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From the Division of Clinical Immunology and Allergy (V.P., I.M., G.M.),
University of Naples Federico II, School of Medicine, Napoli, Italy;
Department of Pathology (E.A., L.V.), University of Pavia, School of Medicine,
Pavia, Italy; and Department of Anesthesiology (B.L.-S., M.A.), Deutsches
Herzzentrum Berlin, Berlin, Germany.
Correspondence to Gianni Marone, MD, Division of Clinical Immunology and Allergy, University of Naples Federico II, Via S Pansini 5, 80131 Napoli, Italy. E-mail marone{at}unina.it
Background—We compared cardiac mast
cell (HHMC) density and the immunological and nonimmunological release
of mediators from mast cells isolated from heart tissue of patients
with idiopathic dilated (DCM) (n=24) and ischemic
cardiomyopathy (ICM) (n=10) undergoing heart
transplantation and from control subjects (n=10) without
cardiovascular disease.
Methods and Results—HHMC density in DCM (18.4±1.6
cells/mm2) and ICM (18.4±1.5 cells/mm2) was
higher than that in control hearts (5.3±0.7 cells/mm2;
P<.01). The histamine and tryptase contents of DCM and
ICM hearts were higher than those of control hearts. The histamine
content of the hearts was correlated with mast cell density
(rs=.91; P<.001). Protein
A/gold staining of heart tissue revealed stem cell factor (SCF), the
principal growth, differentiating, and activating factor of human mast
cells, in HHMC secretory granules. Histamine release from cardiac mast
cells caused by immunological (anti-IgE and rhSCF) and nonimmunological
stimuli (Ca2+ ionophore A23187) was higher in patients with
DCM and ICM compared with control subjects. Immunological activation of
HHMC induced a significantly greater release of tryptase and
LTC4 in patients with DCM and ICM compared with control
subjects.
Conclusions—Histamine and tryptase content and mast cell density
are higher in failing hearts than in control hearts. SCF, present
in secretory granules of HHMC, might represent an autocrine
factor sustaining mast cell hyperplasia in heart tissue in these
patients. The increased local release of fibrogenic factors (eg,
histamine, tryptase, and leukotriene C4) might
contribute to collagen accumulation in the hearts of patients with
cardiomyopathy.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Stem Cell Factor in Mast Cells and Increased Mast Cell Density in Idiopathic and Ischemic Cardiomyopathy
Key Words: cardiomyopathy • fibrosis • leukotrienes • cells, mast
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