results indicate that in acute idiopathic and viral myocarditis, myocardial damage may be due to the action of perforin-secreting lymphocytes.