Aberrant expression of HLA-DR antigen on valvular fibroblasts from patients with active rheumatic carditis.

Immunofluorescence and immunoperoxidase staining was used to investigate the expression of Class II major histocompatibility antigens in myocardial tissue of 16 patients with acute rheumatic carditis. Aberrant expression of HLA-DR was examined using monoclonal anti-Ia antibodies and was detected on the valvular fibroblasts of those valves with ongoing active carditis. Sections of myocardial and valvular tissue from normal controls or from patients dying of other cardiac diseases did not express HLA-DR. The aberrant expression of HLA-DR on valvular fibroblasts could be important in triggering autoimmune destruction in that these cells could present self-antigens to sensitized T-lymphocytes which could initiate autoantibody production or direct destruction of local tissue.